Moncatar Tj Robinson T, Gomez Aliya Vanessa D, Lorenzo Fely Marilyn E, Saniel Ofelia P, Faraon Emerito Jose A, Rosadia Roberto Antonio F, Garcia Fernando B
Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila.
College of Public Health, University of the Philippines Manila.
Acta Med Philipp. 2024 Mar 22;58(5):10-21. doi: 10.47895/amp.vi0.7678. eCollection 2024.
The focusing of resources to COVID-19 response hampered and disadvantaged primary care services including that for Non-Communicable Diseases (NCDs), compromising continuity of care and hence, patients' disease status. However, studies from low- and middle-income countries (LMICs) remain sparse; therefore, evidence generation on how the pandemic impacted the provision of these primary care services in LMICs will help further understand how policies can be reframed, and programs be made more efficient and effective despite similar crises. To bridge this gap, the study investigated how the pandemic affected the implementation of NCD care at the primary care level in the Philippines.
Thirty-one online focus group discussions via Zoom Meetings were conducted among 113 consenting physicians, nurses, midwives, and community health workers from various facilities - community health centers and stations, free-standing clinics, infirmaries, and level 1 hospitals - located within two provinces in the Philippines. All interviews were video-recorded upon participants' consent and transcribed verbatim. Inductive thematic analysis was employed through NViVo 12 to generate themes, identify categories, and describe codes.
The impact of COVID-19 on NCD care at the primary care level revolved around heightened impediments to service delivery, alongside worsening of pre-existing challenges experienced by the healthcare workforce; subsequently compelling the public to resort to unhealthy practices. These detriments to the primary healthcare system involved resource constraints, discontinued programs, referral difficulties, infection, overburden among workers, and interrupted training activities. Citizens were also observed to adopt poor healthcare seeking behavior, thereby discontinuing treatment regimen.
Healthcare workers asserted that disadvantages caused by the pandemic in their NCD services at the primary care level possibly threaten patients' health status. Besides the necessity to address such detriments, this also emphasizes the need for quantitative studies that will aid in drawing inferences and evaluating the effect of health crises like the pandemic on such services to bridge gaps in improving quality of care.
将资源集中用于应对新冠疫情阻碍了包括非传染性疾病(NCD)护理在内的初级保健服务,并使其处于不利地位,损害了护理的连续性,进而影响了患者的疾病状况。然而,来自低收入和中等收入国家(LMICs)的研究仍然很少;因此,关于疫情如何影响LMICs这些初级保健服务提供的证据生成,将有助于进一步了解如何重新制定政策,以及如何在面临类似危机时使项目更高效、更有效。为了弥补这一差距,本研究调查了疫情如何影响菲律宾初级保健层面的非传染性疾病护理实施情况。
通过Zoom会议对来自菲律宾两个省份的113名同意参与的医生、护士、助产士和社区卫生工作者进行了31次在线焦点小组讨论,这些人员来自不同机构,包括社区卫生中心和站点、独立诊所、医务室和一级医院。所有访谈在参与者同意后进行录像,并逐字转录。通过NViVo 12进行归纳主题分析,以生成主题、确定类别并描述编码。
新冠疫情对初级保健层面的非传染性疾病护理的影响主要围绕服务提供方面的障碍加剧,以及医护人员面临的现有挑战恶化;随后迫使公众采取不健康的行为。这些对初级医疗保健系统的损害包括资源限制、项目中断、转诊困难、感染、工作人员负担过重以及培训活动中断。还观察到公民采取了不良的就医行为,从而中断了治疗方案。
医护人员断言,疫情在初级保健层面给他们的非传染性疾病服务带来的不利因素可能威胁患者的健康状况。除了有必要解决这些不利因素外,这也强调了进行定量研究的必要性,这些研究将有助于推断和评估像疫情这样的健康危机对这类服务的影响,以弥合在改善护理质量方面的差距。