Fenta Esete Habtemariam, Tassew Berhan, Abera Admas, Wolde Firmaye Bogale, Legesse Meseret, Pulford Justin, Mor Siobhan, Kaba Mirgissa
School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Epidemiology and Biostatistics Unit, School of Public Health, Haramaya University, Harar, Ethiopia.
PLoS One. 2024 Dec 27;19(12):e0308534. doi: 10.1371/journal.pone.0308534. eCollection 2024.
Worldwide, health systems have been challenged by the overwhelming demands of the COVID-19 pandemic. In Ethiopia, maintaining essential health services during the COVID-19 pandemic is critical to preventing severe outcomes and protecting the gains made over the past years in the health sector. This project aims to explore the health system's response to maintaining essential healthcare services in Addis Ababa, Ethiopia.
A total of 60 key informant interviews were conducted by purposively selecting key stakeholders from Federal Ministry of Health, Addis Ababa Regional Health Bureau, Sub-city Health Offices, and frontline healthcare providers. Interviews were transcribed verbatim and coded using Open Code. Thematic analysis was employed to analyze the data.
COVID-19 affected the delivery of essential health services in several ways, namely: decline in health service utilization, fear of infection among healthcare providers, stigma towards healthcare providers, and perceived decrease in quality-of-service provision. However, the health system actors made efforts to sustain services while responding to the pandemic by enacting changes in the service delivery modality. The most significant service delivery changes included repurposing health centers and prolonged prescriptions (multi-month medication dispensing). The primary challenges encountered were burnout of the health workforce and a shortage of personal protective equipment.
COVID-19 has affected the delivery of essential health services in multifaceted ways. System actors have accordingly made efforts to sustain services while responding to the pandemic.
在全球范围内，卫生系统受到了新冠疫情带来的巨大需求的挑战。在埃塞俄比亚，在新冠疫情期间维持基本卫生服务对于预防严重后果以及保护过去几年在卫生领域取得的成果至关重要。本项目旨在探索埃塞俄比亚亚的斯亚贝巴卫生系统对维持基本医疗服务的应对措施。
通过有目的地从联邦卫生部、亚的斯亚贝巴地区卫生局、分城卫生办公室和一线医疗服务提供者中挑选关键利益相关者，共进行了60次关键信息人访谈。访谈内容逐字记录，并使用开放编码进行编码。采用主题分析法对数据进行分析。
新冠疫情在多个方面影响了基本卫生服务的提供，具体如下：卫生服务利用率下降、医疗服务提供者害怕感染、对医疗服务提供者的污名化以及服务质量感知下降。然而，卫生系统行为者通过改变服务提供方式，在应对疫情的同时努力维持服务。最显著的服务提供变化包括重新调整卫生中心用途和延长处方（数月的药物配给）。遇到的主要挑战是卫生人力倦怠和个人防护装备短缺。
新冠疫情在多方面影响了基本卫生服务的提供。系统行为者相应地在应对疫情的同时努力维持服务。
