Open Access
Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan: results of pre-COVID and COVID-19 lockdown stakeholder engagements
Syed A K Shifat Ahmed
1, 2
,
Motunrayo Ajisola
3, 4
,
Kehkashan Azeem
5, 6
,
Pauline Bakibinga
7
,
Yen-Fu Chen
8, 9
,
Nazratun Nayeem Choudhury
1, 2
,
Olufunke Fayehun
4, 10
,
Frances Griffiths
8, 9, 11, 12
,
Bronwyn Harris
8, 9
,
Peter Kibe
7
,
RICHARD J. LILFORD
13, 14
,
A Omigbodun
4, 15
,
Narjis Rizvi
5, 6
,
Jo Sartori
13, 14
,
Simon Smith
8, 9
,
Samuel I Watson
8, 9, 13, 14
,
Ria Wilson
8, 9
,
Godwin Yeboah
9, 16
,
Navneet Aujla
8, 9
,
Iqbal Azam
5, 6
,
Peter J. Diggle
17, 18
,
Paramjit Gill
8, 9
,
Romaina Iqbal
5, 6
,
Caroline Kabaria
7
,
Lyagamula Kisia
7
,
Catherine Kyobutungi
7
,
Jason J Madan
9, 19
,
Blessing Mberu
7
,
Shukri Mohamed
7, 8, 9
,
Ahsana Nazish
5, 6
,
Oladoyin Odubanjo
20
,
Mary E Osuh
4, 21
,
Eme Owoaje
4, 22
,
Oyinlola Oyebode
8, 9
,
João Paulo Albuquerque Cavalcanti De Albuquerque
9, 16
,
Omar Rahman
23
,
Komal Tabani
5, 6
,
Olalekan John Taiwo
4, 24
,
Grant Tregonning
9, 16
,
Olalekan A. Uthman
8, 9
,
Rita Yusuf
1, 2
1
Centre for Health, Population and Development
3
National Institute for Health Research Project
5
Community Health Sciences Department
7
African Population and Health Research Center
8
Division of Health Sciences, Warwick Medical School
9
UNIVERSITY OF WARWICK
|
10
Department of Sociology, Faculty of Social Sciences
11
Centre for Health Policy, School of Public Health
|
13
Institute of Applied Health Research, College of Medical and Dental Sciences
15
Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine
16
Institute for Global Sustainable Development
17
Lancaster Medical School
19
Warwick Clinical Trials Unit, Warwick Medical School
20
Nigerian Academy of Science
21
Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine
22
Department of Community Medicine, Faculty of Public Health, College of Medicine
23
University of Liberal Arts Bangladesh
|
24
Department of Geography, Faculty of Social Sciences
Publication type: Journal Article
Publication date: 2020-08-21
scimago Q1
wos Q1
SJR: 2.451
CiteScore: 11.7
Impact factor: 6.1
ISSN: 20597908
PubMed ID:
32819917
Public Health, Environmental and Occupational Health
Health Policy
Abstract
Introduction
With COVID-19, there is urgency for policymakers to understand and respond to the health needs of slum communities. Lockdowns for pandemic control have health, social and economic consequences. We consider access to healthcare before and during COVID-19 with those working and living in slum communities.
Methods
In seven slums in Bangladesh, Kenya, Nigeria and Pakistan, we explored stakeholder perspectives and experiences of healthcare access for non-COVID-19 conditions in two periods: pre-COVID-19 and during COVID-19 lockdowns.
Results
Between March 2018 and May 2020, we engaged with 860 community leaders, residents, health workers and local authority representatives. Perceived common illnesses in all sites included respiratory, gastric, waterborne and mosquitoborne illnesses and hypertension. Pre-COVID, stakeholders described various preventive, diagnostic and treatment services, including well-used antenatal and immunisation programmes and some screening for hypertension, tuberculosis, HIV and vectorborne disease. In all sites, pharmacists and patent medicine vendors were key providers of treatment and advice for minor illnesses. Mental health services and those addressing gender-based violence were perceived to be limited or unavailable. With COVID-19, a reduction in access to healthcare services was reported in all sites, including preventive services. Cost of healthcare increased while household income reduced. Residents had difficulty reaching healthcare facilities. Fear of being diagnosed with COVID-19 discouraged healthcare seeking. Alleviators included provision of healthcare by phone, pharmacists/drug vendors extending credit and residents receiving philanthropic or government support; these were inconsistent and inadequate.
Conclusion
Slum residents’ ability to seek healthcare for non-COVID-19 conditions has been reduced during lockdowns. To encourage healthcare seeking, clear communication is needed about what is available and whether infection control is in place. Policymakers need to ensure that costs do not escalate and unfairly disadvantage slum communities. Remote consulting to reduce face-to-face contact and provision of mental health and gender-based violence services should be considered.
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Total citations:
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Citations from 2024:
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(21.12%)
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GOST
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Ahmed S. A. K. S. et al. Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan: results of pre-COVID and COVID-19 lockdown stakeholder engagements // BMJ Global Health. 2020. Vol. 5. No. 8. p. e003042.
GOST all authors (up to 50)
Copy
Ahmed S. A. K. S. et al. Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan: results of pre-COVID and COVID-19 lockdown stakeholder engagements // BMJ Global Health. 2020. Vol. 5. No. 8. p. e003042.
Cite this
RIS
Copy
TY - JOUR
DO - 10.1136/bmjgh-2020-003042
UR - https://doi.org/10.1136/bmjgh-2020-003042
TI - Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan: results of pre-COVID and COVID-19 lockdown stakeholder engagements
T2 - BMJ Global Health
AU - Ahmed, Syed A K Shifat
AU - Ajisola, Motunrayo
AU - Azeem, Kehkashan
AU - Bakibinga, Pauline
AU - Chen, Yen-Fu
AU - Choudhury, Nazratun Nayeem
AU - Fayehun, Olufunke
AU - Griffiths, Frances
AU - Harris, Bronwyn
AU - Kibe, Peter
AU - LILFORD, RICHARD J.
AU - Omigbodun, A
AU - Rizvi, Narjis
AU - Sartori, Jo
AU - Smith, Simon
AU - Watson, Samuel I
AU - Wilson, Ria
AU - Yeboah, Godwin
AU - Aujla, Navneet
AU - Azam, Iqbal
AU - Diggle, Peter J.
AU - Gill, Paramjit
AU - Iqbal, Romaina
AU - Kabaria, Caroline
AU - Kisia, Lyagamula
AU - Kyobutungi, Catherine
AU - Madan, Jason J
AU - Mberu, Blessing
AU - Mohamed, Shukri
AU - Nazish, Ahsana
AU - Odubanjo, Oladoyin
AU - Osuh, Mary E
AU - Owoaje, Eme
AU - Oyebode, Oyinlola
AU - De Albuquerque, João Paulo Albuquerque Cavalcanti
AU - Rahman, Omar
AU - Tabani, Komal
AU - Taiwo, Olalekan John
AU - Tregonning, Grant
AU - Uthman, Olalekan A.
AU - Yusuf, Rita
PY - 2020
DA - 2020/08/21
PB - BMJ
SP - e003042
IS - 8
VL - 5
PMID - 32819917
SN - 2059-7908
ER -
Cite this
BibTex (up to 50 authors)
Copy
@article{2020_Ahmed,
author = {Syed A K Shifat Ahmed and Motunrayo Ajisola and Kehkashan Azeem and Pauline Bakibinga and Yen-Fu Chen and Nazratun Nayeem Choudhury and Olufunke Fayehun and Frances Griffiths and Bronwyn Harris and Peter Kibe and RICHARD J. LILFORD and A Omigbodun and Narjis Rizvi and Jo Sartori and Simon Smith and Samuel I Watson and Ria Wilson and Godwin Yeboah and Navneet Aujla and Iqbal Azam and Peter J. Diggle and Paramjit Gill and Romaina Iqbal and Caroline Kabaria and Lyagamula Kisia and Catherine Kyobutungi and Jason J Madan and Blessing Mberu and Shukri Mohamed and Ahsana Nazish and Oladoyin Odubanjo and Mary E Osuh and Eme Owoaje and Oyinlola Oyebode and João Paulo Albuquerque Cavalcanti De Albuquerque and Omar Rahman and Komal Tabani and Olalekan John Taiwo and Grant Tregonning and Olalekan A. Uthman and Rita Yusuf and others},
title = {Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan: results of pre-COVID and COVID-19 lockdown stakeholder engagements},
journal = {BMJ Global Health},
year = {2020},
volume = {5},
publisher = {BMJ},
month = {aug},
url = {https://doi.org/10.1136/bmjgh-2020-003042},
number = {8},
pages = {e003042},
doi = {10.1136/bmjgh-2020-003042}
}
Cite this
MLA
Copy
Ahmed, Syed A. K. Shifat, et al. “Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan: results of pre-COVID and COVID-19 lockdown stakeholder engagements.” BMJ Global Health, vol. 5, no. 8, Aug. 2020, p. e003042. https://doi.org/10.1136/bmjgh-2020-003042.
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