Health system resilience during COVID-19 understanding SRH service adaptation in North Kivu.

Autor: Ho LS; International Rescue Committee, Health Unit and ReBUILD for Resilience, Washington, DC, USA., Bertone MP; Institute for Global Health and Development, Queen Margaret University and ReBUILD for Resilience, Edinburgh, UK., Mansour W; Department of International Public Health and ReBUILD for Resilience, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK. Wesamatif@hotmail.com., Masaka C; International Rescue Committee, Goma, Democratic Republic of Congo., Kakesa J; International Rescue Committee, Goma, Democratic Republic of Congo.
Jazyk: angličtina
Zdroj: Reproductive health [Reprod Health] 2022 Jun 06; Vol. 19 (1), pp. 135. Date of Electronic Publication: 2022 Jun 06.
DOI: 10.1186/s12978-022-01443-5
Abstrakt: Background: There is often collateral damage to health systems during epidemics, affecting women and girls the most, with reduced access to non-outbreak related services, particularly in humanitarian settings. This rapid case study examines sexual and reproductive health (SRH) services in the Democratic Republic of the Congo when the COVID-19 hit, towards the end of an Ebola Virus Disease (EVD) outbreak, and in a context of protracted insecurity.
Methods: This study draws on quantitative analysis of routine data from four health zones, a document review of policies and protocols, and 13 key-informant interviews with staff from the Ministry of Public Health, United Nations agencies, international and national non-governmental organizations, and civil society organizations.
Results: Utilization of SRH services decreased initially but recovered by August 2020. Significant fluctuations remained across areas, due to the end of free care once Ebola funding ceased, insecurity, number of COVID-19 cases, and funding levels. The response to COVID-19 was top-down, focused on infection and prevention control measures, with a lack of funding, technical expertise and overall momentum that characterized the EVD response. Communities and civil society did not play an active role for the planning of the COVID-19 response. While health zone and facility staff showed resilience, developing adaptations to maintain SRH provision, these adaptations were short-lived and inconsistent without external support and funding.
Conclusion: The EVD outbreak was an opportunity for health system strengthening that was not sustained during COVID-19. This had consequences for access to SRH services, with limited-resources available and deprioritization of SRH.
(© 2022. The Author(s).)
Databáze: MEDLINE
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