In the time after COVID-19 restrictions were lifted, significantly fewer women reported this as displayed in Table 3. Visualization, Affiliation Impact PLOS Mental Health will be a global, multidisciplinary, Open Access journal that brings together research relevant to improving the mental health and well-being of all people around the world. Public Health Informed consent for the longitudinal study was in written and in person, for the phone interviews, participants provided it via their mobile phones. Conceptualization, In April 2021 women were interviewed a last time face-to-face as part of the overall longitudinal study. As the study aimed to examine the impact of COVID-19 restrictions in Tanzania, the time frames of the intimate partner violence measurement of three months were not comparable to the time frame of 12 months used in the pre-COVID-19 waves. Universal Health Coverage (UHC) is achieved when individuals and communities receive the health services they need without suffering financial hardship. For more information about PLOS Subject Areas, click Transportation barriers can be categorized as a non-modifiable barrier to care in the intermediate term, given that this challenge is directly related to facilities physical locations being far away from rural households as well as quality of roads and other transportation infrastructure. No, Is the Subject Area "Survey research" applicable to this article? Our findings demonstrate that across sites, 83% of pregnant women received at least four antenatal care visits, which is consistent with findings at the national level for both countries (79% in Sierra Leone and 87% in Liberia). Citation: Higgins J, JEROME JG, Boima F, Dally E, Krangar L, Boley EJ, et al. The research team sought to replicate key metrics produced by the WHOs Global Health Observatory in order to contextualize healthcare spending among survey respondents [21]. The research team acknowledges that further investigation is required to understand the reasons for persisting user fees for patients who should be receiving free healthcare services, and in the interim, recommends that subsidies are scaled up to include coverage for costs of additional expenditures associated with facility visits, such as medication and transportation fees. Check Out IF Ranking, Prediction, Trend & Key Factor Analysis. PLOS global public health No, Is the Subject Area "Tanzania" applicable to this article? Though the research team acknowledges the difficultly of completely removing barriers to care in rural Liberia and Sierra Leone, we do not view any of these challenges as insurmountable. Though the research team considered assessing the factors strongly associated with the update and utilization of services at the household level via multivariate regression, we opted to reserve the reporting of coefficients for subsequent papers we intend to generate as part of this body of work. To consider access, we asked respondents if they had experienced any acute illness symptoms in the previous month and their severity, and then whether any care was sought for these symptoms. PLOS Global Public Health Only 63% of respondents in Liberia with severe symptoms received care with a clinical professional in a clinic or hospital. They address issues at the interface between science and policy or science and society, present a policy position aimed at influencing policy decisions, and examine and make recommendations on scientific and publishing practices. NIMR/HQ/R.8c/Vol.I/614 and NIMR/HQ/R.8c/Vol. NCD services, including care for patients diagnosed with diabetes, cardiovascular disease, chronic respiratory disease, and, most urgently, cervical cancer, emerged as specific areas of concern in facilities where the SARA survey was administered. Look up their open access statement and their license terms. In the COVID-19 phone surveys, we asked COVID-19 specific questions, including knowledge of COVID-19. We intended to capture this information in each iteration of individual survey questions asked after a respondent indicated they sought treatment, and the provider choice options included in the instrument were as follows: medical doctor, nurse, midwife, community health officer (CHO), dentist, traditional practitioner, and other. Survey weights were used in all statistical summaries to reflect the sampling process. Notably, 84% of respondents who did not seek care when experiencing acute illness in Sierra Leone cited an inability to afford their visit as a barrier to care, while this proportion is much lower in Liberia at 23%. A peer-reviewed, open access journal in & public health. 75% and 91% of facilities in Liberia and Sierra Leone respectively offered tuberculosis servicesthe exceptions were Boniken Health Center in Liberia, and Kangama CHC in Sierra Leone. a CC BY e0002045. www.nber.org. In the Sierra Leone context, the particularly low readiness score for NCD services is likely driven by two low-performing health centers, and the fact that a larger population of individuals reside in catchment areas with poor scoring facilities. Writing original draft, * E-mail: vchung@pih.org (VC); higgins.juliam@gmail.com (JH), Affiliation It was therefore not surprising that a hidden mental health crisis was emerging early in the COVID-19 pandemic, both for previously healthy people but especially for those with pre-existing conditions [3]. https://doi.org/10.1371/journal.pgph.0002045.g001. Materials, Software and Code Sharing. PLOS Global Public Health is a global forum for public health research that reaches across disciplines and regional boundaries to address some of the biggest health challenges and inequities facing our society today. https://doi.org/10.1371/journal.pgph.0002045.t003. PLOS Global Public Health is a global forum for public health research that reaches across disciplines and regional boundaries to address some of the biggest health challenges and inequities facing our society today. National and subnational burden of under-5, infant, and Symptoms of poor mental health reported by women peaked at 20% (n = 85) during COVID-19 restrictions compared to a prevalence of 17% (n = 69) before COVID-19 and the 15% (n = 64) after the restrictions were eased and 11% (n = 44) six months later when pre-Covid-19 life resumed (see Fig 2). PLOS Women reported feeling overwhelmed providing home schooling to children (27%) and more concerns about their childrens safety (61%), which dropped markedly after restrictions ended (8%). This paper reports on the results of a longitudinal study on COVID-19, that consisted of an existing longitudinal study that incorporated a nested COVID-19 study. Formal Comments are invited byPLOS Global Public Healtheditors to promote scientific discourse aboutPLOS Global Public Healtharticles. Note: October 13, 2021; title from caption (PLOS.org website, viewed Nov. 3, 2021). Best Practices in Research Reporting. Within each country, we determined the household per person monthly expenditure and estimated the association between one third of expenditure and consultation rates, number of ANC visits among pregnant women, and receipt of BCG vaccine. Table 2 reports several care use statistics. The research team anticipates that direct investments in NCD services across facilities will incentivize increased healthcare utilization among our survey respondents and increase average readiness scores in future SARA assessments. No, Is the Subject Area "Medical devices and equipment" applicable to this article? Mental health was measured using the Self-Reporting Questionnaire, a 20-item (SRQ20) scale that has been approved by the WHO and validated across many settings, using a cut-off score of 8+ indicating symptoms of poor mental health [17]. The heterogeneity of issues in medication availability across implementation sites suggests that stockout challenges are not insurmountable, and the research team suggests investing in supply chain strengthening efforts to address these issues in PIH catchment areas. The results from this study and others in Africa [20] emphasize the need to ensure that the far-reaching mental health consequences of disease outbreaks and the containment measures are closely monitored and addressed. Based on our healthcare utilization findings, we know that patients seek care from a variety of informal sources. Opinionarticles provide experts with a forum to comment on topical or controversial issues of broad interest. Information on barriers to care were collected utilizing a series of multi-select questions embedded in the household survey; if an individual did not seek care when ill, they provided a reason for why they were deterred from seeking treatment, which was then categorized as a barrier to care seeking by the research team. The analysis was restricted to 415 women who were in a relationship at the time of the survey and participated in all four study waves. Materials, Software and Code Sharing. Furthermore, Sierra Leone introduced a free healthcare initiative in 2010 aimed at reducing medical expenses for women and children, which may be correlated with higher utilization rates for MCH services, compared to other clinical areas. External studies have posited that low uptake of core immunizations (BCG, measles) is linked to the unavailability of vaccination services at under-resourced clinics [28]. WebAims and scope. We issue an urgent call to action to address drug access due to the predicted rise in cancer burden in the region in coming years. The availability of essential medicines and equipment in health facilities is limited, which poses a risk to the delivery of quality care. PLOS Medicine No, Is the Subject Area "Surveys" applicable to this article? Quarrels in relationships decreased or stayed the same during COVID-19 restrictions, as did intimate partner violence. DOAJ 2023 default by all rights reserved unless otherwise specified. Furthermore, we opted to collect expenditure data by asking household heads to recall their monthly expenses across a series of categories. We also estimated annual use rates and proportions across several healthcare areas: annual outpatient consultation rates, annual inpatient discharge rates, proportion of pregnant women receiving four or more antenatal care visits, and the proportion of children receiving BCG and measles vaccines.
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