About: Impact of a free care policy on the utilisation of health services during an Ebola outbreak in the Democratic Republic of Congo: an interrupted time-series analysis

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About: Impact of a free care policy on the utilisation of health services during an Ebola outbreak in the Democratic Republic of Congo: an interrupted time-series analysis Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Impact of a free care policy on the utilisation of health services during an Ebola outbreak in the Democratic Republic of Congo: an interrupted time-series analysis
Creator	Grépin, Karen Abramowitz, Sharon Alcayna-Stevens, Lys Cheng, Lucy Hung, Yuen Kyomba, Gabriel Law, Michael Lurton, Grégoire Mayaka, Serge Olekhnovitch, Romain Ruton, Hinda Ramazani, Sylvain, Yuma
Source	PMC
abstract	BACKGROUND: During past outbreaks of Ebola virus disease (EVD) and other infectious diseases, health service utilisation declined among the general public, delaying health seeking behaviour and affecting population health. From May to July 2018, the Democratic Republic of Congo experienced an outbreak of EVD in Equateur province. The Ministry of Public Health introduced a free care policy (FCP) in both affected and neighbouring health zones. We evaluated the impact of this policy on health service utilisation. METHODS: Using monthly data from the national Health Management Information System from January 2017 to January 2019, we examined rates of the use of nine health services at primary health facilities: total visits; first and fourth antenatal care visits; institutional deliveries; postnatal care visits; diphtheria, pertussis and tetanus (DTP) vaccinations and visits for uncomplicated malaria, pneumonia and diarrhoea. We used controlled interrupted time series analysis with a mixed effects model to estimate changes in the rates of services use during the policy (June–September 2018) and afterwards. FINDINGS: Overall, use of most services increased compared to control health zones, including EVD affected areas. Total visits and visits for pneumonia and diarrhoea initially increased more than two-fold relative to the control areas (p<0.001), while institutional deliveries and first antenatal care increased between 20% and 50% (p<0.01). Visits for DTP, fourth antenatal care visits and postnatal care visits were not significantly affected. During the FCP period, visit rates followed a downward trend. Most increases did not persist after the policy ended. INTERPRETATION: The FCP was effective at rapidly increasing the use of some health services both EVD affected and not affected health zones, but this effect was not sustained post FCP. Such policies may mitigate the adverse impact of infectious disease outbreaks on population health.
has issue date	2020-07-27(xsd:dateTime)
bibo:doi	10.1136/bmjgh-2019-002119
bibo:pmid	32718948
has license	cc-by-nc
sha1sum (hex)	32867e3fc9366875f718e8950cb64b00d2ea2ee4
schema:url	https://doi.org/10.1136/bmjgh-2019-002119
resource representing a document's title	Impact of a free care policy on the utilisation of health services during an Ebola outbreak in the Democratic Republic of Congo: an interrupted time-series analysis
has PubMed Central identifier	PMC7389747
has PubMed identifier	32718948
schema:publication	BMJ Glob Health
resource representing a document's body	covid:32867e3fc9366875f718e8950cb64b00d2ea2ee4#body_text
is schema:about of	named entity 'health' named entity 'Ebola' named entity 'malaria' named entity 'vaccination' named entity 'per-capita' named entity 'EVD' named entity 'time series analysis' named entity 'over-dispersion' named entity 'health services' named entity 'EVD' named entity 'health workers' named entity 'health services' named entity 'low income' named entity 'EVD' named entity 'pneumonia' named entity 'healthcare services' named entity 'Ministry of Public Health' named entity 'peer reviewed' named entity 'maternal health' named entity 'health services' named entity 'Ebola outbreak' named entity 'EVD' named entity 'EVD' named entity 'EVD' named entity 'interrupted time-series' named entity 'health services' named entity 'EVD' named entity 'HMIS' named entity 'West African' named entity 'vaccination' named entity 'health services' named entity 'population health' named entity 'diarrhoea' named entity 'general population' named entity 'missing data' named entity 'PHC' named entity 'health services' named entity 'EVD' named entity 'Bikoro' named entity 'Wangata' named entity 'diagnostic testing' named entity 'EVD' named entity 'West Africa' named entity 'open access' named entity 'Conference Board of Canada' named entity 'Ministry of Public Health' named entity 'epidemic' named entity 'immunisation' named entity 'infection' named entity 'health services' named entity 'health systems' named entity 'malaria' named entity 'EVD' named entity 'health centres' named entity 'EVD' named entity 'malaria' named entity 'pneumonia' named entity 'community health services' named entity 'primary health services' named entity 'control group' named entity 'COVID-19' named entity 'sustainability' named entity 'health issues' named entity 'outbreak of Ebola virus' named entity 'infectious diseases' named entity 'tetanus' named entity 'EVD' named entity 'May 14' named entity 'health facilities'

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