Disruption i.e., change or drop in hospital attendance |
Service distruption |
“… For instance, at the clinic prior to the COVID-19 outbreak, the monthly patient load was 400. But since the COVID-19 outbreak in March, the monthly patients load ranges from 30 to 50, people are afraid to come to hospital …. The monthly admitted male patients used to be 45-50. Since COVID-19, we admitted 11 per month. … .and only 80 women delivered in the health facility instead of the average 150 women per month.” - D 20: Private HF, “We were receiving 2000 clients for vaccination monthly but dropped to 900 -1000 since COVID-19.” - D 27: Private HF. |
Causes of health service disruption |
Patient’s fear of being diagnosed with COVID |
“Because of fear, some sick patients preferred to die at home rather than come to the health facility and were diagnosed with COVID.”- D 28: Public HF. “… “Very ill patients refuse to be referred to the county’s referral hospital due to the fear of being isolated and suspected to have COVID-19 disease.”- D 34: Private HF. |
Prevent contracting infection by avoiding the health facility and health care workers |
“… the closure of the health facility following a confirmed case of COVID-19 infection among health workers made the community members stigmatize health facility staff and refuse to seek health care in the health facility after reopening.” - D 3: Private HF, and D 33: Private HF |
Perception that healthcare workers will inject them and their children with COVID-19 vaccine |
. “… health workers have been given money to infect our children with COVID-19 vaccine.” - D 13: Public HF. “Parents are no longer bringing their children for vaccination, … they think that people are moving around vaccinating children with COVID-19 vaccine.” D 34: Private HF. |
Recovery strategy from health service disruption |
Health promotion and awreness creation |
“… the hospital set up a health promotion team that went into the camps to educate the community dwellers, especially for pregnant women and children vaccination.” - D 26: Private HF, “The communities are now cooperating with us; they are attending the hospital with the help of health education and awareness. Before they will not attend the facility if they have signs and symptoms of COVID-19.” - D 16: Public HF |
Reduce number of staff per shift |
“… the health facility reduced the number of staff working per time on duty to prevent contacting COVID-19 infection.” - D 3: Public HF
|
Close and reschedule clinic attendance for patients |
. “… we postponed TB Clinic for a week for us to come up with a strategy of scheduling patients and observe social distancing.” -D 39: Public HF. |