在 COVID-19 大流行的第一年,孟加拉国考克斯巴扎尔地区的医疗保健利用情况:在收容社区开展的混合方法研究。

IF 2.3 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Global Public Health Pub Date : 2024-01-01 Epub Date: 2024-01-22 DOI:10.1080/17441692.2024.2305364
Chiara Altare, Natalya Kostandova, Md Abul Hasan, Jogie Abucejo Agbogan, Md Lalan Miah, Hannah Crockett, Madison Bates, Sharon Leslie, Brigitte Tonon, Caroline Antoine, Paul Spiegel
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引用次数: 0

摘要

为应对 COVID-19 大流行,各国采取了公共卫生和社会措施,这些措施产生了间接的社会和经济后果。流行病期间的关注点包括常规医疗服务的连续性。我们调查了 COVID-19 大流行的第一年期间,孟加拉国考克斯巴扎尔收容社区的医疗保健利用率和就医行为是如何变化的。这项混合方法研究结合了常规医疗数据的定量分析和基于人群的医疗行为调查结果。就诊趋势随医疗机构级别的不同而变化(级别较高的医疗机构包括乡卫生所和县医院;级别较低的医疗机构包括社区诊所和联合卫生与家庭福利中心)。大流行开始时,较高级别的医疗机构在门诊部(OPD)就诊、呼吸道感染和产前护理方面的就诊人数有所下降。在较低级别的医疗机构中,同样的服务有所减少或增加。半数分区报告,门诊部和呼吸道感染就诊人数累计增加。大多数分区报告产前护理累计减少。所有分区的儿童疫苗接种量都有所下降,其中半数分区没有跟上,导致累计接种量减少。害怕感染 COVID-19 和经济拮据是接种率下降的主要原因。应更好地了解就医行为的驱动因素,以指导小学和中学的准备工作和服务提供模式。
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Health care utilisation in Cox's Bazar district, Bangladesh, during the first year of the COVID-19 pandemic: A mixed-methods study among host communities.

To respond to the COVID-19 pandemic, countries introduced public health and social measures that had indirect societal, economic consequences. Concerns during epidemics include continuity of routine health services. We investigate how healthcare utilisation and healthcare seeking behaviour changed during the first year of the COVID-19 pandemic among host communities in Cox's Bazar, Bangladesh. This mixed-methods study combines quantitative analyses of routine health data and population-based findings about healthcare seeking behaviours. Trends in consultations changed according to facility level (higher-level facilities included Upazila Health Complexes and District Hospitals; lower-level facilities included Community Clinics and Union Health and Family Welfare Centers). At the pandemic's beginning, drops were seen at higher-level health facilities for outpatient department (OPD) consultations, respiratory infections, and antenatal care. Minor reductions or increases were seen at lower-level facilities for the same services. Half of the subdistricts reported a cumulative increase in OPD and respiratory tract infection consultations. Most subdistricts reported a cumulative decrease in antenatal care. Child vaccinations dropped in all subdistricts, half of which did not catch-up, resulting in a cumulative decrease of delivered doses. Fear of contracting COVID-19 and financial constraints were the main reasons for decreased access. Drivers of healthcare seeking behaviours should be better understood to guide preparedness and service delivery modalities at primary and secondary levels.

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来源期刊
Global Public Health
Global Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.50
自引率
3.00%
发文量
120
期刊介绍: Global Public Health is an essential peer-reviewed journal that energetically engages with key public health issues that have come to the fore in the global environment — mounting inequalities between rich and poor; the globalization of trade; new patterns of travel and migration; epidemics of newly-emerging and re-emerging infectious diseases; the HIV/AIDS pandemic; the increase in chronic illnesses; escalating pressure on public health infrastructures around the world; and the growing range and scale of conflict situations, terrorist threats, environmental pressures, natural and human-made disasters.
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