Abstract
Abstract
Background
The COVID-19 pandemic led to disruption in health services globally, Africa and in Ghana leading to reduction in health service utilization (HSU). Most studies on HSU in Ghana are facility or disease-based. The impact of COVID-19 pandemic on HSU has not been studied generally in Ghana. We aimed to assess trends in COVID-19 incidence and changes in HSU from the pre-pandemic to the pandemic period, and to compare these changes between an epicentre and a non-epicentre region in Ghana.
Methods
We conducted a retrospective study using data from the District Health Information Management Software 2 (DHIMS-2) at the National and Regional levels from 1st March 2018 to 31st March 2022. Monthly counts and quarterly proportional changes were computed to determine changes in hospital admissions, out-patient clinic attendance, non-communicable disease (NCD) clinic attendance, ante-natal care (ANC) and childhood vaccination clinics attendance in the Ashanti and Northern regions in Ghana.
Results
Four waves in the incidence of COVID-19 cases were identified during the pandemic period in Ghana. The lowest monthly counts were recorded in April 2020 with 1,905,242 outpatient clinic visits and 119,894 inpatient admissions, considerably lower than the median of 2,643,136 and 156,074 respectively for the study period. Generally, there were proportionally greater reductions in HSU in the Northern region than in the Ashanti region. For the Ashanti region and Northern regions, the percentage changes in admission utilization were − 9.5% vs -23.7%, -16.0% vs -28.1% for out-patient clinic utilization, -1.7% vs -11.2% for NCDs clinics and − 1.8% vs 4.1% for childhood vaccination clinic respectively. However, there was however an increase in ANC service utilization by 5.5% in the Northern region as compared to a reduction of 2.0% in the Ashanti region.
Conclusion
The COVID-19 pandemic led to reduction in HSU in a non-epicentre as compared to an epicentre in Ghana implying that measures to mitigate the effect of a pandemics should consider its effect on HSU even in non-epicentres regions in future pandemics.