Bangladesh population

Health system impact of COVID-19 on the urban slum population of Bangladesh: a mixed-method rapid evaluation study

This article was originally published here

BMJ open. 2022 Feb 23;12(2):e057402. doi:10.1136/bmjopen-2021-057402.


OBJECTIVE: Our objective was to rapidly assess the impact of COVID-19 on the health system in the urban slums of Bangladesh.

DESIGN: Framework and participantsA cross-sectional survey of 476 households was conducted from October to December 2020 in five selected urban slums in Dhaka North, Dhaka South and Gazipur City Corporation. In-depth interviews with 22 purposively selected slum dwellers and key informant interviews with 16 local health care providers and four policymakers and technical experts were also conducted.

OUTCOME MEASURES: Percentage of people with general illnesses, percentage of people with chronic illnesses, percentage of people seeking health care, percentage of people seeking maternal care, health system challenges resulting from COVID-19.

RESULTS: About 12% of members had general illness and 25% reported chronic illness. More than 80% sought health care and the majority sought care from informal health care providers. 39% of women who have recently given birth consulted care in the 3 months preceding the survey. An overall reduction in healthcare utilization was reported during the lockdown period compared to the pre-pandemic period. Mismanagement and inefficient use of resources have been reported as health financing challenges during the pandemic. Health information sharing was inadequate in urban slums, due to lack of community and stakeholder engagement (51% received information related to COVID-19, 49% of respondents knew the phone number). National COVID-19 Hotline). The shortage of human resources for health has been reported to be acute during the pandemic, resulting from the shortage of medical specialists and the uneven distribution of health personnel. COVID-19 testing was inadequate due to the lack of adequate testing facilities and the stigma associated with COVID-19. Lack of strong leadership and stakeholder engagement were seen as barriers to effective pandemic management.

CONCLUSION: The results of this study should help the government adapt interventions and allocate resources more efficiently and in a timely manner during a pandemic.

PMID:35197355 | DO I:10.1136/bmjopen-2021-057402