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Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study

Nigeria has the second largest share of undiagnosed TB cases in the world and a large private health sector estimated to be the point of initial care-seeking for 67% of TB patients. There is evidence that COVID-19 restrictions disrupted private healthcare provision, but insufficient data on how priv...

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Autores principales: Oga-Omenka, Charity, Sassi, Angelina, Vasquez, Nathaly Aguilera, Baruwa, Elaine, Rosapep, Lauren, Daniels, Benjamin, Olusola-Faleye, Bolanle, Huria, Lavanya, Adamu, Abdu, Johns, Benjamin, Das, Jishnu, Pai, Madhukar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038269/
https://www.ncbi.nlm.nih.gov/pubmed/36963094
http://dx.doi.org/10.1371/journal.pgph.0001618
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author Oga-Omenka, Charity
Sassi, Angelina
Vasquez, Nathaly Aguilera
Baruwa, Elaine
Rosapep, Lauren
Daniels, Benjamin
Olusola-Faleye, Bolanle
Huria, Lavanya
Adamu, Abdu
Johns, Benjamin
Das, Jishnu
Pai, Madhukar
author_facet Oga-Omenka, Charity
Sassi, Angelina
Vasquez, Nathaly Aguilera
Baruwa, Elaine
Rosapep, Lauren
Daniels, Benjamin
Olusola-Faleye, Bolanle
Huria, Lavanya
Adamu, Abdu
Johns, Benjamin
Das, Jishnu
Pai, Madhukar
author_sort Oga-Omenka, Charity
collection PubMed
description Nigeria has the second largest share of undiagnosed TB cases in the world and a large private health sector estimated to be the point of initial care-seeking for 67% of TB patients. There is evidence that COVID-19 restrictions disrupted private healthcare provision, but insufficient data on how private healthcare provision changed as a result of the pandemic. We conducted qualitative interviews and a survey to assess the impact of the pandemic, and government response on private healthcare provision, and the disruptions providers experienced, particularly for TB services. Using mixed methods, we targeted policymakers, and a network of clinical facilities, laboratories, community pharmacies, and medicine vendors in Kano and Lagos, Nigeria. We interviewed 11 policymakers, surveyed participants in 2,412 private facilities. Most (n = 1,676, 70%) facilities remained open during the initial lockdown period, and most (n = 1,667, 69%) offered TB screening. TB notifications dipped during the lockdown periods but quickly recovered. Clinical facilities reported disruptions in availability of medical supplies, staff, required renovations, patient volume and income. Few private providers (n = 119, 11% in Kano; n = 323, 25% in Lagos) offered any COVID-19 screening up to the time of the survey, as these were only available in designated facilities. These findings aligned with the interviews as policymakers reported a gradual return to pre-COVID services after initial disruptions and diversion of resources to the pandemic response. Our results show that COVID-19 and control measures had a temporary impact on private sector TB care. Although some facilities saw decreases in TB notifications, private facilities continued to provide care for individuals with TB who otherwise might have been unable to seek care in the public sector. Our findings highlight resilience in the private sector as they recovered fairly quickly from pandemic-related disruptions, and the important role private providers can play in supporting TB control efforts.
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spelling pubmed-100382692023-03-25 Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study Oga-Omenka, Charity Sassi, Angelina Vasquez, Nathaly Aguilera Baruwa, Elaine Rosapep, Lauren Daniels, Benjamin Olusola-Faleye, Bolanle Huria, Lavanya Adamu, Abdu Johns, Benjamin Das, Jishnu Pai, Madhukar PLOS Glob Public Health Research Article Nigeria has the second largest share of undiagnosed TB cases in the world and a large private health sector estimated to be the point of initial care-seeking for 67% of TB patients. There is evidence that COVID-19 restrictions disrupted private healthcare provision, but insufficient data on how private healthcare provision changed as a result of the pandemic. We conducted qualitative interviews and a survey to assess the impact of the pandemic, and government response on private healthcare provision, and the disruptions providers experienced, particularly for TB services. Using mixed methods, we targeted policymakers, and a network of clinical facilities, laboratories, community pharmacies, and medicine vendors in Kano and Lagos, Nigeria. We interviewed 11 policymakers, surveyed participants in 2,412 private facilities. Most (n = 1,676, 70%) facilities remained open during the initial lockdown period, and most (n = 1,667, 69%) offered TB screening. TB notifications dipped during the lockdown periods but quickly recovered. Clinical facilities reported disruptions in availability of medical supplies, staff, required renovations, patient volume and income. Few private providers (n = 119, 11% in Kano; n = 323, 25% in Lagos) offered any COVID-19 screening up to the time of the survey, as these were only available in designated facilities. These findings aligned with the interviews as policymakers reported a gradual return to pre-COVID services after initial disruptions and diversion of resources to the pandemic response. Our results show that COVID-19 and control measures had a temporary impact on private sector TB care. Although some facilities saw decreases in TB notifications, private facilities continued to provide care for individuals with TB who otherwise might have been unable to seek care in the public sector. Our findings highlight resilience in the private sector as they recovered fairly quickly from pandemic-related disruptions, and the important role private providers can play in supporting TB control efforts. Public Library of Science 2023-03-24 /pmc/articles/PMC10038269/ /pubmed/36963094 http://dx.doi.org/10.1371/journal.pgph.0001618 Text en © 2023 Oga-Omenka et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Oga-Omenka, Charity
Sassi, Angelina
Vasquez, Nathaly Aguilera
Baruwa, Elaine
Rosapep, Lauren
Daniels, Benjamin
Olusola-Faleye, Bolanle
Huria, Lavanya
Adamu, Abdu
Johns, Benjamin
Das, Jishnu
Pai, Madhukar
Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study
title Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study
title_full Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study
title_fullStr Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study
title_full_unstemmed Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study
title_short Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study
title_sort tuberculosis service disruptions and adaptations during the first year of the covid-19 pandemic in the private health sector of two urban settings in nigeria—a mixed methods study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038269/
https://www.ncbi.nlm.nih.gov/pubmed/36963094
http://dx.doi.org/10.1371/journal.pgph.0001618
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