Preparedness for and impact of COVID-19 on primary health care delivery in urban and rural Malawi: a mixed methods study
Objective Across Africa, the impact of COVID-19 continues to be acutely felt. This includes Malawi, where a key component of health service delivery to mitigate against COVID-19 are the primary healthcare facilities, strategically placed throughout districts to offer primary and maternal healthcare....
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e051125.full |
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| author | Tracy Morse Kondwani Chidziwisano Gift Kawalazira Mackwellings Maganizo Phiri Eleanor Elizabeth MacPherson Mindy Panulo Khumbo Kalua Chawanangwa Mahebere Chirambo Zaziwe Gundah Penjani Chunda |
| author_facet | Tracy Morse Kondwani Chidziwisano Gift Kawalazira Mackwellings Maganizo Phiri Eleanor Elizabeth MacPherson Mindy Panulo Khumbo Kalua Chawanangwa Mahebere Chirambo Zaziwe Gundah Penjani Chunda |
| author_sort | Tracy Morse |
| collection | DOAJ |
| description | Objective Across Africa, the impact of COVID-19 continues to be acutely felt. This includes Malawi, where a key component of health service delivery to mitigate against COVID-19 are the primary healthcare facilities, strategically placed throughout districts to offer primary and maternal healthcare. These facilities have limited infrastructure and capacity but are the most accessible and play a crucial role in responding to the COVID-19 pandemic. This study assessed health facility preparedness for COVID-19 and the impact of the pandemic on health service delivery and frontline workers.Setting Primary and maternal healthcare in Blantyre District, Malawi.Participants We conducted regular visits to 31 healthcare facilities and a series of telephone-based qualitative interviews with frontline workers (n=81 with 38 participants) between August 2020 and May 2021.Results Despite significant financial and infrastructural constraints, health centres continued to remain open. The majority of frontline health workers received training and access to preventative COVID-19 materials. Nevertheless, we found disruptions to key services and a reduction in clients attending facilities. Key barriers to implementing COVID-19 prevention measures included periodic shortages of resources (soap, hand sanitiser, water, masks and staff). Frontline workers reported challenges in managing physical distancing and in handling suspected COVID-19 cases. We found discrepancies between reported behaviour and practice, particularly with consistent use of masks, despite being provided. Frontline workers felt COVID-19 had negatively impacted their lives. They experienced fatigue and stress due to heavy workloads, stigma in the community and worries about becoming infected with and transmitting COVID-19.Conclusion Resource (human and material) inadequacy shaped the health facility capacity for support and response to COVID-19, and frontline workers may require psychosocial support to manage the impacts of the COVID-19 pandemic. |
| format | Article |
| id | doaj-art-7093bfd22ce7464daece6af9f1a455a9 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-7093bfd22ce7464daece6af9f1a455a92025-01-24T21:15:08ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-051125Preparedness for and impact of COVID-19 on primary health care delivery in urban and rural Malawi: a mixed methods studyTracy Morse0Kondwani Chidziwisano1Gift Kawalazira2Mackwellings Maganizo Phiri3Eleanor Elizabeth MacPherson4Mindy Panulo5Khumbo Kalua6Chawanangwa Mahebere Chirambo7Zaziwe Gundah8Penjani Chunda92 Department of Environmental Health, University of Malawi - Polytechnic, Blantyre, Southern Region, Malawi4 Department of Environmental Health and WASHTED, Malawi University of Business and Applied Sciences, Blantyre, Malawi6 Ministry of Health, Blantyre, MalawiSocial Science Department, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, MalawiMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, MalawiDepartment of Enviromental Health and WASHTED Centre, Polytechnic, University of Malawi, Blantyre, MalawiBlantyre Institute for Community Outreach, Blantyre, MalawiBlantyre Institute for Community Outreach, Blantyre, MalawiBlantyre District Health Office, Blantyre, MalawiBlantyre District Health Office, Blantyre, MalawiObjective Across Africa, the impact of COVID-19 continues to be acutely felt. This includes Malawi, where a key component of health service delivery to mitigate against COVID-19 are the primary healthcare facilities, strategically placed throughout districts to offer primary and maternal healthcare. These facilities have limited infrastructure and capacity but are the most accessible and play a crucial role in responding to the COVID-19 pandemic. This study assessed health facility preparedness for COVID-19 and the impact of the pandemic on health service delivery and frontline workers.Setting Primary and maternal healthcare in Blantyre District, Malawi.Participants We conducted regular visits to 31 healthcare facilities and a series of telephone-based qualitative interviews with frontline workers (n=81 with 38 participants) between August 2020 and May 2021.Results Despite significant financial and infrastructural constraints, health centres continued to remain open. The majority of frontline health workers received training and access to preventative COVID-19 materials. Nevertheless, we found disruptions to key services and a reduction in clients attending facilities. Key barriers to implementing COVID-19 prevention measures included periodic shortages of resources (soap, hand sanitiser, water, masks and staff). Frontline workers reported challenges in managing physical distancing and in handling suspected COVID-19 cases. We found discrepancies between reported behaviour and practice, particularly with consistent use of masks, despite being provided. Frontline workers felt COVID-19 had negatively impacted their lives. They experienced fatigue and stress due to heavy workloads, stigma in the community and worries about becoming infected with and transmitting COVID-19.Conclusion Resource (human and material) inadequacy shaped the health facility capacity for support and response to COVID-19, and frontline workers may require psychosocial support to manage the impacts of the COVID-19 pandemic.https://bmjopen.bmj.com/content/12/6/e051125.full |
| spellingShingle | Tracy Morse Kondwani Chidziwisano Gift Kawalazira Mackwellings Maganizo Phiri Eleanor Elizabeth MacPherson Mindy Panulo Khumbo Kalua Chawanangwa Mahebere Chirambo Zaziwe Gundah Penjani Chunda Preparedness for and impact of COVID-19 on primary health care delivery in urban and rural Malawi: a mixed methods study BMJ Open |
| title | Preparedness for and impact of COVID-19 on primary health care delivery in urban and rural Malawi: a mixed methods study |
| title_full | Preparedness for and impact of COVID-19 on primary health care delivery in urban and rural Malawi: a mixed methods study |
| title_fullStr | Preparedness for and impact of COVID-19 on primary health care delivery in urban and rural Malawi: a mixed methods study |
| title_full_unstemmed | Preparedness for and impact of COVID-19 on primary health care delivery in urban and rural Malawi: a mixed methods study |
| title_short | Preparedness for and impact of COVID-19 on primary health care delivery in urban and rural Malawi: a mixed methods study |
| title_sort | preparedness for and impact of covid 19 on primary health care delivery in urban and rural malawi a mixed methods study |
| url | https://bmjopen.bmj.com/content/12/6/e051125.full |
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