Investigation of the Covid-19 pandemic impact on Child Health and Nutrition Services in Primary Health Care facilities, Mnquma Local Municipality: A retrospective study
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Date
2023-08-31
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University of Fort Hare
Abstract
Introduction
The Coronavirus-19 (COVID-19) pandemic, a global phenomenon with multiple waves of infection, significantly disrupted livelihoods and health services worldwide. While evidence suggested children were less susceptible to severe illness and death from the virus itself, the pandemic’s indirect effects put them at risk. many countries including South Africa, responded by declaring a state of disaster and implementing movement restrictions to control the spread of the virus. This study investigated the impact of these measures on child health and nutrition services in the Mnquma subdistrict of the Amathole District, South Africa.
Methods
This study employed an explanatory sequential mixed method of quantitative and qualitative designs. In terms of quantitative data, retrospective data was analysed in two parts. Firstly, Part One involved reviewing twenty health patient records from 2019/20 to 2020/21 period. Part Two (2) focussed on twelve child health and nutrition indicators for children aged two years old, extracted from the District Health Information Management System (DHIS). This allowed for a comparison of trends in service utilisation between pre-pandemic and pandemic periods. On the other hand, qualitative research explored factors contributing to reduced access to health care and disruptions in services. The researcher used purposive sampling to select the five clinics for convenience and proximity. During data collection at each clinic, caregivers were recruited and interviewed until data saturation was reached.
Results
The study revealed the negative consequence of the COVID-19 pandemic on child health service utilisation. Data from the District Health Information System (DHIS) for 2019/20 showed generally lower immunisation rates in 2020 compared to 2019 except for the first dose Diphtheria, Tetanus, and Pertussis (DTaP) vaccine. Interestingly the variations in proportions between the two years for DTaP (first dose), DTaP (third vi dose), and measles vaccination were statistically significant (chi -square=3668.5, pvalue<0.0001). Analysis of the data also indicated a decline in the number of children fully immunised. These decreases ranged from 1.9% to 4.4% in Mpukane, Nqancule, and Zazulwana clinics. Conversely, Hebe-Hebe and Ndabakazi clinics reported increases of 4.8% and 1.6% respectively. Reviews of children’s medical records revealed coughs as the most prevalent illness affecting 50% of children’s visits. Vomiting was a less frequent issue accounting for15% of consultations for this symptom. Notably, the study found no significant changes in the nutritional status during the pandemic. Caregiver interviews identified challenges during the pandemic that likely hindered access to child health and nutrition services. These challenges included movement restrictions due to COVID-19 regulations, temporary clinic closures, fear of contracting COVID-19, and clinic staff shortages that further strained the services. Additionally, the high cost of private health care made it difficult for some caregivers to access necessary care for their children.
Conclusion
This study concluded that the COVID-19 pandemic significantly disrupted access to and utilisation of child health and nutrition services in the Mnquma sub-district, South Africa. Children primarily presented with COVID-19-related symptoms like cough, gastroenteritis, and eye/ear infections. Several factors hindered service utilisation, including movement restrictions due to lockdown, clinic closures, and caregiver fear of contracting the virus. Furthermore, the reported hunger, household food insecurity, school closures, and long queues at grocery stores negatively impacted the nutritional status of children.
Description
Mini dissertation
Keywords
Covid-19 (Disease)
Citation
Mdingi-Buqa, N.L.. 2023. Investigation of the COVID-19 pandemic impact on child health and nutrition services in primary health care facilities, Mnquma Local Municipality: A retrospective study. Master's mini-dissertation. University of Fort Hare.