ArticleBMJ global health2021
The impact of the COVID-19 pandemic on hospital utilisation in Sierra Leone.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 1 of them a synthesis that pooled it.
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Who cites it
52 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of COVID-19 on Maternal Health Service Uptake and Perinatal Outcomes in Sub-Saharan Africa: A Systematic Review.International journal of environmental research and public health · 2024Pooled it
- Widespread SARS-CoV-2 Transmission Despite Limited Reported Cases and Clinical Disease: Exploring the Role of Pre-Existing Humoral Immunity to SARS-CoV-2 in Eastern Sierra Leone.Immunity, inflammation and disease · 2026Article
- The effects of COVID-19 on reproductive, maternal, neonatal, and child health service provision and utilisation: qualitative results from Burkina Faso and Mozambique.Journal of global health · 2026Article
- Development of paediatric surgical care in Sierra Leone: a repeated nationwide cross-sectional study from 2012 to 2023.BMJ public health · 2026Article
- Strengthening infection prevention and control during the COVID-19 pandemic: implementation of a decentralised mentorship model across 450 primary health facilities in Sierra Leone, 2021-2022.Frontiers in health services · 2026Article
- Strengthening health system resilience during COVID-19: a qualitative study of national-level decision-makers in Guinea and Sierra Leone.BMJ global health · 2025Article
- Health-seeking behaviour, health service delivery and its perceived impact among stroke survivors in Sierra Leone: a longitudinal qualitative study embedded in the SISLE project.BMC health services research · 2025Article
- Evidence of resiliency in maternal health services and outcomes in Kono District, Sierra Leone during the COVID-19 pandemic: an observational study.BMC public health · 2025Observational
- Antimicrobial Resistance Trends, Resistance Mechanisms, and Antibiotic Consumption in COVID-19 Versus Non-COVID-19 Units: A Seven-Year Retrospective Cohort Study.Antibiotics (Basel, Switzerland) · 2025Article
- Trends in Avoidable Hospitalizations Before and During the COVID-19 Pandemic: Multiple Cross-Sectional Study Using Administrative Data From Beijing, China.JMIR public health and surveillance · 2025Article
- Surgical task-sharing in Sierra Leone: barriers and enablers from provider and facilitator perspectives.BMJ global health · 2025Article
- Article
- Influence of SARS-CoV2 Pandemic on Colorectal Cancer Diagnosis, Presentation, and Surgical Management in a Tertiary Center: A Retrospective Study.Diagnostics (Basel, Switzerland) · 2025Article
- COVID-19 prevention and preparedness among healthcare workers in Sierra Leone.Journal of public health in Africa · 2025Article
- Public health system in post-pandemic Sierra Leone: a scoping review.BMC infectious diseases · 2024Article
- Responding to fluctuations in public and community trust and health seeking behaviour during the COVID-19 pandemic: a qualitative study of national decision-makers' perspectives in Guinea and Sierra Leone.BMC public health · 2024Article
- The impact of COVID-19 on health service utilization in sub-Saharan Africa-a scoping review.BMC global and public health · 2024Article
- In the Line of Duty: Militarizing African Epidemics.Global policy · 2024Article
- Impact of COVID-19 on the Utilization of HIV Testing and Linkage Services in Sierra Leone: Experience from Three Public Health Facilities in Freetown.AIDS and behavior · 2024Article
- Perspectives and experiences of healthcare providers on the response to the COVID-19 pandemic in three maternal and neonatal referral hospitals in Guinea in 2020: a qualitative study.BMC health services research · 2024Article
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15 authors.
Funding
Abstract
introductionThe COVID-19 pandemic has adversely affected health systems in many countries, but little is known about effects on health systems in sub-Saharan Africa. This study examines the effects of COVID-19 on hospital utilisation in a sub-Saharan country, Sierra Leone.
methodsMixed-methods study using longitudinal nationwide hospital data (admissions, operations, deliveries and referrals) and qualitative interviews with healthcare workers and patients. Hospital data were compared across quarters (Q) in 2020, with day 1 of Q2 representing the start of the pandemic in Sierra Leone. Admissions are reported in total and disaggregated by sex, service (surgical, medical, maternity and paediatric) and hospital type (government or private non-profit). Referrals in 2020 were compared with 2019 to assess whether any changes were the result of seasonality. Comparisons were performed using Student's t-test. Qualitative data were analysed using thematic analysis.
resultsFrom Q1 to Q2, weekly mean hospital admissions decreased by 14.7% (p=0.005). Larger decreases were seen in male 18.8% than female 12.5% admissions. The largest decreases were in surgical admissions, a 49.8% decrease (p<0.001) and medical admissions, a 28.7% decrease (p=0.002). Paediatric and maternity admissions did not significantly change. Total operations decreased by 13.9% (p<0.001), while caesarean sections and facility-based deliveries showed significant increases: 12.7% (p=0.014) and 7.5% (p=0.03), respectively. In Q3, total admissions remained 13.2% lower (p<0.001) than Q1. Mean weekly referrals were lower in Q2 and Q3 of 2020 compared with 2019, suggesting findings were unlikely to be seasonal. Qualitative analysis identified both supply-side factors, prioritisation of essential services, introduction of COVID-19 services and pausing elective care, and demand-side factors, fear of nosocomial infection and financial hardship.
conclusionThe study demonstrated a decrease in hospital utilisation during COVID-19, the decrease is less than reported in other countries during COVID-19 and less than reported during the Ebola epidemic.
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