ArticleNature medicine2022
COVID-19 and resilience of healthcare systems in ten countries.
Article in Nature medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 226 papers, 6 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
226 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Impact of COVID-19 pandemic on non-communicable diseases care and service deliveries in Sub-Saharan Africa: A systematic review.BMC health services research · 2025Pooled it
- The global impact of the COVID-19 pandemic on delays and disruptions in cancer care services: a systematic review and meta-analysis.Nature cancer · 2025Pooled it
- Masks and respirators for prevention of respiratory infections: a state of the science review.Clinical microbiology reviews · 2024Pooled it
- Changes in the global hospitalisation burden of respiratory syncytial virus in young children during the COVID-19 pandemic: a systematic analysis.The Lancet. Infectious diseases · 2024Pooled it
- Health system quality and COVID-19 vaccination: a cross-sectional analysis in 14 countries.The Lancet. Global health · 2024Pooled it
- Barriers against and strategies for malaria control during the COVID-19 pandemic in low- and middle-income countries: a systematic review.Malaria journal · 2023Pooled it
- Bilateral hypoglossal nerve stimulation for obstructive sleep apnea: a nonrandomized clinical trial.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Trial
- Assessing the resilience of a key health service: The response of acute surgical provision in England to the disruption of the COVID-19 pandemic.Journal of health services research & policy · 2026Article
- Tracking funding disparities in global health aid with machine learning.Nature communications · 2026Article
- Absorbing the shock: the role of lower-level health facilities in immunization resilience in Sidama, Ethiopia during COVID-19 pandemic.BMC health services research · 2026Article
- Article
- The effect of age-specific stay-at-home recommendation on healthcare utilization: Evidence from Finland's COVID-19 policy.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Impact of the COVID-19 pandemic on hepatitis C care across the cascade of care: a scoping review.BMC infectious diseases · 2026Article
- Municipal implementation of community-based preventive programs during the COVID-19 pandemic and long-term care certification trends in Japan: a nationwide ecological analysis.BMC health services research · 2026Article
- Causes and extent of avoidable mortality across the european union: insights for advancing healthy aging.GeroScience · 2026Article
- Observational
- Patient-reported quality of primary care and facility endorsement in Addis Ababa.BMC health services research · 2026Article
- Trends and Disruptions in Antiretroviral Treatment Enrollment in Haiti, 2018-2024.The American journal of tropical medicine and hygiene · 2026Article
- Medical care cost dynamics during COVID-19 pandemic: financial implications for Japanese health insurance system.Health economics review · 2026Article
- "If they were telling us to go, we will go": factors associated with effective postnatal care coverage before and after discharge - a mixed-methods study in rural western Kenya.BMJ global health · 2026Article
166 more citing papers are in PubMed but not listed here.
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Authors and funding
42 authors.
Funding
Abstract
Declines in health service use during the Coronavirus Disease 2019 (COVID-19) pandemic could have important effects on population health. In this study, we used an interrupted time series design to assess the immediate effect of the pandemic on 31 health services in two low-income (Ethiopia and Haiti), six middle-income (Ghana, Lao People's Democratic Republic, Mexico, Nepal, South Africa and Thailand) and high-income (Chile and South Korea) countries. Despite efforts to maintain health services, disruptions of varying magnitude and duration were found in every country, with no clear patterns by country income group or pandemic intensity. Disruptions in health services often preceded COVID-19 waves. Cancer screenings, TB screening and detection and HIV testing were most affected (26-96% declines). Total outpatient visits declined by 9-40% at national levels and remained lower than predicted by the end of 2020. Maternal health services were disrupted in approximately half of the countries, with declines ranging from 5% to 33%. Child vaccinations were disrupted for shorter periods, but we estimate that catch-up campaigns might not have reached all children missed. By contrast, provision of antiretrovirals for HIV was not affected. By the end of 2020, substantial disruptions remained in half of the countries. Preliminary data for 2021 indicate that disruptions likely persisted. Although a portion of the declines observed might result from decreased needs during lockdowns (from fewer infectious illnesses or injuries), a larger share likely reflects a shortfall of health system resilience. Countries must plan to compensate for missed healthcare during the current pandemic and invest in strategies for better health system resilience for future emergencies.
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