ArticleBMC health services research2023
Associations between the stringency of COVID-19 containment policies and health service disruptions in 10 countries.
Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Increased utilization of health care services for non-communicable diseases during the COVID-19 pandemic among refugees in Jordan: a mixed-methods study.Conflict and health · 2026Article
- Article
- COVID-19 and Emergency Department Visits: An Interrupted Time Series Analysis of Ontario and Alberta, Canada.The western journal of emergency medicine · 2026Article
- A comparative analysis of the role of containment policies, vaccination strategies and virus variants in the COVID-19 pandemic across nine European countries.Scientific reports · 2025Article
- Variation of healthcare associated infections at a tertiary hospital in Southwest China over a 5-year period (2019-2023): a retrospective observational study.BMC infectious diseases · 2025Observational
- Dealing with the extraordinary: how a community of practice supports resident training during the COVID-19 pandemic and beyond.BMC medical education · 2025Article
- Community engagement and local governance for health equity through trust: lessons from developing the CONNECT Initiative in the Lao People's Democratic Republic.BMJ global health · 2024Article
- Trust in health workers and patient-centeredness of care were strongest factors associated with vaccination for Kenyan children born between 2017-2022.Vaccine: X · 2024Article
- Motivational Interviewing as a Strategy to Improve Adherence in IBD Treatment: An Integrative Review Amidst COVID-19 Disruptions.Healthcare (Basel, Switzerland) · 2024Review
- Utilisation of and factors associated with non-COVID-19 healthcare services in public facilities amongst cross-border migrants in Thailand, 2019-2022.BMC public health · 2024Article
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24 authors.
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Abstract
backgroundDisruptions in essential health services during the COVID-19 pandemic have been reported in several countries. Yet, patterns in health service disruption according to country responses remain unclear. In this paper, we investigate associations between the stringency of COVID-19 containment policies and disruptions in 31 health services in 10 low- middle- and high-income countries in 2020.
methodsUsing routine health information systems and administrative data from 10 countries (Chile, Ethiopia, Ghana, Haiti, Lao People's Democratic Republic, Mexico, Nepal, South Africa, South Korea, and Thailand) we estimated health service disruptions for the period of April to December 2020 by dividing monthly service provision at national levels by the average service provision in the 15 months pre-COVID (January 2019-March 2020). We used the Oxford COVID-19 Government Response Tracker (OxCGRT) index and multi-level linear regression analyses to assess associations between the stringency of restrictions and health service disruptions over nine months. We extended the analysis by examining associations between 11 individual containment or closure policies and health service disruptions. Models were adjusted for COVID caseload, health service category and country GDP and included robust standard errors.
findingsChronic disease care was among the most affected services. Regression analyses revealed that a 10% increase in the mean stringency index was associated with a 3.3 percentage-point (95% CI -3.9, -2.7) reduction in relative service volumes. Among individual policies, curfews, and the presence of a state of emergency, had the largest coefficients and were associated with 14.1 (95% CI -19.6, 8.7) and 10.7 (95% CI -12.7, -8.7) percentage-point lower relative service volumes, respectively. In contrast, number of COVID-19 cases in 2020 was not associated with health service disruptions in any model.
conclusionsAlthough containment policies were crucial in reducing COVID-19 mortality in many contexts, it is important to consider the indirect effects of these restrictions. Strategies to improve the resilience of health systems should be designed to ensure that populations can continue accessing essential health care despite the presence of containment policies during future infectious disease outbreaks.
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