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Journal article
Patterns and determinants of healthcare utilization and medication use before and during the COVID-19 crisis in Afghanistan, Bangladesh, and India
BMC Health Services Research, Vol.24, 416
2024
Abstract
Background
COVID-19 rapidly spread through South Asian countries and overwhelmed the health systems that were unprepared for such an outbreak. Evidence from high-income countries showed that COVID-19 impacted healthcare utilization, including medication use, but empirical evidence is lacking in South Asia. This study aimed to investigate the effect of COVID-19 on healthcare utilization and medication use in South Asia.
Method
The current study used longitudinal data from the ‘Premise Health Service Disruption Survey’ 2020 and 2021. The countries of interest were limited to Afghanistan, Bangladesh, and India. In these surveys, data related to healthcare utilization and medication use were collected for three-time points; ‘Pre-COVID phase’, ‘Initial phase of COVID-19 outbreak’, and ‘One year of COVID-19 outbreak’. Generalized estimating equation (GEE) along with McNemar’s test, Kruskal–Wallis test and χ2 test were applied in this study following the conceptualization of Andersen’s healthcare utilization model.
Result
The use of healthcare and medication was unevenly impacted by the COVID-19 epidemic in Afghanistan, Bangladesh, and India. Immediately after the COVID-19 outbreak, respondents in Bangladesh reported around four times higher incomplete healthcare utilization compared to pre-COVID phase. In contrast, respondents in Afghanistan reported lower incomplete utilization of healthcare in a similar context. In the post COVID-19 outbreak, non-adherence to medication use was significantly higher in Afghanistan (OR:1.7; 95%CI:1.6,1.9) and India (OR:1.3; 95%CI:1.1,1.7) compared to pre-COVID phase. Respondents of all three countries who sought assistance to manage non-communicable diseases (NCDs) had higher odds (Afghanistan: OR:1.5; 95%CI:1.3,1.8; Bangladesh: OR: 3.7; 95%CI:1.9,7.3; India: OR: 2.3; 95% CI: 1.4,3.6) of non-adherence to medication use after the COVID-19 outbreak compared to pre-COVID phase.
Conclusion
The present study documented important evidence of the influence of COVID-19 epidemic on healthcare utilization and medication use in three countries of South Asia. Lessons learned from this study can feed into policy responses to the crisis and preparedness for future pandemics.
Details
- Title
- Patterns and determinants of healthcare utilization and medication use before and during the COVID-19 crisis in Afghanistan, Bangladesh, and India
- Authors/Creators
- Md Tauhidul Islam - Murdoch UniversityMieghan Bruce - Murdoch University, Centre for Biosecurity and One HealthKhurshid Alam - Murdoch University, Centre for Healthy Ageing
- Publication Details
- BMC Health Services Research, Vol.24, 416
- Publisher
- BioMed Central Ltd unless otherwise stated. Part of Springer Nature.
- Identifiers
- 991005652869907891
- Copyright
- © The Author(s) 2024.
- Murdoch Affiliation
- Centre for Biosecurity and One Health; Murdoch Business School; Ngangk Yira Institute for Change; School of Veterinary Medicine; Centre for Healthy Ageing; Centre for Molecular Medicine and Innovative Therapeutics
- Resource Type
- Journal article
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- Citation topics
- 1 Clinical & Life Sciences
- 1.104 Virology - General
- 1.104.2776 COVID-19 Healthcare Impact
- Web Of Science research areas
- Health Care Sciences & Services
- ESI research areas
- Clinical Medicine