The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic.

Introduction: The COVID-19 pandemic has disrupted provision of essential health services and overwhelmed even robust health systems worldwide. The Afghanistan health system has suffered both from the pandemic, as well as from political upheaval and regime change. Methods: We evaluated essential service delivery using data collected from a cross-sectional survey of health care facilities in Afghanistan based on administration of a World Health Organization standardized assessment of frontline service readiness. A multi-stage sampling scheme was used to identify a representative sample of 92 health facilities (68 clinics and 24 hospitals) providing essential health services in five provinces. Facility managers were asked to report on changes in health service delivery in late 2021 and early 2022 (corresponding to the end of a significant national COVID-19 surge in infections) compared to the same period one year earlier. Results: Among health facilities evaluated; 29 were in urban and 63 were in rural settings. Most facilities reported an increase in the provision of outpatient care particularly in maternal and child health services as well as for tuberculosis, chronic respiratory diseases, mental health, and substance abuse; the number of in-patients also increased. In contrast, provision of services for malaria, neglected tropical diseases, and community outreach programs decreased. Nearly all facilities used strategies to maintain services, including targeting high-risk patients, promoting self-care, and redirecting patients to alternative health care sites. Nearly three fourth (70.6%) of facilities provided no training about COVID-19 to staff; only 65.2% referred COVID-19 patients to designated hospitals and 44.6% had safe transportation for these patients. Discussion: Increased demand for services during this period was likely due to a backlog in need generated during the preceding COVID-19 surge and the political changes happened a few months earlier to this survey. Facilities used various methods to maintain services, although the decrease in provision of community outreach was concerning. Facilities appeared to be able to maintain essential health services, despite an increase in demand. However, awareness and training of COVID-19 protocols and appropriate and safe referrals need to be improved. In general, these series of surveys are informative and helpful to identify any changes in provision of essential health services and can facilitate recovery of health systems during and after pandemics.

The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic

Introduction The COVID-19 pandemic has disrupted provision of essential health services and overwhelmed even robust health systems worldwide. The Afghanistan health system has suffered both from the pandemic, as well as from political upheaval and regime change. Methods We evaluated essential service delivery using data collected from a cross-sectional survey of health care facilities in Afghanistan based on administration of a World Health Organization standardized assessment of frontline service readiness. A multi-stage sampling scheme was used to identify a representative sample of 92 health facilities (68 clinics and 24 hospitals) providing essential health services in five provinces. Facility managers were asked to report on changes in health service delivery in late 2021 and early 2022 (corresponding to the end of a significant national COVID-19 surge in infections) compared to the same period one year earlier. Results Among health facilities evaluated;29 were in urban and 63 were in rural settings. Most facilities reported an increase in the provision of outpatient care particularly in maternal and child health services as well as for tuberculosis, chronic respiratory diseases, mental health, and substance abuse;the number of in-patients also increased. In contrast, provision of services for malaria, neglected tropical diseases, and community outreach programs decreased. Nearly all facilities used strategies to maintain services, including targeting high-risk patients, promoting self-care, and redirecting patients to alternative health care sites. Nearly three fourth (70.6%) of facilities provided no training about COVID-19 to staff;only 65.2% referred COVID-19 patients to designated hospitals and 44.6% had safe transportation for these patients. Discussion Increased demand for services during this period was likely due to a backlog in need generated during the preceding COVID-19 surge and the political changes happened a few months earlier to this survey. Facilities used various methods to maintain services, although the decrease in provision of community outreach was concerning. Facilities appeared to be able to maintain essential health services, despite an increase in demand. However, awareness and training of COVID-19 protocols and appropriate and safe referrals need to be improved. In general, these series of surveys are informative and helpful to identify any changes in provision of essential health services and can facilitate recovery of health systems during and after pandemics.

Knowledge, attitudes, practice of people toward the COVID-19 pandemics, and its impact in Afghanistan.

COVID-19 pandemic disrupted the social and economic norms. Knowledge, Attitude and Practices studies are used to address the information gap for further strategic decision making to control the pandemic. This study aimed to find the level of Knowledge, Awareness, Attitudes, and behavioral practices of the people of Afghanistan about the COVID-19 and its impact on health and socio-economic dimension of their routine lives. We used a cross-sectional method with two stage sampling design. Data analysis was performed using SPSS v.20. The survey focused on adults including men and women all over the country to represent the country, including the urban and rural areas. Most of the respondents are in the age group of 21-30 years (46.5%); 60.15% of the participants are married. Almost 75% of females and 84% of males were literate and most participants have a bachelor's degree (34%). More than 80% of participants knew they can prevent themselves from contacting COVID-19 through hand washing frequently with soap and water and wearing a mask. More than 80% of participants responded that they would go for a lab test for detection of the virus as well as COVID-19 vaccination if it is available. Almost 35% reported always wearing a mask to prevent COVID-19 transmission; more than half of participants always wash their hands, more than 60% of them do not touch their eyes, nose, and mouth frequently. Nearly 60% of participants indicated that their household had problems satisfying food needs partly during the COVID-19 pandemic. Nearly half of participants believed that the government was successful in applying lockdown measures and in awareness rising (56.8 and 69.8%). The study findings provide some useful insight about the KAP of communities in Afghanistan, which could assist policy makers in public health to design and implement interventions based on the information gaps reported.

Knowledge, attitudes, practice of people toward the COVID-19 pandemics, and its impact in Afghanistan

COVID-19 pandemic disrupted the social and economic norms. Knowledge, Attitude and Practices studies are used to address the information gap for further strategic decision making to control the pandemic. This study aimed to find the level of Knowledge, Awareness, Attitudes, and behavioral practices of the people of Afghanistan about the COVID-19 and its impact on health and socio-economic dimension of their routine lives. We used a cross-sectional method with two stage sampling design. Data analysis was performed using SPSS v.20. The survey focused on adults including men and women all over the country to represent the country, including the urban and rural areas. Most of the respondents are in the age group of 21–30 years (46.5%);60.15% of the participants are married. Almost 75% of females and 84% of males were literate and most participants have a bachelor's degree (34%). More than 80% of participants knew they can prevent themselves from contacting COVID-19 through hand washing frequently with soap and water and wearing a mask. More than 80% of participants responded that they would go for a lab test for detection of the virus as well as COVID-19 vaccination if it is available. Almost 35% reported always wearing a mask to prevent COVID-19 transmission;more than half of participants always wash their hands, more than 60% of them do not touch their eyes, nose, and mouth frequently. Nearly 60% of participants indicated that their household had problems satisfying food needs partly during the COVID-19 pandemic. Nearly half of participants believed that the government was successful in applying lockdown measures and in awareness rising (56.8 and 69.8%). The study findings provide some useful insight about the KAP of communities in Afghanistan, which could assist policy makers in public health to design and implement interventions based on the information gaps reported.