Health system impact of COVID-19 on urban slum population of Bangladesh: a mixed-method rapid assessment study
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Date
2022-02-23Author
Mahmood, Shehrin Shaila
Hasan, Md. Zahid
Hasan, A M Rumayan
Rabbani, Md. Golam
Begum, Farzana
Yousuf, Tariq Bin
Hanifi, Syed Manzoor Ahmed
Reidpath, Daniel
Rasheed, Sabrina
Metadata
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Mahmood, S.S., Hasan, Md.Z., Hasan, A.M.R., Rabbani, Md.G., Begum, F., Yousuf, T.B., Hanifi, S.M.A., Reidpath, D.D. and Rasheed, S. (2022) ‘Health system impact of COVID-19 on urban slum population of Bangladesh: a mixed-method rapid assessment study’, BMJ Open, 12(2), p. e057402. Available at: https://doi.org/10.1136/bmjopen-2021-057402.
Abstract
Design Setting and participants
A cross-sectional survey among 476 households was conducted during October–December 2020 in five selected urban slums of Dhaka North, Dhaka South and Gazipur City Corporation. In-depth interviews with purposively selected 22 slum dwellers and key informant interviews with 16 local healthcare providers and four policymakers and technical experts were also conducted.
Outcome measures Percentage of people suffering from general illness, percentage of people suffering from chronic illness, percentage of people seeking healthcare, percentage of people seeking maternal care, health system challenges resulting from COVID-19.
Results About 12% of members suffered from general illness and 25% reported chronic illness. Over 80% sought healthcare and the majority sought care from informal healthcare providers. 39% of the recently delivered women sought healthcare in 3 months preceding the survey. An overall reduction in healthcare use was reported during the lockdown period compared with prepandemic time. Mismanagement and inefficient use of resources were reported as challenges of health financing during the pandemic. Health information sharing was inadequate at the urban slums, resulting from the lack of community and stakeholder engagement (51% received COVID-19-related information, 49% of respondents knew about the national hotline number for COVID-19 treatment). Shortage of human resources for health was reported to be acute during the pandemic, resulting from the shortage of specialist doctors and uneven distribution of health workforce. COVID-19 test was inadequate due to the lack of adequate test facilities and stigma associated with COVID-19. Lack of strong leadership and stakeholder engagement was seen as the barriers to effective pandemic management.
Conclusion The findings of the current study are expected to support the government in tailoring interventions and allocating resources more efficiently and timely during a pandemic.