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Research Article

Barriers to Accessing Healthcare during COVID-19 LOCKDOWN: A Point Prevalence Study amongst Patients Attending Emergency and General Out-patient Clinics of PATAN HOSPITAL, NEPAL

Yogendra Amatya, Amanda Helen Douglas, Nisha Devi Gurung, Aashutosh Jha

Correspondence Address :

Amanda Helen Douglas
Dept of GP, Patan Academy of Health Sciences (PAHS)
Lalitpur, P.O.Box 26500, Kathmandu
Nepal

Received on: February 23, 2021, Accepted on: March 01, 2021, Published on: March 05, 2021

Citation: Yogendra Amatya, Amanda Helen Douglas, Nisha Devi Gurung, Aashutosh Jha (2021) Barriers to Accessing Healthcare during COVID-19 LOCKDOWN: A Point Prevalence Study amongst Patients Attending Emergency and General Out-patient Clinics of PATAN HOSPITAL, NEPAL

Copyright: 2021 Amanda Helen Douglas, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Abstract

Background: Barriers to healthcare exist, particularly for poor, vulnerable patients. The coronavirus pandemic and resulting lockdowns, impacted healthcare access worldwide. January 2020, Nepal reported its first Covid-19 case, as cases increased worldwide, the government imposed a four-month lockdown. Our study evaluates the prevalence of barriers to healthcare during this lockdown.
Methods: This is an observational cross-sectional point prevalence study. All patients attending Patan Hospital’s emergency department (ED), general out-patient (OPD) and fever clinics (FC) during a 24-hour period were included. Data were collected through researcher administered, Nepali, written surveys.
Results: Data were collected from 117 participants, none declined. Hospital attendance was reduced compared to 2019. 51% participants were male, mean age 29yrs (range 0.16 - 85yrs). Most frequent attendance reasons; vaccination 17% (OPD 31%), respiratory symptoms/fever 15% (25% FC) and abdominal pain 15% (40% ED). Mean symptom duration was 6 days (4 days ED). 42% patients (50% FC) delayed attendance for; virus exposure fear 32% (47% OPD), transportation problems 23% (29% OPD) and hospital opening uncertainty 11% (21% OPD). 50% of patients (69% FC) reported difficulties; security stops 44% (55% OPD), transportation 37% (45% OPD) and financial 12% (20% FC).
Discussion: Fewer patients attended hospital than 2019 average, those attending described considerable barriers; physical, psychological and knowledge. Many experienced difficulties and delayed presenting. Transportation, security stops and financial issues were significant, potentially insurmountable barriers to vulnerable patients. Lack of public transportation and affordable ambulances must be addressed and virtual consultations considered to overcome barriers.

Psychological barriers were prevalent, with high virus exposure anxiety. Lack of knowledge surrounding hospital provision and travel regulations presented additional barriers. Dissemination of frequent, accurate information regarding services and infection control measures is vital to reassure populations.

Conclusion: Lockdowns generate significant barriers to healthcare. Governments and providers need to understand and ameliorate these to ensure access during lockdowns.

Keywords: Asia, Barriers, Covid-19, Lockdown, Nepal