Executive Summary
Non-Communicable Diseases (NCDs) are health conditions that cannot be transmitted from one patient to another, and usually manifest a prolonged, persistent, and slow pathology. NCDs are responsible for over 70% of all deaths, with nearly 80% of these deaths occurring in low-and middle-income countries. In addition, NCDs constitute approximately 80% of all years lived with disability globally. With the global population aging, rises in multi-morbidity, longer life expectancies, and increasing survival rates, more and more people are expected to live with the health burden of NCDs (WHO, 2020).
COVID-19 is an ongoing pandemic that emerged at the end of 2019 in China and spread quickly to the rest of the world, affecting, both directly and indirectly, the health and life of the global population. This research attempts to understand the effects of the COVID-19 pandemic on NCDs in Burkina Faso, Bangladesh, Colombia, DRC, Nigeria, and Syria. All six countries are included in the iMMAP COVID-19 Situational Analysis Program, as they are affected by humanitarian crises and conflicts. The report covers the effects of COVID-19 on access to health services, resources allocations, and the medical status of the patients with NCDs.
The research relies on the data collected from trusted academic and institutional sources stored in the DEEP Platform, or directly from World Health Organization (WHO), Centre for Disease Control (CDC), British Medical Journal (BMJ), and ELSEVIER. This secondary data review was complemented with primary data, collected through a key informants’ survey conducted using Kobo Toolbox. For the complete questionnaire, please see Annex1.
Key findings:
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Access: the research revealed that the COVID-19 pandemic directly affected access to health services. Mitigation measures across the targeted countries, including movement restrictions and closures, taken to manage the pandemic, had financial implications that prevented patients from seeking health services or accessing medication. This was mainly due to the inability of patients (as well as health workers, medicine, and equipment) to reach the health facilities. All these factors played a role in hindering access to health services, without considering pre-existing problems such as lack of security, conflicts, flooding, among others.
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Comorbidity and the effects of COVID-19 on the medical status of NCD patients represent the direct effects of the outbreak on the patients’ medical status. This study established pre-existing NCDs as a risk factor for becoming infected by a severe form of COVID-19, leading to death in most cases. It also revealed the effects of COVID-19 on NCD outcomes and complications.
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COVID-19 undermined the provision of NCD health services. While governments and healthcare providers tried to keep the health facilities operational, available information indicate that if the COVID-19 pandemic impacted all health services, NCD health services were most directly affected. The analysis of the number of health services from pre- pandemic 2019 until 2021 shows that the number of services declined during the peak of the COVID-19 pandemic (in mid-2020), before showing a limited recovery.
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COVID-19 affected the human and financial resources allocated to providing NCD health services in different ways. Generally, some health workers assigned to NCD health services were later reallocated to support the COVID-19 response partially, and the impression is that the same applies to NCDs funds (which is already limited). The research revealed the need to collect data about the NCDs in all situations and integrate these services in all health levels and in all situations, especially during disasters and emergencies. The main recommendation includes raising awareness on NCDs, collecting data on NCDs, starting to use some kind of Telemedicine with the needed capacity building for the doctors regarding telemedicine, and arranging home delivery of NCD medications. It is also recommended to develop a well trusted and accredited website to offer health information under home health care, to contextualize NCDs within a vision for planetary health, and maximize the role of patients on self- care management and behavior changes for NCDs.