Utilization of essential under 5 health services in Sierra Leone during the COVID 19 outbreak

Abstract

Background: In a health crisis the focus of health systems shifts away from providing essential health services to the management and containment of  the crisis. This has devastating effects on vulnerable children under the age of five. This study was conducted to determine the utilization of essential  health services for children under 5 in the Western area rural district of Freetown during the COVID-19 outbreak.

Methods: An explanatory mixed-methods cross-sectional study was done in two phases. First, a quantitative household survey of 300 caregivers of  children under 5 from the two most populous communities within the western area rural district was done. Data was collected using questionnaires and  analyzed using Microsoft Excel and SPSS. Then a qualitative exploration of the views of healthcare workers in the study area using focus group discussion  was done. The qualitative data was analyzed with thematic analysis.

Results: Over 90% of respondents stated that they had under 5 health cards and 99% had sought routine immunization services for the under 5 children  at a health care facility at least once. Of respondents surveyed 26% stated that there was a decrease in their utilization of essential under 5 health  services as a consequence of the COVID-19 outbreak. Healthcare workers also noticed a decreased demand for under 5 health services in healthcare  facilities across the district.

Conclusion:There has been a decline in the utilization of under 5 healthcare services as a result of the COVID 19 outbreak.  Health authorities and policy makers have to prioritize maintaining services to mitigate the potential consequences on children under the age of 5.