医療システムと政策研究

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Effects Of A Free-Care Policy On The Demand For Routine Medical Services In The Democratic Republic Of The Congo During A Lengthy Ebola Outbreak

Abhimanyu Singh

In order to sustain routine service levels, the government subsidised health services in a few health zones in reaction to the DRC's 10th Ebola Virus Disease epidemic. In order to test the hypothesis that routine services would not significantly decline during the FCP, we evaluate the effects of the initial and revised Free Care Policies on overall clinic visits, uncomplicated malaria, simple pneumonia, fourth antenatal care clinic visits, and measles vaccinations. Methodology and results From January 2017 to November 2020, we used data from the DRC's national health information system. Facilities that were originally and subsequently enrolled in the FCP, which took place in August 2018 and November 2018, respectively, were considered intervention facilities. In the North Kivu Province, only comparison facilities from the health regions where at least one Ebola case was reported. An examination of a controlled interrupted time series was performed. As comparison to comparable locations, the FCP appeared to have a favourable impact on boosting overall clinic attendance rates, uncomplicated malaria case rates, and simple pneumonia case rates. Most of the FCP's long-term effects were insignificant or, if they were, just of modest significance. The introduction of the FCP did not appear to have any significant effects on the rates of measles vaccines or fourth ANC clinic visits, compared to reference locations. We did not notice the drop in measles vaccination rates that has been noted in other places. The study has limitations because we were unable to take health facility into account. Service volumes and bypassing in private healthcare facilities. Conclusions: Our results show that FCPs can be used to continue providing ordinary services during epidemics. The study's design also shows that regularly reported health data from the DRC are capable of picking up changes in health policy.

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