Opinion: Post lockdown: Are we prepared for the non- Covid-19 health crisis?

By Claire Marunga

The lockdown has bought Uganda time to improve our systems to better handle the Coronavirus pandemic.

It’s anticipated that there may be a surge in Covid-19 cases in Uganda post lockdown, as has happened in a number of countries that have already eased their lockdown restrictions.

During the lockdown, government has focused on strengthening the capacity of health facilities to properly handle Covid-19 cases through expanding bed capacity and increasing resources (staff and equipment).

However, the emphasis has largely been on provision of inpatient medical services in preparation of this anticipated increase.

An unintended ramification of this disproportionate focus has been a cutback in resources for outpatient medical services and the other diseases that constitute Uganda’s health burden.

Uganda’s disease burden is dominated by communicable diseases, which account for over 50% of morbidity and mortality with also a growing burden of non-communicable diseases such as diabetes, high blood pressure including mental health disorders.

Government’s response to the Covid-19 crisis including a ban on public and private transport, social distancing and its communication on avoidance of non-urgent visits to health facilities has led to many potential patients not seeking medical care.

This issue has been compounded by the decreased affordability of health care due to the lockdown’s detrimental effect on people’s income, further exacerbating the already limited access to healthcare for most Ugandans.

Reliance on home remedies and therapies, which play a significant role in many Ugandan households, has increased during this lockdown.

All this has consequently led to a noticeable country wide downtrend in patients being evaluated in health facilities’ out-patient departments.

This could result in patients presenting in advanced disease stages/conditions in health facilities and increased hospital admissions for decompensation of chronic conditions like heart disease, diabetes, high blood pressure post lockdown.

Health facilities should thus be prepared for a surge in non-Covid-19 related cases, post lockdown. These cases will most probably include those patients with interruptions in on-going treatment plans, acute medical conditions with delayed diagnoses and chronic conditions which they have been managing at home or avoiding follow-up due to the difficulty in medical care access.

The government should therefore holistically support medical facilities to handle the challenge that this postulated resurgence of non-Covid-19 related cases will present, in not only facilities’ inpatient departments but also in their outpatient settings to cater to both Coronavirus  and non Covid-19 related cases.

The referral system, an important component of health systems, should be adhered to.

This means that all health centers, primary care facilities and outreach services must be better equipped.

This will lessen the possibly inevitable burden on the designated safety-net secondary and tertiary hospitals and ensure their optimal cost-effective use.

This will also serve to alleviate the added concern of possible delays in care for patients presenting with non-COVID 19 related issues due to prioritization of the Covid-19 related cases in medical centers post lockdown.

Claire Marunga is a pharmacist.

Email: clairmarunga@gmail.com