Impact of COVID-19 pandemic on non-communicable diseases care and service deliveries in Sub-Saharan Africa: A systematic review

Abstract

BACKGROUND: Non-communicable diseases (NCDs) care and services play a crucial role in reducing mortality and morbidity associated with NCDs. However, COVID-19 pandemic has worsened the disparities in NCDs care and services in Sub-Saharan Africa (SSA). To date, there is limited synthesized evidence on the impact of COVID-19 on NCDs care and service delivery in this region. Therefore, this review aims to examine the impact of the COVID-19 pandemic on NCDs care and service in SSA. METHOD: A systematic search was conducted on various databases and grey literature sources, including PubMed, CINAHL, Web of Science, Embase, Scopus, Google Scholar, and the World Health Organization database. Studies evaluating the impacts of COVID-19 on the management and provision of major NCDs care in SSA were included. Data extraction and review were performed using the JBI SUMARI and PRISMA 2020 checklist, and a narrative synthesis approach was used due to the high heterogeneity of the included studies. The review protocol has been registered with PROSPERO code CRD42022350528. RESULT: A total of 2,387 records were initially identified, with 2,207articles excluded during abstract and title screening, and 60 articles excluded during full-text screening. Ultimately, 18 studies (13 quantitative and 5 qualitative) were included. The review identified significant disruptions in delivery of care for NCD care across SSA during the pandemic. It include substantial reduction in outpatient attendance, delayed or cancelled diagnostic service and compromised disease management. These disruptions were influenced by healthcare system overloads, patient fears of contracting COVID-19, and public health measures limiting access to routine care. The studies emphasize an urgent need for adaptive strategies to maintain continuity of care for individuals with NCD during health crises. CONCLUSION: The provision of healthcare services for NCDs experienced substantial disruptions during the COVID-19 pandemic, leading to a shift towards managing emergency care. Individuals with NCDs have encountered increased risks of morbidity and mortality due to the delayed access to essential care amidst the pandemic. Emergent solutions like digital health technologies have shown potential in enhancing NCD care access during such crises. Moving forward, it is critical that countries prioritize NCD care and integrate robust systems to ensure the continuous provision of essential services, regardless of the COVID-19 pandemic and other healthcare emergencies.