INADEQUATE CARE OF HYPERTENSION AND OTHER NON-COMMUNICABLE DISEASES DURING THE COVID-19 PANDEMIC IN SOUTH AFRICA

Abstract

Objective: In the setting of an already overburdened healthcare system, South Africa has a high burden of hypertension and other non-communicable diseases (NCDs), and the country experienced a high COVID-19 caseload. The aim of this study was to examine the perceptions and experiences of 1) healthcare professionals (HPs) on the preparedness of health systems to provide NCD care and of NCD management during the COVID-19 pandemic, and 2) people living with NCDs (PLWNCDs) on the care they received for hypertension and other NCDs during the COVID-19 pandemic in South Africa. Design and method: Across the country, we recruited a convenience sample of 1) HPs who worked in healthcare management i.e., public health officials and healthcare workers who provided care and engaged with patients in any healthcare capacity, and 2) PLWNCDs with at least 1 NCD. Questionnaires included quantitative and open-ended follow-up questions. Quantitative analyses were conducted using SPSS. The qualitative open-ended questions were evaluated using content analysis with inductive reasoning. Results: There were 31 HPs and 79 PLWNCDs (59 with hypertension) included in this cross-sectional study. HPs perceived COVID-19 care to be adequate, while NCD care was poor during the pandemic. There were service disruptions including for emergency and specialised NCDs care. Strategies for the care of non-COVID-19 illnesses during the pandemic were absent. This would have serious long-term consequences for PLWNCDs and the healthcare system. Perceptions of inadequate hypertension and other NCD care were reiterated by PLWNCDs; 49% felt they received ’very little’ or no adequate care. 18% had a scheduled appointment cancelled. Additionally, many PLWNCDs (52%) felt anxious, lonely, or frightened during the pandemic and 15% felt their mental health had deteriorated. The utility of digital health in future was positively perceived by both HPs and PLWNCDs and may be able to improve health provision during crises. Conclusions: Policies are required 1) so that NCD care will not be overlooked during future crises and 2) to encourage PLWNCDs to timeously access healthcare services during such periods. Such strategies may incorporate digital health apps to improve care and target the mental healthcare needs of PLWNCDs.