The impact of COVID-19 on health service utilization in sub-Saharan Africa: a scoping review

Abstract

Abstract Background The COVID-19 pandemic has affected health systems and impacted health service utilization (HSU) globally. The aim of this scoping review is to synthesize the available evidence on HSU in sub-Saharan Africa during the COVID-19 pandemic focusing on (1) changes in HSU compared to the pre-pandemic period, (2) changes in HSU amongst particular patient groups studied, and (3) identify factors determining changes in HSU as a result of the COVID-19 pandemic. Methods The Scoping review is guided by the methodological framework developed by Arskey and O'Malley. We have searched for relevant studies in PubMed(MEDLINE), EMBASE, Scopus and Web of Science and for grey literature on governmental and organizational websites. Search terms combined synonyms for three main concepts: (1) ‘COVID-19 pandemic’, (2) ‘health service utilization’, and (3) ‘sub-Saharan Africa’. Two reviewers independently screened articles at the title and abstract stage for inclusion into full text screening for data extraction. We provide a general descriptive overview, tabular summaries and thematic analysis of the extracted data. Results We identified a total of 21,440 titles. After removal of duplicates, 14,626 titles and abstracts are currently being screened. Data extraction and analysis will be completed before the conference. We will provide a comprehensive overview of studies on health service utilization during the COVID-19 pandemic conducted in sub-Saharan Africa. We will describe the settings and methods used by identified studies, analyze the types of diseases studied (communicable, non-communicable, and injuries), and present the discussed reasons for changes in health service utilization. Conclusions This review is the first to describe the impact of the COVID-19 pandemic on HSU in sub-Saharan Africa. Understanding the effects of the pandemic on HSU is important to support the development of better policies for pandemic preparedness and response in the region.