Impact of Hospital Closure on Patients with Communicable and Non-Communicable Diseases During the COVID-19 Pandemic in Uganda: A Cross-Sectional and Mixed-Methods Study

This study investigated the impact of service disruption in a tertiary hospital (ERRH) that was converted to a COVID-19-dedicated hospital for two years in Uganda. This mixed-methods study focused on the ERRH patients with tuberculosis (TB), human immunodeficiency virus (HIV), diabetes, hypertension, and mental illness. A quantitative study used a structured questionnaire with the primary outcome measure being the discontinuation of access to healthcare. A qualitative study with a focus group discussion (FGD) was conducted on eight patients. Of the 202 quantitative survey participants, 17.8% discontinued necessary healthcare due to ERRH closure, and the discontinuation rates differed by disease: 48.1% of tuberculosis patients, 16.0% of HIV patients, 7.8% of diabetes/hypertension patients, and 4.0% of mental health patients (P < 0.001). Almost 90% of the patients reported worsening health conditions. Patients under 30 were 3.15 times more likely to experience service interruptions compared to those over 50. The FGD also identified difficulties in obtaining medication during the ERRH closure and movement restrictions, especially for TB patients, even though the ERRH provided outreach services. Our study revealed that ERRH closures and lockdowns had profound negative impacts on access to health care and health conditions. Younger patients and those with TB were the most affected patients. This study provides suggestions from the field for policy makers to strengthen universal health access during health crises in Uganda and other sub-Saharan countries.