• SA's largest household study has found that access to healthcare services has been hindered during the nationwide lockdown.
• This is because those who needed medical care were either too scared of coronavirus or simply unable to go.
• Some participants were unable to access medication, condoms and contraceptives during the period.

South Africa's current largest household study, which surveyed about 7 000 households, has found that access to medical services was hindered during the nationwide lockdown.

The healthcare section of the National Income Dynamics Coronavirus Rapid Mobile Survey (NIDCRAM) looked at unmet health needs, including findings which provide "supplementary evidence to address concerns about the unintended health effects of Covid-19 due to large observed drops in ART (antiretroviral therapy) visits and TB (tuberculosis) tests".

New and pregnant HIV-positive mothers ran out of ARTs

The survey reports that, out the 1 610 new or expecting mothers who required ARTs, 175 (11%) said they had run out, with 40% of this group saying the reason was that they were "afraid of getting coronavirus".

"This fraction is very concerning as interruption in ART risks the health of the mother, as well as increasing the risk of transmission to the baby, whether vertical or through breastfeeding."

Mothers reported two-month gap in care

A total of 3 140 mothers and pregnant women were surveyed at the end of June and 513 women said their last visit to the clinic was in April or earlier.

"This equates to a two-month gap in care, which represents a risk to pregnant mothers and to new lives in this important developmental phase. Admittedly, the risk varies substantially based on the individual's health," the survey said.

Of that group, 9% reported it was more than three months since their last visit, the study noted with concern, and of those who had not gone to the clinic, 37% gave coronavirus as a reason.

People with chronic conditions unable to see healthcare worker

The study found that 96% of people who said they needed to visit a healthcare worker for a chronic condition such as HIV, TB or diabetes said they were able to so in the period between 7 May and 27 June.

"Approximately 19% of the sample (1 612 respondents) reported that in the last four weeks they needed to see a health worker about a chronic condition… Of this group, 90% reported that they did actually visit a healthcare facility.

"This is encouraging since the period referred to was during Level 5 and Level 4 lockdown in South Africa," the survey said.

Acute care

From those surveyed who needed care for an acute condition, 78% visited a healthcare facility.

"Of those that likely needed care, 22% did not visit a healthcare facility. Although this is a relatively small number of respondents (133 individuals) their stated reasons for not seeking care are nevertheless interesting to unpack further. It is worrying that for those respondents who did not seek care for their acute health needs, Covid-19 and lockdown-related fears were mentioned as the number one reason," the study said.

ALSO READ | Covid-19 puts pressure on medicine supply

Medication, condoms and contraceptives

The study also found that 23% of those surveyed were unable to access medication, condoms and contraceptives between 7 May and 27 June.

"Among the nearly 1-in-5 respondents (18%) who had a chronic condition such as HIV, TB, a lung condition, a heart condition or diabetes, the reported inability to access medication, condoms and contraception is considerably higher," the study found.

Of the 1 524 people with chronic health conditions, 39% said they could not access these essential products.