Challenges Associated With Healthcare Service Delivery during Covid-19 Era in Rwanda

ABSTRACT From 2019, the world has faced the pandemic of high severity ever inexperienced: COVID 19. It has called the efforts of various stakeholders for prevention of its propagation, treatment of infected persons, limitation of its effects, etc. Healthcare workers have been at the forefront of response to COVID-19, risking their lives and their physical and mental health. Despite many efforts to improve the overall quality of healthcare service delivery during COVID-19 era, a number of patients reported to receive inadequate healthcare service. The objective of this research was to understand factors associated with the quality of healthcare service delivery, especially those linked to COVID-19 pandemic. Findings of research will contribute on the efforts for effective strategies for quality assurance in healthcare services delivery. This research was conducted in Kigali City, Southern and Eastern provinces of Rwanda, from January to April 2022. 385 respondents were identified among healthcare service providers and beneficiaries of those services. Data was collected using a questionnaire and interview guide. Quantitative data collected using a questionnaire was analyzed using SPSS version 22. On the other hand, qualitative data collected through interviews was analyzed using thematic analysis method. Results from data analysis were discussed before addressing conclusion and recommendations. The big proportion of healthcare service providers (56%) and beneficiaries (61%) ranked healthcare service delivery as good, while 78.6% of beneficiaries and 100% of healthcare service providers confirmed that they have observed the change in healthcare service delivery during this COVID-19 era. The great change was reported by 3.6% of beneficiaries, while only 17.8% of beneficiaries have not observed the change. The quality of healthcare service delivery has not been affected at the same level in all health institutions. The increased workload in health sector has been mentioned as the main factor which has strongly affected healthcare service delivery in public hospitals and health centers, while lockdowns have particularly affected healthcare service delivery for beneficiaries of referral hospitals. Specific short-term, medium-term, and long-term recommendations to strengthen health system or accessible high quality health care services during and after COVID-19 era were addressed. Keywords: COVID-19, SARS-COV-2, healthcare, healthcare service delivery