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Center for Global Development Project

Over the last year, the IFK partnered with the Center for Global Development (CGD) to explore the indirect health effects of COVID-19. The project with the CGD focussed on reviewing the indirect health effets brought on by disruptions to essential health services. 
The IFK worked with the CGD and researches from Kenya, The Philippines, and Uganda to produce several publications. These include: 


Direct and Indirect Health Effects of Lockdown in South Africa - Benjamin Smart, Herkulaas Combrink, Alex Broadbent and Piet Streicher.
Abstract: This paper investigates both the potential impact of national lockdown measures on COVID-19 transmission, and other health and non-health indicators in South Africa, based on available data. We present findings relating to both “costs” and “benefits” in health terms of the national lockdown side by side. Cumulative and new daily cases were plotted against changes in regulations. Disease transmission during each lockdown level was estimated using effective reproduction rate as a proxy, calculated using the EpiEstim method. The reproduction number was calculated at national and provincial level. To compare township and suburb living environments, the Cape Town township of Khayelitsha was compared with the southern suburbs of the same city. Indirect health effects were assessed by official reports and releases from government departments and institutes. Crime statistics were retrieved from the South African Police Service and StatsSA. We find that for large parts of the country and parts of the population, stringent lockdown was little or no better than measures already in place for controlling transmission of COVID-19. The net health effect of COVID-19 lockdowns in South Africa cannot yet be assessed because causes of death data have not been made available. Substantial excess deaths relative to previous years were observed, and the majority of these are not accounted for. There is reason to anticipate significant future health consequences of lockdown. 

It is available for download here.

Effects of the COVID-19 Pandemic on Health Services and Mitigation Measures in Uganda - Nazarius Tumwesigye , Okethwangu Denis , Mary Kaakyo and Claire Biribawa

Abstract: On 21st March 2020, Uganda reported its first COVID-19 case. The government responded by instituting a lockdown and other measures. We assess the effects of the COVID-19 containment measures on health services to better inform the next preventive measures. We use a case study approach that involved document reviews and secondary analysis of data on attendance of key health services and mortality for the years 2019 and 2020. The services included outpatient department (OPD), antenatal care (ANC), malaria, immunization, TB, and hypertension. Interrupted time series analysis was applied to test the significance of difference between pre-and postintervention. We find that from March to April 2020, attendance to health services reduced and then rose in June or July. Notable reduction was in general OPD (17%), malaria-OPD (7%), ANC (8%), immunization (10%), hypertension (17%), and diabetes (10%). Institutional mortality reduced in same period. The intervention significantly affected the level and trends of malaria-OPD and immunization. We conclude that the lockdown reduced access to health services while institutional mortality fell due to reduced number of patients. There is need to emphasize other mitigation measures rather than lockdowns.

It is available for download here.

Analysis and Commentary:

The Indirect Health Effects of COVID-19: Emerging Findings from Kenya, the Philippines, South Africa, and Uganda -  Carleigh Krubiner, Y-Ling Chi, Lydia Regan, Edwine Barasa, Diana Beatriz S. Bayani, Claire Biribawa, Alex Broadbent, Benjamin Smart, Nazarius Tumwesigye and Damian Walker

Available for viewing here.

How Should We Evaluate Lockdowns? Disentangling Effectiveness, Context, and Politics - Alex Broadbent, Herkulaas Combrink, Carleigh Krubiner, Benjamin Smart and Damian Walker

Available for viewing here.