Coronavirus and the fear of beneficiaries to seek routine health services in health facilities
By Ibrahim Sorie Koroma
Baromi Conteh (not her real name), a 29 year old resident of Moyeba Community in the east of Freetown is in her first trimester of pregnancy (first 3 months of pregnancy) and was due for FREE treated mosquito net upon her first visit to the nearest government health facility in her community, which is the Moyeba Community Health Center (CHC), centrally located at the center of the community for easy movement of pregnant women like Baromi Conteh and children under five years, who are most at risk of Malaria.
This writer was visiting an old time friend, who stays on the sloppy rouged part of the community and Baromi was sitting in full view as I almost slipped my way to my friend’s place, which attracted a sympathetic but a helpful cry from Baromi; shouting politely in or local parlance, “take tem Oooo….. brother, leh u nor fordom”, meaning be careful brother not to fall on the ground. As a way of paying her back and as a practicing health Promotion practitioner; I have the eyes for good health and always prevail on any given opportunity to at least do health promotion/education even in the context of coronavirus but with social distancing in mind and in practice.
When I got closer to Baromi, I tried to cool off a bit as I was somehow exhausted and after that I started asking Baromi of her pregnancy status. Upon open conversation, this writer realized that Baromi was due to go to the nearest health facility in her community for anti-malaria treatment in which she would also be given a FREE treated mosquito net to prevent her and the unborn baby against malaria. She stated that, she could not go because of the fear that if she had gone to the clinic, she would have been admitted and treated for Coronavirus.
So you see, misconceptions like this are preventing people, especially pregnant woman and caregivers of children Under Five years to seek routine health care services in our government health facilities because of the lack of knowledge which should trigger informed action and even if they have the required knowledge, issues like misconceptions, rumors and fake news are major limitations for pregnant women and caregivers like Baromi to seek health services in health facilities, more so when the country is fighting the spread of coronavirus in communities. This writer would like to state that, even though coronavirus is a deadly and highly infectious disease, there are a lot of other diseases that are equally deadly like Coronavirus that are killing people in communities unnoticed.
You can agree with this writer that, if we are to do a formative research on the uptake of routine services during the COVID-19 pandemic period, results would definitely show a decrease in uptake of RI services, which will impact negatively on the country’s aspiration of attaining the Universal Health Coverage which pinpoints on specific health indicators like child health and Maternal Mortality of which are still a major issues in the country’s health system.
So, community people, especially pregnant women and caregivers of under-fives should continue to seek routine health services, like vaccination for polio, measles, whooping cough, Yellow fever, tetanus toxoid, and anti-malaria treatment. Even, as we fight COVID-19 there is a report of confirmed Measles cases in Karane District, North-West of Sierra Leone, should this be a full blown outbreak without a reactive public health intervention, we would be in a situation of responding to two highly infectious diseases which will be a huge burden to the government and its health partners.
In a related development, the National Malaria Control Programme in the Ministry of Health and Sanitation together with its partners on Saturday 25th April 2020, joined the rest of the world to celebrate World Malaria Day, a day set aside to glorify the gains already made and the gaps in the malaria fight. It is also geared-up towards raising awareness on actions communities should take to prevent malaria and advocate for more support through Public-Private Partnership.
At the celebrate, one of the key topic of discussion was to encourage the general public, Pregnant women and caregivers of under-fives to take action to prevent malaria during pregnancy and in infants by always sleeping inside a treated mosquito net, and always seek FREE treatment for Malaria prevention at the nearest health facility.
Another key discussion that caught the writer’s eye was the issue of FEVER, which they discussed, is one of the simplest signs of Malaria which is also true for Corona. This they noted can be confusing in terms of meeting case definition for both diseases. They argued that this was the right moment to discuss malaria because if people are able to take actions to prevent themselves against malaria, they can also take informed actions to prevent themselves against Coronavirus; thereby preventing the most visible sign for both malaria and corona, which is Fever.
With all the advocacy and clarion call by stakeholders for caregivers and pregnant women to seek health services at the health facilities, I believe there is that major impediment to this which is fear which has the propensity to thwart the gains already made in our national health coverage over the years which cannot be restored easily if early efforts are not made to change the narrative, because it seems all efforts are being diverted to the fight against COVID-19 and our caregivers are riddled with fear, preventing them from accessing and utilizing our routine health services, which will cost us greatly, if prudent measures are not put in place.
Let me end by reminding that, COVID-19 is deadly…. Oh yes, but there are lot of other diseases that are equally deadly like coronavirus disease that are also killing people every day. Let us take Malaria for example, malaria is not only a disease burden in Sierra Leone, but is the highest killer disease in the country, especially for pregnant women and children under-fives. Now, from the look of thinks pregnant women like Baromi are not accessing the health facilities for their anti-malaria treatment because of fear of coronavirus, not to talk of caregivers of under fivers whose children badly need anti malaria drug to prevent them from the disease, thereby preventing death and morbidity.
About the Author:
Ibrahim Sorie Koroma is a graduate in Mass Communication and Health Education/Promotion Officer at the Health Education/Promotion Division in the Ministry of Health and Sanitation.