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ACADEMIA Letters Effects of COVID-19 Pandemic on Community Health Services in Ilorin South Local Government Area of Kwara State, Nigeria. Sesan Busayo Right from the early outbreak of coronavirus in Nigeria there have been several responses from various quarters on the effects the pandemic has done to the community health services and the health providers. The objectives of this study were to; assess effect of the Corona Virus pandemic on community health services in Ilorin South Local Government Area of Kwara State. A descriptive research design of a survey method was employed for this study. The population of the study was 120. A multistage sampling technique was used to select the respondents. The researcher structured questionnaire and validated the questionnaire by three experts in a related field. A reliability coefficient of r=0.79 was obtained through test re-test method using Cronbach Alpha correlation method. Four hypotheses were tested using Chi-square (χ2) at 0.05 alpha level. The results revealed that: 1. COVID-19 pandemic significantly affect community health services in Ilorin South Local Government of Kwara State 2. COVID-19 pandemic significantly affect health promotion programs in Ilorin South Local Government of Kwara State 3. COVID-19 pandemic significantly affect the treatment of disorders in Ilorin South Local Government of Kwara State Academia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Sesan Busayo, busayosesan99@yahoo.com Citation: Busayo, S. (2021). Effects of COVID-19 Pandemic on Community Health Services in Ilorin South Local Government Area of Kwara State, Nigeria. Academia Letters, Article 3335. https://doi.org/10.20935/AL3335. 1 4. COVID-19 pandemic significantly affect rehabilitation activities in Ilorin South Local Government of Kwara State Thus, it was recommended that there should be more sensitization campaigns for junior and senior staff about the pandemic. An educative program should be developed if there is rising cases of this pandemic. Introduction The World Health Organization (WHO) (2018) define community health as a branch of public health that focuses on people and their role as determinants of their own and other people’s health in contrast to environmental health, social and economic resources to sustain emotional and physical wellbeing among people in ways that advance their aspirations and satisfy their needs in their unique environment. Community health is a major field of study within the medical and clinical sciences that focuses on the maintenance, protection, and improvement of the health status of population groups and communities. It is a distinct field of study that may be taught within a separate school of public health or environmental health (Patel & Jernigan 2019). Medical interventions that occur in communities can be classified into three categories: primary care, secondary care, and tertiary care. Each category focuses on a different level and approaches towards the community or population group. In Kwara State, for instance, community health is rooted within the primary health care sector through the National Primary Healthcare Development Agency (NPHCDA), an arm of the Ministry of health, Nigeria. Primary healthcare programs aim to reduce risk factors and increase health promotion and prevention. Secondary healthcare is related to “hospital care” where acute care is administered in a hospital department setting. Tertiary healthcare refers to highly specialized care usually involving disease or disability management. The success of community health programs relies upon the transfer of information from health professionals to the general public using one on one or one to many communications (Olapegba et al., 2020). In the early outbreak of coronavirus in Nigeria there have been several responses from various quarters on the effect of the pandemic has done to health care providers. Wuhan Municipal Health claimed in their 2020 report that coronavirus disease also called the COVID19 or severe acute respiratory syndrome (SARS-COV-2) belongs to a family of viruses that may cause various symptoms such as pneumonia, fever, breathing difficulty, and lung infection (Olapegba et al., 2020). Academia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Sesan Busayo, busayosesan99@yahoo.com Citation: Busayo, S. (2021). Effects of COVID-19 Pandemic on Community Health Services in Ilorin South Local Government Area of Kwara State, Nigeria. Academia Letters, Article 3335. https://doi.org/10.20935/AL3335. 2 Concept of Community Health Services In 1960, there was no strong focus on health systems development in Nigeria. Policymakers and political actors made efforts to establish and expand healthcare infrastructures with more emphasis placed on curative medicine rather than preventive medicine. From 1975 to 1980, health system development was initiated with Community Health System CHS as the cornerstone. The National Basic Health Services Scheme (NBHSS) was developed based on a PHC approach. Unfortunately, the NBHSS program could not achieve its goals due to implementation challenges; hence, CHS services were not delivered across Nigeria. In 1985 Professor Olikoye Ransome-Kuti was appointed the Minister of Health. Professor Ransome-kuti adopted Primary Health Care (PHC) of Community Health System CHS in 52 local government areas as models based on the Alma Ata Declaration of 1978. Furthermore, Nigeria’s first comprehensive National Health Policy based on PHC was launched in 1988. From 1986 to 1990, Professor Olikoye Ransome-Kuti expanded PHC to all local governments, achieved universal child immunization of over 80%, and devolved responsibility for PHC to the local government areas (Hellewell et al., 2020). Professor Olikoye Ransome-Kuti worked assiduously between 1985 and 1992 to implement PHC policy based on the Alma Ata declaration for the benefit of the Nigerian population. Professor Olikoye Ransome-Kuti introduced a comprehensive National Health Policy with a focus on PHC, placed emphasis on preventive medicine and healthcare services at the grass-root, ensured exclusive breastfeeding practice, introduced free immunization to children, encouraged the use of oral rehydration therapy by nursing mothers, made compulsory the recording of maternal deaths, and encouraged continuous nationwide vaccination and pioneered effective HIV/AIDS campaign (Olapegba et al., 2020). In 1992, the National Primary Health Care Development Agency (NPHCDA) was established to ensure that the community health system agenda is continued and sustained. The military takeover of a government that occurred in 1993 brought to an end the giant strides recorded under the leadership of Professor Olikoye Ransome-Kuti from 1985 to 1992. The PHC under one roof (PHCUOR) policy was formulated in 2011 to address the problem of fragmentation in PHC and ensure the integration of PHC services under one authority. Its impact is yet to be felt on health status and utilization of PHC in Nigeria since PHC under one roof became a national policy only a few years ago. The inability of PHC centers to provide basic medical services to the Nigerian population have made both secondary and tertiary health-care facilities experience an influx of patients; this now has its toll on the secondary and tertiary levels of care (Olapegba et al., 2020) Part of the Alma Ata Declaration is that health is a fundamental human right and govern- Academia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Sesan Busayo, busayosesan99@yahoo.com Citation: Busayo, S. (2021). Effects of COVID-19 Pandemic on Community Health Services in Ilorin South Local Government Area of Kwara State, Nigeria. Academia Letters, Article 3335. https://doi.org/10.20935/AL3335. 3 ments should be responsible for the health of the people (WHO, 2020). Health is rarely seen as a fundamental human right by policy makers in Nigeria; hence, the inability to implement the Abuja Declaration in which African heads of state pledged to set a target of earmarking at least 15% of their annual budget to improve the health sector. Increasing investment in health of the people has been a challenge for decision makers in spite of evidence showing the link between health and economic development (WHO, 2020). Many African countries, including Nigeria, fall short of the Abuja declaration of 2001 in spite of the pledge by heads of state of African Union countries. Therefore it is established that the successful implementation of PHC in any country requires adequate financial resources (WHO, 2020). The current state of PHC system in Nigeria is appalling with only about 20% of the 30,000 PHC facilities across Nigeria working (Adewale, 2016). Presently, most of the PHC or facilities in Nigeria lack the capacity to provide essential healthcare services, in addition to having issues such as poor staffing, inadequate equipment, poor distribution of health workers, poor quality of healthcare services, poor condition of infrastructure, and lack of essential drug supply (chinawa 2015). In part, problems with the implementation of PHC in Nigeria are related to the handover in the 1970s to the local government administration, which is the weakest level of government (Olapegba et al., 2020). Factors Affecting Community Health Services During COVID-19 Pandemic. Some factors that are affecting community health services during the COVID-19 pandemic are as follows: The Lockdown and social distancing The WHO in their report in May 2020 stated that the lockdown and social distancing during COVID-19 will have a great impact on the health services and economy at large. The impact directly caused by the lockdown could be profound, for example resulting in bankruptcies, unemployment, more domestic abuse, neglect, and hardship. Early estimates show an unprecedented economic shock, with the office for Budget Responsibility forecasting a 35% reduction in GDP in the second quarter of 2020 (Heesterbeek, Klinkenberg, & Hollingsworth, 2020). Academia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Sesan Busayo, busayosesan99@yahoo.com Citation: Busayo, S. (2021). Effects of COVID-19 Pandemic on Community Health Services in Ilorin South Local Government Area of Kwara State, Nigeria. Academia Letters, Article 3335. https://doi.org/10.20935/AL3335. 4 Logistics and funding for community health worker programs During this pandemic disruption of drug and equipment supplies was common as such, policies and mechanisms to address them from an early phase of the outbreak were reported to be important. Also this might be expected along with shortfalls in routine supportive supervision methods. Sustained investments in community Health Services is required during pandemic response including revisiting financial investment, the evidence base is mostly from countries with existing Community Health Services programs where they were additionally engaged for COVID-19 activities (Heesterbeek, Klinkenberg, & Hollingsworth, 2020). Effective Health Care Deliver Arguably, health care delivery continues to be the single greatest community health challenge in Nigeria. The exorbitant cost of health care is impacting the entire economy of the country. Even though the annual growth rate in national health expenditure slowed during the late 1990s due primarily to the advent of managed care, the United States continues to spend more money on health care than any other industrialized country. In 2002, health care than expenditures made up about 14.9% of the country (WHO 2020). The presidential task force (PTF) in one of their press briefing in early May 2020 said that they have provided enough personal protective equipment (PPE) will enable effective health care delivery in cases of COVID-19 (Patel & Jernigan, 2019). Environmental Problems Millions of Nigerians live in unsafe communities where the water is unsafe to drink, or solid waste is disposed of improperly. With a few minor exceptions, the rate at which we pollute our environment continues to increase. Many people still believe that our natural resources are unlimited and that their individual contributions to the overall pollution are insignificant. In actuality, we must improve upon our efforts in resource preservation and energy conservation if our children are to enjoy an environment as clean as ours (Olapegba et al., (2020). Rehabilitation Process of Health Workers According to Olapegba et al., (2020), rehabilitation reduces the impact of a broad range of health conditions. Typically rehabilitation occurs for a specific period of time, but can involve single or multiple interventions delivered by an individual or a team of rehabilitation Academia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Sesan Busayo, busayosesan99@yahoo.com Citation: Busayo, S. (2021). Effects of COVID-19 Pandemic on Community Health Services in Ilorin South Local Government Area of Kwara State, Nigeria. Academia Letters, Article 3335. https://doi.org/10.20935/AL3335. 5 workers, and can be needed from the acute or initial phase immediately following recognition of a health condition through to post-acute and maintenance phases. Rehabilitation involves identification of a person’s problems and needs, relating the problems to relevant factors of the person and the environment, defining rehabilitation goals, planning and implementing the measures, and assessing the effects. Educating people with disabilities is essential for developing knowledge and skills for self-help, care, management, and decision-making (Cucinotta, & Vanelli, 2020). References Anderson, R., Heesterbeek, H., Klinkenberg, D., & Hollingsworth, T. (2020). How will country-based mitigation measures influence the course of the COVID-19 epidemic?. The Lancet, 395(10228), 931-934. https://doi.org/10.1016/s0140-6736(20)30567-5 Cucinotta, D., & Vanelli, M. (2020). WHO Declares COVID-19 a Pandemic. Acta Biomed, 91(1), 157-160. https://doi.org/10.23750/abm.v91i1.9397 external icon. Hellewell, J., Abbott, S., Gimma, A., Bosse, N., Jarvis, C., & Russell, T. et al. (2020). Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts. The Lancet, 8(4), 488-496. https://doi.org/10.1016/S2214-109X(20)30074-7 Patel A, Jernigan DB. Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak — United States, December 31, 2019–February 4, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:140–146. http://dx.doi.org/10.15585/ mmwr.mm6905e1 World Health Organization. (2020). Water, sanitation, hygiene, and waste management for the COVID-19 virus. Geneva: WHO. Retrieved 11 May 2020, from https://www.who.int/ publications-detail/water-sanitation-hygiene-and-waste-management-for-covid-19 World Health Organization. (2020). Coronavirus disease (COVID-19) outbreak: rights, roles and responsibilities of health workers, including key considerations for occupational safety and health. Geneva: WHO. Retrieved 11 May 2020, from https://www.who.int/ publications-detail/coronavirus-disease-(covid-19)-outbreak-rights-roles-and-responsibilitiesof-health-workers-including-key-considerations-for-occupational-safety-and-health World Health Organization. (2020). Course: RRT Training Packages for COVID-19. ReAcademia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Sesan Busayo, busayosesan99@yahoo.com Citation: Busayo, S. (2021). Effects of COVID-19 Pandemic on Community Health Services in Ilorin South Local Government Area of Kwara State, Nigeria. Academia Letters, Article 3335. https://doi.org/10.20935/AL3335. 6 trieved 28 April 2020, from https://extranet.who.int/hslp/training/course/view.php?id=327 Academia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Sesan Busayo, busayosesan99@yahoo.com Citation: Busayo, S. (2021). Effects of COVID-19 Pandemic on Community Health Services in Ilorin South Local Government Area of Kwara State, Nigeria. Academia Letters, Article 3335. https://doi.org/10.20935/AL3335. 7