144 Chapter 6 3.2.3 COVID hindered patients from accessing care With the uncertainty around COVID-19, most chronic care patients stopped visiting health facilities to avoid infection, hindering routine care, and increasing their risks of poor treatment outcomes. “… but they (patients) were afraid to come to the clinic because they thought they would contract COVID-19 from the facility” R5 “Patients were not coming to the clinic for monitoring and check-ups due to fear of contracting COVID, this led to other patients being severely attacked by TB and others had their DM escalated” R7 3.2.4 Patients defaulted due to the lockdown The respondents observed that some patients, besides not visiting the health facilities, stopped taking their medications while others could not be reached or contacted (Table 3). These losses to follow-up were, attributed to the different COVID-19 prevention measures and limited resources at some health facilities to provide alternative means of care such as home visits. 3.2.5 COVID impacted the quality of care Some of the COVID-19 infection prevention measures instituted at different health facilities may have impacted the quality of care provided by healthcare workers (Table 3). Limiting the services available, restricting the number of patients that are reviewed daily and increased time before accessing a service due to patient screening and triaging contributed to decreased quality of care. 3.2.6 Increased risk of infections in healthcare workers Respondents had reservations about interacting with patients as they were at an increased risk of infection with COVID-19. Some of their colleagues nonetheless got infected, reducing the number of staff available for patient care, and further impacting the quality of care negatively. “Sputum induction was stopped due to the pandemic since we were in fear of the exposure to COVID-19” R2 “We were afraid of the patients because we were afraid of contracting COVID-19 from them” R10 “One can also talk about the issue of human resources during COVID-19 since many of our staff were affected (infected) this affected the standard of care for patients” R19
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