COVID-19 Pandemic Disrupts Healthcare for People Living with Chronic Conditions

Strategic Insights -

The COVID-19 pandemic has caused significant disruptions to routine healthcare services, particularly for individuals with chronic conditions such as type 2 diabetes (T2D). In response, the Western Cape Government Health implemented home delivery of medication (HDM) via community health workers (CHWs) to maintain continuity of care. A recent study from the University of Cape Town aimed to evaluate the association between socioeconomic factors and access to HDM among T2D patients in Cape Town, South Africa, during the pandemic.

Key Takeaways:

  • The COVID-19 pandemic disproportionately affected people living with chronic conditions, including type 2 diabetes (T2D).
  • The Western Cape Government Health implemented home delivery of medication (HDM) via community health workers (CHWs) to maintain continuity of care.
  • The study found that language, marital status, employment, access to piped water, distance from the clinic, and duration of diabetes were significantly associated with access to HDM.
  • IsiXhosa-speaking and unmarried participants were less likely to receive HDM, while unemployed individuals and those with longer diabetes duration were more likely to benefit.
  • Geographic and infrastructural barriers further limited access, suggesting that HDM implementation may have inadvertently excluded vulnerable groups.
  • The study concluded that language, social support, and geographic location emerged as key barriers to access to healthcare during the pandemic.
  • The research underscores the need for inclusive, community-informed service design and the critical role of CHWs in delivering equitable, person-centred care.
  • The study's findings highlight the importance of addressing structural barriers to ensure equitable access to healthcare during crises and beyond.

Statistics:

  • 267 patients receiving care at 4 public primary care facilities participated in the study.
  • The study found that 43% of participants who spoke IsiXhosa as their primary language did not access HDM, compared to 26% of English-speaking participants.
  • 55% of unmarried participants did not access HDM, compared to 38% of married participants.
  • 61% of unemployed individuals accessed HDM, compared to 45% of those with employment.
  • 65% of participants with shorter diabetes duration (less than 5 years) accessed HDM, compared to 42% of those with longer diabetes duration (more than 10 years).

Sources:

  • Social Determinants Influencing Access to Home Delivery of Medication During the COVID-19 Pandemic for Cape Town Residents Living With Type 2 Diabetes. Journal of Primary Care & Community Health, 2025,16.
  • https://doi.org/10.1177/21501319251371807