Impact of Covid-19 on access to paediatric surgery in Teso sub-region, Eastern Uganda

Abstract The COVID-19 pandemic posed a significant threat to healthcare systems worldwide. Efforts to contain the pandemic, including lock-down and cancellation of elective surgery, increased barriers to healthcare. Its impact on the access to surgical care of children in less resourced contexts is not known. This study investigated how paediatric surgical services was affected during the pandemic in the Teso sub-region in Eastern Uganda. Data were collected from theatre logbooks about surgical activity before and during the pandemic (2019–2021). Data about health workers’ and parents’ experience of how access to surgical service for children was affected during the Covid-19 pandemic were collected through interviews. Total surgical procedures for children increased by 24% between 2019 (n = 1407) and 2021 (n = 1751). Procedures performed for pregnancy-related conditions increased most (58.3% increment). 12 parents and 25 health workers participated in the interviews. Using reflexive thematic analysis, two themes emerged. A reduction of surgical service delivery was expected as barriers to surgical care increased in several ways. However, the number of surgical procedures performed increased compared to before the pandemic. Many lessons were learned, and health care system was reinforced. This is an important momentum for building a resilient health care system for future challenges.