Several studies have reported adverse consequences of the COVID-19 lockdowns on the utilization of healthcare services across Africa. However, little is known about the channels through which lockdowns impacted healthcare utilization. This study focuses on unaffordability as a reason for not utilizing healthcare services. We estimate the causal impacts of the COVID-19 lockdown on healthcare inaccessibility and affordability in Uganda relative to the nonlockdown periods of the pandemic. We use nationally representative longitudinal household data and a household fixed-effects model to identify the impact of the lockdown on whether households could not access medical treatment and whether the reason for not getting care was the lack of money. We find that the lockdown in Uganda was associated with an 8.4% higher likelihood of respondents being unable to access healthcare when treatment was needed relative to the nonlockdown periods. This implies a 122% increase in the share of respondents unable to access healthcare. As lockdown restrictions eased, the likelihood of being unable to access medical treatment decreased. The main reason for the increase in inaccessibility was the lack of money, with a 71% increase in the likelihood of respondents being unable to afford treatment. We find little evidence that the effects of the lockdown differed by wealth status or area of residence. Our results indicate the need for policymakers to consider immediate social support for households as a strategy for balancing the disruptions caused by lockdowns.

Bose, Bijetri, Shamma A. Alam, and Claus C. Pörtner. Impacts of the COVID-19 Lockdown on Healthcare Inaccessibility and Unaffordablity in Uganda. The American Journal of Tropical Medicine and Hygiene 109, no. 3 (2023): 527–535. https://www.ajtmh.org/view/journals/tpmd/109/3/article-p527.xml?rskey=p7VaZX&result=1&tab_body=abstract

Copyright © 2023 The author(s)

This is an Open Access article distributed under the terms of the
Creative Commons Attribution (CC-BY) License, https://creativecommons.org/licenses/by/4.0/, which permits
unrestricted use, distribution, and reproduction in any medium, pro-
vided the original author and source are credited

Shamma Alam is a professor of International Studies at Dickinson College.

This published version is made available on Dickinson Scholar with the permission of the publisher. For more information on the published version, visit The American Journal of Tropical Medicine and Hygiene's Website. https://www.ajtmh.org/view/journals/tpmd/109/3/article-p527.xml?rskey=p7VaZX&result=1&tab_body=abstract

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