Exploring the status of non-communicable disease care Nesstar Publisher Exploring the status of non-communicable disease care during the COVID-19 pandemic in 13 countries Exploringthestatusofnon-communicablediseasecare Nasheeta Peer Tshephang Mashiane Michel Oris Kibachio Joseph Mwangi Sugitha Sureshkumar Andre-Pascal Kengne Nesstar Publisher South Africa GroupA.NSDstat 9 3 Nesstar 200801 GroupC.NSDstat 26 93 Nesstar 200801 GroupD.NSDstat 79 38 Nesstar 200801 V1 9 A001,2021-12-20,Limpopo ,Female,1988-03-23,35,Black,9,Pharmacy Manager,Private sector,4,3,no_data,3,888,1,They allow doctors to write prescription for 12 months.,There was minimum contact between doctor and patient but patient had to come nd collect their medications at the pharmacy.,no_data,1,yes,1,2,888,3,COPD,2,888,1,no_data,1,no_data,2,888,1,2,3,Primary level,3,no_data,1,1,1,2,888,1,1,Prevention is better than cure.,3,We must always be ready for anything.,2,2,2,1,4,1,1,3,1,no_data,3,1,2,2,2,2,1,2,2,1,2,1,none 1 A002,2022-03-09,KwaZulu-Natal,Female,1992-05-03,31,Indian,10,Nursing Manager,Private sector,2,1,Delivery and collection of chronic medication during the pandemic was difficult however we have managed to communicate directly with public hospital pharmacies and get their full cooperation,3,888,3,888,888,888,3,yes,1,1,Chronic patients had to catch up on doctor visitors at hospital and routine checks up for everyone was back in play, postponed investigations had resumed. ,4,Cardiac, diabetes,hypertension and hyperlipidaemia,2,888,2,888,888,888,888,888,1,0,2,Tertiary level,2,no_data,no_data,1,2,2,888,2,1,A system needs to be put in place should for all public facilities and their patients perhaps local assistance per area can be arranged, unfortunately the effects of the pandemic has been too great, and we are still trying to make up for it . ,1,Our country and health minister has overlooked NCD as a whole, there has not been any consideration for proactive patient care in a crisis ,3,1,1,1,3,2,1,1,2,Depression, fear, over-worked,fatigue,1,1,1,3,3,3,1,3,4,1,1,2,888 1 A003,2022-03-10,KwaZulu-Natal,Female,1963-01-27,60,Indian,7,Nursing Manager,Private sector,2,2,Training were provided to heath care workers on the vaccination process and also to notify when there was a positive case with in our facilities. 1 A004,2022-03-25,KwaZulu-Natal,Female,1986-08-23,37,Indian,14,Nursing Manager,Private sector,4,2,Severe emergencies needng hospitalization.,3,888,2,888,888,888,3,yes,1,2,888,4,Delay of speciality scans,consultations booked with specialists cancelled,1,Many times when ambulance services were called out for emergencies like chest pains, CVA, Hperglycemia hospitals were full or not accepting cases. Patients were often left to wait for a day or two if sent to casuality. 1 A005,2022-04-12,KwaZulu-Natal,Female,1977-10-11,46,Indian,20,Pharmacy Manager,Private sector,4,1,no_data,3,888,3,888,888,888,3,no_data,2,1,no_data,3,no_data,2,888,3,888,888,888,888,888,888,888,3,no_data,3,120 beds, 6 wards and ward type is private.,1,1,2,2,888,1,1,no_data,2,no_data,3,2,3,2,4,1,1,1,1,no_data,1,1,1,1,1,1,1,1,1,2,3,1,none 1 1 Many patients were afraid to go to hospital and clinics to collect medication/see doctor for script renewals due to the fear of contacting Covid 19. Many elders defaulted on chronic medication due to this and the long waiting lines. 1 New protocols were in place to prevent the spread of COVID 19 among the Elders with in the homes. Visitation of family and friend to the home was stopped and staff were locked down in the facilities to protect the Elders. 1 Participant number,Date of interview ,Place of interview,Gender,Date of birth,Age ,Population group,Years working,Profession,Sector,A1,A1(a),A1(b),A1(c),A1(d),A1(e),A1(f),1(g),A1(h),A2,A2(a),A3,A3(a),A3(b),A4,A4(a),A4(b),A4(c),A5,A5(a),A5(b),A5(c),A5(d),A5(e),A5(f),A5(g),A6,A6(a),A6(b),A7,A8,A8(a),A9,A9(a),A9(1a),A9(b),A10,A10(a),A10(b),A10(c),A11,A11(b),A11(b),A11(c),A12,A12(a),A12(b),A12(c),A12(d),A13,A13(a),A13(a),A14,A14(a),A14 (b),A14(c),A15,A16,A17,A17(a),A17(b),A18,A18(a) 1 V2 1 ,2,888,888,888,888,888,1,2,3,Primary level,1,4 beds, type of ward is rooms.,2,1,1,2,888,1,1,Due to the vaccine and the symptoms experienced by most elders, when they go to get medical diagnosis and treatment they were told their symptoms could be due to the vaccine side effect.,1,The health care services should put plans in place to ensure the continuation of NCD care and treatment goes uninterrupted should we be faced to another infectious disease outbreak.,3,2,2,2,3,2,1,2,2,Exhaustion, menatl fatigue, depression, fear/anxiety,2,2,2,2,2,2,1,2,4,1,1,1,none 1 V3 1 ,1,no_data,3,888,888,888,3,yes,no_data,no_data,no_data,4,Cancelled routine appointments,2,888,3,888,888,888,888,888,888,888,1,Tertiary level,3,5 beds only,no_data,1,2,2,888,1,1,COVID had a big impact on the treating of other conditions. Health educations needs to be focused around the NCD conditions. ,3,Taking better care of one self, prevention of conditions, early detection and correct treatment and adherence to treatment. Those that had co morbidities the effect of COVID 19 were far worse.,4,1,1,2,4,2,2,2,1,Paranoid,3,3,3,2,2,2,2,888,4,1,2,1,none 1 V1 26 0 C001 1 C002 1 C003 1 C004 1 C005 1 C006 1 C007 1 C008 1 C009 1 C010 1 C011 1 C012 1 C013 1 C014 1 C015 1 C016 1 C017 1 C018 1 C019 1 C020 1 C021 1 C022 1 C023 1 C024 1 C025 1 Participant number 1 V2 26 0 2021-12-08 2 2022-01-03 1 2022-01-06 1 2022-02-03 1 2022-02-23 1 2022-03-17 1 2022-04-12 1 2022-05-09 1 2022-05-13 2 2022-05-19 2 2022-05-26 1 2022-05-28 1 2022-05-29 1 2022-05-30 1 2022-05-31 1 2022-06-06 1 2022-06-07 1 2022-06-08 1 2022-06-14 2 2022-06-17 1 2022-06-21 1 Date of interview 1 V3 26 0 Gauteng 12 KwaZulu-Natal 7 Mpumalanga 2 North West 1 Place of interview 1 Western Cape 3 V4 26 0 Female 20 Gender 1 Male 5 V5 26 0 1951-10-09 1 1967-04-01 1 1977-12-14 1 1979-07-26 1 1985-11-15 1 1986-05-17 1 1987-03-06 1 1989-09-17 1 1990-02-21 1 1990-06-13 1 1991-03-14 1 1991-04-11 1 1991-04-20 1 1992-05-24 1 1992-06-18 1 1993-06-12 1 1994-02-16 1 1997-04-21 1 1997-05-19 1 1997-09-17 1 1997-10-06 1 1998-02-27 1 1998-05-30 1 1998-07-01 1 1999-05-24 1 Date of birth 1 V6 26 0 24 1 25 3 26 4 29 1 30 1 31 2 32 3 33 2 34 1 36 1 37 1 38 1 44 1 46 1 56 1 72 1 Age 1 V7 26 0 Black 17 Indian 3 Population group 1 White 5 V8 26 0 1 1 1.4 1 1.5 2 1.8 2 11 1 13 1 14 1 16 1 2 3 20 1 3 1 32 1 4 1 46 1 5 3 6 1 8 2 8.6 1 Years working 1 V9 26 0 Dietician 5 Medical doctor 13 Nurse 2 Occupational therapist 1 Optometrist 1 Pharmacist 2 Physiotherapist 1 Profession 1 V10 26 0 Private sector 9 Public sector 16 Sector 1 V11 26 0 1 5 2 3 3 16 888 1 C1 1 V12 26 0 1 4 2 12 3 9 C1(a) 1 V13 26 C1(b) 1 Continue to see acute/unstable/urgent haematology and oncology patients without delay while protecting staff and patients by attempting to decrease exposure and crowding. 1 Emergency services: casualty and emergency theater. 1 Essential services included the healthcare workers,food manufacturers,policemen,fire fighters,soldiers. 1 I am not in the state sector, but it was very difficult for routine services to continue although there were attempts at zoom/telemedicine. 1 I don’t know. 1 Inpatient care, emergency outpatient reviews and emergency surgery continued. 1 Medical services (hospitals, clinics,private practices), convenience stores,transport indutsry (mainly taxi and bus services). 1 Most hospitals and clinics in South Africa have outpatient department which are chronic disease clinics that operate during the weekday. 1 1 None 1 None I'm aware of. 1 Ongoing dialysis and cancer care. Continued accessibility to NCD clinics and wards. 1 Surgeons,physicians,nurses,physiotherapists, resources such as ventilators and ICU drugs. 1 The WCDH utilised CHW to deliver NCD medication for patients attending chronic club at community health centres (for DM,dyslipidemia,HTN etc., not sure about other NCDs like cancer. NCD care really suffered as a result of the COVID pandemic in my opinion. 1 The government initiated a lock down. 1 The hospitals were still open and accessible for people with NCD. 2 To ensure that there was progress in terms of managing patient conditions in relation to the holistic advice given, such as checking anthropometric measurements, blood tests and dietary advice. 1 Unsure 1 Unsure,many diabetic patients did not have their regular checkups 1 no_data 5 V14 26 0 1 2 2 13 3 10 C1(c) 1 V15 26 888 23 C1(d) 1 For infectious diseases the protocols were more well understood and followed. Better triaging in mass casualty situation. 1 Staff was redistributed to key acute care areas to deal with added burden of acutedly sick COVD-19 patients. 1 V16 26 0 1 8 2 9 3 8 C1(e) 1 V17 26 888 17 At the hospital were I work, if a patient was well controlled on their chronic medication, they were given repeat scripts as opposed to being seen monthly. Therefore, some where only seen after 6 months. Please note: (they work together hence the same responses) 1 At the hospital were I work, if a patient was well controlled on their chronic medication, they were given repeat scripts as opposed to being seen monthly. Therefore, some where only seen after 6 months.Please note: (they work together hence the same responses) 1 C1(f) 1 COVID positive patients were given priority. 1 Cancellation of elective surgeries, division of our physiotherapy team 3 1/4 for COVID-19,1/4 for the rest of diseases. 1 Patients suffering from NCDs were given medication for 3-6 months and were encouraged to stay indoors unless they experience an emergency that requires medical attention. 1 People would only be allowed for follow-up at local clinic. Hospital outpatient departments were closed and only available were emergency services. Reallocation of staff. 1 Some wards treating NCD patients were temporaliry closed to cater for COVID-19 patients. 1 no_data 1 V18 26 888 17 C1(g) 1 Chronic scripts could last for up to 12 months. 1 Good: chronic but stable patients still had follow-up outpatient visits. 1 I don’t think that it was due to delays in communication. 1 I don’t think that it was very success. 1 1 1 It was successful cause even though some wards were closed, there was clear information given to patients on where to access urgent/emergency care. 1 Not very successful, a lot of patients defaulted treatment as a result. 1 V19 26 0 1 1 2 22 888 2 C2 1 V20 26 0 888 24 C2(a) 1 Some public patients were allowed to get their chronic medication from private hospitals/pharmacies. 1 V21 26 0 1 1 2 3 3 16 4 4 C3 1 no_data 1 V22 26 0 C3(a) 1 No 5 Yes 19 no_data 1 V23 26 0 2 1 3 12 4 8 C4 1 no_data 4 V24 26 0 C4(a) 1 No 5 Yes 19 no_data 1 V25 26 0 Adequate 16 C4(b) 1 Inadequate 7 no_data 2 V26 25 888 16 C4(c) 1 Inadequate face mask, not always enough PPE. 1 Masks were limited in the beginning (1 mask per week) it was changed a few weeks into the pandemic to 1 mask a day. No overshoes were given. Visors were of poor quality(impaired vision after a couple of washes) resulting in one buying their own visors. Hand sanitizer bottles were used to refill new sanitizer. enough sanitizers. 1 Most PPE were provided but in some areas (depending on the hospital), we needed to use the same masks as there was shortages, or sometimes certain PPE were unavailable such as shoe covers or hairnets. 1 Needed to re-use masks and no shoe covers. 1 The only thing that was provided is a face mask that I had to wash and resuse, and sanitizers. There were no shoe covers or protective gowns given the nature of the environment and the number of patients these were essential. 1 no_data 3 V27 26 0 1 21 C5 1 no_data 4 V28 26 0 1 8 2 17 C5(a) 1 V29 26 888 17 C5(b) 1 Fortunately where I was working, we prioritized patients who had COVID-19 to provide the best effective treatment. The change that will occur once COVID-19 has calm down will be that we will be seeing more patients with NCD that may have not been managed so well during the period of COVID-19 waves. 1 Hospitals units gradually had less covid cases in the units, at a point only 1 funcioning COVID unit. Leaving other units to focus on new covid patients with medical needs. 1 1 1 Once the situation improved our outpatient services ran at full capacity and our surgical cases resumed firstly doing the semi-elective cases then progressing to the purely elective cases. 1 Wards were turned back to either PUI or normal wards. 1 1 no_data 1 V30 26 0 1 2 2 3 3 12 4 8 C6 1 V31 26 All chronic clinic followups and elective surgeries 1 C6(a) 1 COPD 1 Cancelled elective surgeries 1 Cancer,diabetes and hypertension 1 Diabetes 3 Diabetes and cardiovascular diseases 1 Diabetes and hypertension 1 Diabetes, COPD and small amount of cardiovascular 1 Diabetes,cancer and hypertension 1 1 Dialysis service and CT scans 1 Elective surgical cases 1 Emergency cases and no beds vailable in hospital and patients dying while awaiting transfer. Oncology cases not being able to come for their appointments. Cancellation of elective surgery 1 Hypertension and diabetes 1 Hypertension, diabetes, epilepsy,COPD and autoimmune diseases 2 Hypertension,diabetes and metabolic syndrome 1 It would be cancer patients but mostly all patients were affected including more elective operation 1 Most patients who were supposed to go for elective surgeries were postponed 1 Not sure 1 Orthopaedic surgical cases and cardiac cases 1 Renal failure patients and transplant services completely stopped 1 We stopped all transplantation during COVID 1 V32 26 0 1 11 2 14 C6(b) 1 V33 26 888 14 1 All organ transplant were stopped which had severe consequences for the patients and services/the availability of dialysis slots. 1 C6(c) 1 Cessation of all transplants during COVID. 1 Collecting of chronic medication especially in the public sector. 1 1 Elective surgical patients had to be cancelled/postponed. 1 Follow-ups for wound care for example was very difficult. 1 Lack of transport to bring our outpatients from the peripheral hospitals.Cancellation of elective surgery. 1 Multiple cancellations of elective cases, complications of surgical conditions while awaiting resumption of elective surgery. 1 The risk of COVID-19 infection is patients receiving chemotherapy. 1 Travel, worried about COVID transmission. 1 V34 26 Acquire more machines for dialysis. Open up more dialysis centres in rural/perurban areas. 1 An accessible online platform must be in place to accommodate the patients during times of isolation. Health and safety standard should always be in place to ensure that during crisis it is safe to see patients. 1 C7 1 Consulting rooms would have to have different examination rooms and maybe entrances for acute communicable diseases. 1 Give prior education to patients to look out for early signs and symptoms. Have more regular check-ups so there is no sudden emergency. Outpatient rehabilitation programmes to manage the condition. 1 1 I am not sure as I am resigning from the public health system. 1 It would be to equip local clinics better in order to handle the burden handed over them. 1 1 No plan. 1 1 Regular follow-ups even if it is a clinic level to relieve on the burden on hospitals. 2 Telehealth where feasibe. 1 Telemedicine is an option. Allowing patients to pick up medications at private institutions or pharmacies may have also help ensure patient compliance. 1 There are no documented plans. 1 There should be more staff hired instead of overworking same people because this leads to descrepencies. There should be a budget dedicated to that disaster because working with a bear minimum of equipment starins the most. 1 To ensure that there is sufficient patient contact information so that in crises where the patient is not able to come to us, that we are able to contact or get hold of the patient. Although there can sometimes be limited space to see patients(smaller hospital),a backup plan can be considered in terms of alternative consultation areas should there be a need for social distancing or isolation of patients. 1 no_data 7 ongoing use of telemedicine/zoom. 1 V35 26 Agility. 1 C7(a) 1 Continue with vaccinations. 1 Decentralisation of care is essential to clinics,rural areas. Train more non-medial personel like nurses to deliver renal services. 1 Different access and consultation. 1 Elective surgery should not be disrupted for conditions that have potential of complications. 1 Financial back-up. 1 I think nothing because most systems fell apart and patients did receive their medication but lacked adequate care. 1 Nothing that I know of these services were also disrupted and neglected during the pandemic. 1 Patient education, healthcare worker raining regarding the pandemic and patient care and better execution preventative and management strategies. 1 Patients had booked dates to have check-ups, this helps with overcrowding. 1 The EPI vacination program worked well despite the pandemic. 1 To continue but with enough Covid protocol in place. 1 1 Unsure 2 Ventilators would be borrowed from hospitals with less covid patients to those in the hotspot areas of covid. 1 Zoom/telemedicine service. 1 how certain services may have been proactive in preparing for future crisis. 1 no_data 7 V36 26 1 C8 1 Chronic patients can access health-care advise and symptom management online. 1 Dietary counselling sessions and follow-ups. 1 Digital health could be used to conduct tele-consultations particularly for patients who are unable to present due to reasons such as disability, to the health facility or are COVID-19+. I believe this will assist patients greatly. 1 Doing consultations online, especially for stable chronic patients to prevent them from coming to the clinics unnecessarily e.g for scripts renewals. 1 Follow-ups can be done through online consultations. 1 For established patients, patients on chronic medication, patients with non-complicated conditions. 1 It would be to write scripts for patients that have access to internet or to employ more HCW in the community that can move home to home. 1 Keeping records of PPE to make sure sufficient stock is in the wards/departments so that staff and patients are protected. Being able to keep track of which hospitals/areas have more than sufficient stock of PPEs and share to ensure there is sufficient PPE for everyone to use when dealing with COVID-19 patients. 1 Local clinics,access to wifi. 1 Make telephonic consults more fissible. Be able to/monitor treatment sessions like dialysis offside. 1 Many patients attending CHCs for NCD care are older and from disadvantaged communities and do not have smart phones s perhaps telemedicine along with digital. But my views are form personal experience. More research can be done here in Soutrh African Public Health context. 1 Mobile platforms. 1 No, vulnerable patients do not have access to technology. 1 Not too sure as Zoom is already a viable and useful alternative. Not sure we have need of any further "eHealth" services 1 Outpatient department; initial telehealth consult to determine severity and whether in patient assessment is required, adjusting medicatins or add additional medications where needed and continuation of follow-up care. 1 Patients who don’t require to go to the hospital all the time for minor follow ups such as results or blood test interpretations can be telephonically or online to limit in traffic hospital. 1 This can be intergrated anywhere in the infrustracture from early detection to disposal of medicines. 2 To call or chat to a doctor from ehealth to know if hospital visit is necessary or a condition or problem can be treated online via script renewal. 1 Very limited application given in our setting,public patients don’t hve routine access to digital platforms. 1 Yes. 1 for outpatients and emergency consults to be able to advise on patient management at the peripheral hospitals. 1 no_data 2 V37 26 0 1 9 2 16 C8(a) 1 V38 26 0 1 14 2 3 3 8 C8(b) 1 V39 26 20 beds,2 wards, ICU ward 1 20 beds,2 wards, quarantine ward 1 20 beds,2 wards, ward and ICU 1 30 beds,3 wards,COVId-19 ward 1 36 beds for adults and ±10 beds for peadiatrics, 1 ward, general ward 1 40 beds,4 wards, wards were divided into patients under investigation;COVID-19 positive high care;COVID-19 positive continuing care 1 60 beds,2 wards, highcare ward 1 1 >30 beds,1 ward, ward 1 1 C9 1 I don’t know 1 Many, exact numbers not known 1 No extensive beds. 1 Not sure 1 Not sure of the number of beds,17 wards, 1 theathre and COVID-19 ward, ICU 1 1 1 no _data for number of beds and ward type. Number of wards is 3 1 no_data 5 ±60 beds, 2 wards, general 1 ±60 beds, 2wards,general 1 V40 26 0 1 20 2 5 C10 1 V41 26 0 1 and half year 1 1 year 1 1 year 10 months. 1 12 months 1 15 months 1 2 months 2 2 year 1 2 years 2 2020-2021 December 1 2020-2022 1 3 months 1 6 months 1 888 5 9 months 1 C10 (a) 1 Few times during the last 5 months 1 From start of pandemic till date 1 The entire pandemic 1 Throughout to various degrees 1 ±3 months 1 V42 26 0 1 7 2 8 3 5 888 5 C10(1b) 1 V43 26 0 1 4 2 10 3 6 888 5 C10(2b) 1 V44 26 0 2 9 3 11 888 5 C10(3b) 1 V45 26 0 1 5 2 12 3 3 888 5 C10(4b) 1 V46 26 0 1 15 2 9 C11 1 no_data 1 V47 26 0 1 18 2 6 C12 1 no_data 1 V48 26 0 1 21 2 3 C12(a) 1 no_data 1 V49 26 0 1 14 2 10 C12(b) 1 no_data 1 V50 26 0 1 9 2 15 C12(c) 1 no_data 1 V51 26 1 day; Washinng hands techniques, social distancing, what COVID is and how it spreads. 1 1 30 minutes to an hour; Triage of suspected covid cases, care patients on high flow and ventilator,incubation and covid documentation. 1 888 16 < 1 hour or more per topic 1 C12(d) 1 Ongoing lessons for 6 months; Infection control and management of urinalysis and its complication. 1 1 Unsure 1 Unsure; Use of PPE,sanitizing,hygiene and safety. 1 Weekly; Covid updates and protocols and best medical management/ coping mechanisms, new medical research. 1 V52 26 0 1 6 2 2 888 16 C12(e) 1 no_data 1 V53 26 0 1 8 2 2 3 15 C12(f) 1 V54 26 0 1 7 2 10 3 8 C12(g) 1 V55 26 0 1 22 2 1 3 2 C12(h) 1 V56 26 0 1 22 2 1 3 2 C13 1 V57 26 C13(a) 1 Due to the pandemic, many patients have been unable to or have been hesitant to come to hospitals/clinics for follow-ups on their disease or condition. This resulted in mismanagement as it is difficult to monitor and pick up problems earliers on in a patients care. This is detrimental to some patients as regular monitoring is important to make sure they are managing their conditions effectively to prevent relapses (egg malnutrition in paediatrics/adults, cancer patients,uncontrolled diabetes/hypertension/other chronic diseases of lifestyle. 1 Hopefully health systems will be more prepared is a similar situation arises in the future, because I believe quite a bit of damage was done to patients themselves and to continuity of care. 1 I think NCD care should not be compromised regardless of pandemic as poor NCD care may worsen the pandmeic outcomes. 1 I think our healthcare system will never learn from its mistakes. 1 I think that this pandemic shwoed/warned us about the risk that policies during a epidemic/pandemic pose to care continously of NCD,perventative medicine and non-essential care. 1 I think the pandemic may have played a role in highliting how broken our helath care system is. I hope it has prompted the development of better strategies to deal with crisis in the health system for future pandemics. 1 I think we are better equiped and knowlageable with the pandemic and can improve on the quality of care and management we render to NCD patients. Yes, when the pandemic started NCD patients were somewhat "neglected" because all attention was given to this new deadly disease (Covid-19). Now we know and have seen better. 1 It has changed patient health seeking behaivour, more patients will be presenting with more complex conditions. 1 Less time with doctors and allied staff to educate,answer questions,arrange follow-up consult. 1 Most NCD follow-up and cases have resumed back to normal, so shouldn’t have much of an impact further. 1 NCD care will further be neglected. 1 Once the frenzy of the pandemic had died down and more people have received their vaccines. As healthcare providers we can place more focus on patients suffering from NCDs. Patients can go back to getting holistic medical services/management. 1 Pandemic highlighted the need to improve and strenghten preventative measures for NCDs. 1 Prioritize health literacy to encourage compliance and adherence to treatment. 1 Proper measures and adequate guidelines needs to be shared to everyone. 1 Should there be future lockdown. 1 Taking into consideration all the funds contributed in the pandemic, the suffering from shortage of medicines for the treatment of NCD patients will worsen. Some patient symptoms have worsen and this progression requires more care. 1 The notion that if people present to hospitals they will contract covid 19 needs to be addressed with the public and removed so that people are not afraid to present themselves for follow-ups and for queries. 2 There needs to be considering pf patients with NCD especially when there is national/global crisis is to ensure adequate care for these types of patients and reduce risk of getting any communicable disease. 1 There will be more NCD complications as most people with NCDs were not properly follwed-up during the pandemic. 1 We have definitely learnt a lot from the pandemic 1 although it has been a very difficult time, it seems to me that services have more or less returned to normal 1 no_data 2 V58 26 0 1 23 2 1 3 1 C14 1 V59 26 0 1 14 2 6 3 5 C15 1 V60 26 0 1 12 2 13 C15(a) 1 V61 26 888 13 Better planning and preparation for any circumstance that could result in national state of disaster but this would require government to allocate the necessary funds to allow adequate staff employment to continue caring for the NCD patients during these periods. 1 C15(1a) 1 Digital access. 1 Early referral of sick ptients to ensure adequate care and quick recovery in diseases which are curable, as well as continous management of important conditions where possible to ensure sufficient nutrition support. 1 Elective surgery should continue, prioritizing cases with potential complication first, we had empty surgical wards and theatre that were never used for COVID-19 patients and delayed surgery unnecessarily. 1 Equiped local clinics better. 1 Facilities that could care for critical covid cases could have continued to manage the health of th patients with NCDs,ensuring that patients were well traced and managing their treatment well. 1 Hiring some staff to be able to take care of all patients holistically. Covid-19 compromised staffing a lot and that led to wards with patients who had no Covid receiving less attention than patients in Covid wards. 1 Incorporate NCD-related objectives to pandemic preparedness plans and ensure sufficient human resources to prevent existing staff from being redirected leaving their core duties unattended too. 1 It is unfortunatley the case that infectious conditions will always need to be isolated by their very nature. Hence I would support increasing use of telemedicine/digital platforms. 1 Set up contingency plans and deliberate carefully before classifying NCD care as non-essential especially in the public sector where patients don’t necessarily have other avenues to attain care. 1 1 Use the media to educate patients. Health education will improve patient compliance and co-operation. 1 V62 26 0 1 5 2 16 3 4 C16 1 V63 26 888 20 C16(b) 1 Care in the institution was not compromised, however care at primary health and community base was. Programme coordinators and community health workers were redirected to COVID-19 services,neglecting their duties relating to child care. 1 Due to cancelation of elective cases. 1 Isolation of children who have COVID contact resulted with delayed interventions. 1 Services usually conducted at schools (eye care and vaccination drives as examples) and organised by the school nurses were halted because kids were learning from home/not attending school. 1 we had to cancel elective surgical procedures due to the COVID pandemic. Theatre booking lists are now very long. 1 V64 26 0 1 1 2 3 3 14 4 7 C17 1 V65 26 0 1 7 2 16 3 2 C17(a) 1 V66 26 0 1 8 2 13 3 4 C17(b) 1 V67 26 0 1 3 2 17 3 5 C17(c) 1 V68 26 0 1 6 2 14 3 5 C17(d) 1 V69 26 0 1 16 2 9 C18 1 V70 26 0 1 16 2 9 C19 1 V71 26 0 1 12 2 5 3 8 C20 1 V72 26 0 1 3 2 8 3 14 C20(a) 1 V73 26 0 1 13 2 12 C20(b) 1 V74 26 0 1 10 2 15 C20(c) 1 V75 26 0 2 6 3 12 4 7 C21 1 V76 26 0 1 11 2 13 3 1 C21(a) 1 V77 26 0 1 2 2 13 3 10 C22 1 V78 26 0 2 14 3 11 C22(a) 1 V79 26 0 2 14 3 11 C22(b) 1 V80 26 0 1 6 2 9 3 10 C22(c) 1 V81 26 0 2 17 3 8 C23 1 V82 26 0 1 20 2 5 C23(a) 1 V83 26 0 1 17 2 6 3 2 C24 1 V84 26 0 1 6 2 11 3 8 C24(a) 1 V85 26 0 1 19 2 6 C25 1 V86 26 0 2 4 4 14 888 5 C26 1 no_data 2 V87 26 0 1 1 2 8 3 7 4 3 C27 1 no_data 6 V88 26 0 1 15 2 2 3 8 C27(a) 1 V89 26 0 1 4 2 11 3 10 C27(b) 1 V90 26 0 1 4 2 14 C27(c) 1 no_data 7 V91 26 0 1 3 2 1 888 21 C27(d) 1 V92 26 0 C28 1 No 2 Yes 23 V93 26 888 2 C28(a) 1 No 3 No, you may quote any of my answers. 1 None 8 Please avoid my name, contact details and DOB. 1 Responses related to health facilities as I have never worked in hospital so some of the information provided is based of what I experienced working in a telemedical facility. 1 This study is a neccesary back look at how things were handled and a good reflection tool. 1 You can quote any responses, however if I could please remain anonymous. (I work at a government hospital). Thank you. 2 none 6 Participant number 79 0 D001 1 D002 1 D003 1 D004 1 D005 1 D006 1 D007 1 D008 1 D009 1 D010 1 D011 1 D012 1 D013 1 D014 1 D015 1 D016 1 D017 1 D018 1 D019 1 D020 1 D021 1 D022 1 D023 1 D024 1 D025 1 D026 1 D027 1 D028 1 D029 1 D030 1 D031 1 D032 1 D033 1 D034 1 D035 1 D036 1 D037 1 D038 1 D039 1 D040 1 D041 1 D042 1 D043 1 D044 1 D045 1 D046 1 D047 1 D048 1 D049 1 D050 1 D051 1 D052 1 D053 1 D054 1 D055 1 D056 1 D057 1 D058 1 D059 1 D060 1 D061 1 D062 1 D063 1 D064 1 D065 1 D066 1 D067 1 D068 1 D069 1 D070 1 D071 1 D072 1 D073 1 D074 1 D075 1 D076 1 D077 1 D078 1 D079 1 Date of interview 79 0 2021-11-03 1 2021-11-04 1 2021-11-25 1 2021-11-26 3 2021-11-29 2 2021-12-08 1 2021-12-14 1 2021-12-20 1 2022-01-13 1 2022-01-18 1 2022-01-19 1 2022-01-25 1 2022-01-27 1 2022-01-28 1 2022-02-03 1 2022-02-07 1 2022-02-16 1 2022-02-17 1 2022-02-24 1 2022-03-01 12 2022-03-10 5 2022-03-11 2 2022-03-12 1 2022-03-13 2 2022-03-14 2 2022-03-15 7 2022-03-23 1 2022-04-01 1 2022-04-06 1 2022-05-04 2 2022-05-09 4 2022-05-10 1 2022-05-11 1 2022-06-09 14 2022-12-05 1 Place of interview 79 0 Gauteng 9 KwaZulu-Natal 2 Limpopo 2 Western Cape 66 Gender 79 0 Female 62 Femle 2 Male 15 Date of birth 79 0 1932-07-11 1 1935-09-02 1 1936-09-07 1 1937-02-16 1 1937-04-25 1 1937-12-26 1 1941-09-15 1 1943-09-12 1 1944-07-17 1 1944-10-06 1 1945-10-29 1 1946-05-10 1 1946-07-20 1 1947-08-28 1 1947-09-02 1 1948-12-01 1 1949-01-24 1 1949-08-22 1 1949-12-18 1 1950-04-15 1 1950-07-21 1 1950-09-16 1 1950-10-13 1 1950-10-24 1 1950-12-21 1 1950-12-28 1 1951-03-10 1 1951-10-03 1 1951-11-01 1 1952-01-28 1 1952-06-13 1 1952-10-10 1 1952-12-25 1 1953-06-06 1 1954-01-01 1 1954-03-15 1 1954-07-23 1 1955-07-13 1 1955-08-17 1 1955-10-27 1 1955-11-15 1 1956-01-16 1 1956-03-22 1 1956-05-12 1 1957-02-15 1 1957-03-14 1 1957-05-16 1 1957-10-26 1 1957-12-26 1 1958-01-24 1 1958-02-06 1 1958-06-07 1 1958-10-18 1 1959-03-17 1 1959-05-20 1 1959-05-29 1 1959-06-22 1 1959-09-09 1 1959-11-02 1 1960-10-28 1 1961-02-14 1 1961-06-13 1 1961-10-07 1 1962-01-07 1 1962-07-16 1 1963-01-11 1 1964-03-06 1 1965-02-07 1 1966-01-01 1 1966-03-25 1 1969-01-11 1 1970-01-01 1 1974-05-28 1 1981-02-04 1 1981-04-30 1 1982-01-23 1 1989-09-07 1 1990-06-14 1 1996-12-18 1 Age 79 0 27 91 67.127 12.032 Population group 79 0 Black 27 Coloured 52 D1 79 0 1 36 2 24 3 14 4 5 D2 79 0 1 18 2 21 3 40 D2(a) 79 0 1 14 2 65 D2(b) 79 0 888 65 Four times 2 Once 7 Three times 1 Twice 4 D2(c) 79 0 1 5 2 8 3 66 D3 79 0 1 62 2 10 3 7 D4 79 0 1 15 2 57 3 7 D5 79 0 1 23 2 7 3 9 4 40 D5(a) 79 0 1 6 2 32 3 41 D5(b) 79 0 0 2 1 3 3 74 D5(c) 79 0 1 15 2 21 3 43 D5(d) 79 0 1 34 2 39 3 6 D5(e) 79 0 1 24 2 45 3 10 D6 79 0 1 35 2 32 3 12 D7 79 0 1 14 2 57 3 8 D7(a) 79 0 1 12 2 59 3 8 D5(f) 79 0 1 15 2 21 3 43 D5(g) 79 0 1 34 2 39 3 6 D7(h) 79 0 1 20 2 51 3 8 D8 79 0 1 34 2 39 3 6 D8(a) 79 0 1 23 2 43 3 13 D8(b) 79 0 1 51 2 19 3 9 D9 79 0 1 2 2 23 3 54 D9(a) 79 0 1 3 2 8 3 14 4 54 D9(b) 79 0 888 68 All alone with no visitors 1 Alot of customers 1 Different working environment 1 Less staff available 1 Not working during the pandemic 1 Pensioner 2 Retired 3 Retired, more tasks at home 1 D10 79 0 1 26 2 43 3 10 D10(a) 79 0 0 888 596 419.566 D10(b) 79 0 1 888 663.468 388.11 D10(c) 79 0 1 45 2 5 3 29 D11 79 0 Anxiety/panic disorder, migraine headaches 1 Asthma, high cholesterol,athritis 1 Asthma, hypertension,heart attack,high cholesterol,diabetes,athritis 1 Asthma,hypertension,diabetes 1 Asthma,hypertension,heart attack,stroke,high cholesterol,athritis,diabetes 1 Athritis 1 Cancer 1 Diabetes 5 Diabetes,asthma 1 Diabetes,athritis 2 Epilepsy 1 Heart attack 1 High cholesterol 1 High cholesterol,depression 1 High cholesterol,diabetes,athritis 1 High cholesterol,diabetes,depression,athritis 1 High cholesteroldiabetes 1 Hypertension 17 Hypertension, high cholesterol,diabetes 1 Hypertension,asthma 1 Hypertension,asthma,high cholesterol,athritis 1 Hypertension,athritis 6 Hypertension,athritis,stroke 1 Hypertension,depressin,athritis 1 Hypertension,diabetes 9 Hypertension,diabetes,asthma 1 Hypertension,diabetes,athritis 1 Hypertension,diabetes,high cholesterol,athritis 1 Hypertension,heart attack,high cholesterol 1 Hypertension,heart attack,high cholesterol,athritis 1 Hypertension,heart attack,stroke 1 Hypertension,high cholesterol 1 Hypertension,high cholesterol,athritis 1 Hypertension,high cholesterol,diabetes 8 Hypertension,high cholesterol,diabetes,depression 1 Hypertension,high cholesterol,diabetes,depression,athritis 1 Hypertension,stroke,high cholesterol 1 Systemic lupus erythematosus (SLE) 1 D12 79 0 Both 3 Private sector 12 Public sector 64