Evidence mapPaperPMID 40923592Full record

ArticleJournal of primary care & community health

Social Determinants Influencing Access to Home Delivery of Medication During the COVID-19 Pandemic for Cape Town Residents Living With Type 2 Diabetes.

Klaus B von Pressentin, Omotayo S Alaofin, Graham Bresick, Neal David, Hayli Geffen, Natasha Moodaley, James Porter, Haniem Salie, Leigh Wagner, Robert J Mash

Abstract read
In one paragraph

Article in Journal of primary care & community health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Klaus B von PressentinDivision of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, South Africa.ORCID 0000-0001-5965-9721
Omotayo S AlaofinDivision of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, South Africa.
Graham BresickDivision of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, South Africa.ORCID 0000-0001-8512-9329
Neal DavidDivision of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, South Africa.
Hayli GeffenDivision of Family Medicine and Primary Care, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.ORCID 0009-0009-0147-464X
Natasha MoodaleyDivision of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, South Africa.ORCID 0000-0001-6450-6631
James PorterDivision of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, South Africa.ORCID 0000-0003-4476-5323
Haniem SalieDivision of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, South Africa.
Leigh WagnerDivision of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Cape Town, South Africa.
Robert J MashDivision of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Cape Town, South Africa.ORCID 0000-0001-7373-0774

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe COVID-19 pandemic disrupted routine healthcare services, disproportionately affecting people living 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. This study aimed to evaluate the association between socioeconomic factors and access to HDM among T2D patients in Cape Town, South Africa, during the pandemic, with a focus on equity and health system responsiveness.

methodsA descriptive cross-sectional survey was conducted via telephone interviews with 267 patients receiving care at 4 public primary care facilities. Sociodemographic, economic, and treatment-related variables were collected. Fisher's exact test and multivariable logistic regression were used to assess the associations between these variables and access to HDM.

resultsLanguage, 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.

conclusionWhile HDM was a valuable innovation during the pandemic, its uneven reach highlights the persistence of health inequities. Language, social support, and geographic location emerged as key barriers. These findings underscore the need for inclusive, community-informed service design and the critical role of CHWs in delivering equitable, person-centred care. Future interventions should prioritise co-design with communities and address structural barriers to ensure equitable access to healthcare during crises and beyond.

Indexed as

COVID-19Diabetes Mellitus, Type 2Health Services AccessibilityHome Care ServicesSocial Determinants of HealthAdultAgedCross-Sectional StudiesFemaleHumansMaleMiddle AgedSARS-CoV-2Socioeconomic FactorsSouth Africacommunity health workersCOVID-19health equityhome delivery of medicationprimary healthcareSouth Africatype 2 diabetes

Identifiers

PMID40923592
PMCPMC12420979

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.