ArticleJournal of public health in Africa2025
Enhancing awareness and uptake of home-based care services during the coronavirus disease 2019 pandemic in Zambia.
Article in Journal of public health in Africa, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The COVID-19 pandemic placed pressure on health systems, exposing workforce shortages and prompting innovative strategies to manage patients with mild to moderate symptoms. Home-based care emerged as a practical approach to reduce facility burden while maintaining quality care. Aim: To assess the implementation and acceptability of the COVID-19 home management model in Zambia. Setting: The study was conducted in 11 purposively selected districts with high levels of home-based management. Methods: A comparative cross-sectional study was conducted. Data were collected in June 2023 and September 2023 from 566 individuals with confirmed COVID-19 eligible for home management, sampled systematically from health facility line lists. Descriptive statistics summarised participant characteristics, and multivariable logistic regression identified factors associated with accepting home-based care. Results: Sixty per cent participants were female, with a median age of 28 years. Awareness of the home management model (adjusted odds ratio [AOR] = 5.11; 95% confidence interval [CI]: 2.61-10.0), income between 600 and 1000 kwacha (AOR = 2.64; 95% CI: 1.10-6.85), and perceiving the model as effective (AOR = 7.88; 95% CI: 3.56-18.3) increased odds of acceptance, while formal employment reduced it (AOR = 0.38; 95% CI: 0.18-0.78). Conclusion: Home-based care is a strategy for easing health system pressure. Strengthening awareness and addressing socio-economic barriers could increase uptake in Zambia. Contribution: This study contributes new evidence on the determinants of home-based care uptake within a low-resource context. The study provides actionable insights for policymakers and programme implementers seeking to strengthen community-based models of care.
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