483 Pediatric primary health care in earthquake-affected areas of Sisak-Moslavina County during the COVID-19 pandemic

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Background The COVID-19 pandemic spread to Croatia on February 25, 2020, which required a change in the organization of health care institutions and the provision of health services with as few contacts as possible between staff and patients. Besides, Sisak-Moslavina County on December 29, 2020 hit by a strong earthquake that destroyed most of the facilities of the health care system. The pandemic and earthquake have affected adversely the physical, mental, and social well-being of children and their families. Aim To present the organization of pediatric primary health care in Sisak-Moslavina County in the complex conditions of lack of staff, facilities, and equipment after the earthquake during the COVID-19 pandemic. Results In 2020 749 newborns were born In the Sisak maternity hospital, and about 13,000 children live in the earthquake-affected area. Primary pediatric care covers 8,348 children up to 14 years of age, of which 4,736 children up to 7 years of age are cared for by 7 primary pediatric teams. Out of 4 pediatric outpatient clinics (covered by 3 pediatric teams) in Sisak caring for 5,140 children, two work in containers, and one is dislocated in the suburbs of Sisak. From Glina, the primary pediatric outpatient office caring for 1,247 children was moved to Topusko. In the Petrinja area, two primary pediatric teams are working at the same location as before the earthquake and caring for a total of 1,961 children. Thanks to the UNICEF Office for Croatia and the Ministry of Health of the Republic of Croatia, containers, and the most necessary equipment for pediatric teams were acquired. The salutogenic approach to the health of families and children was maintained in an emergency, which included breastfeeding support, continued implementation of pediatric preventive health care measures, including vaccination, care for vulnerable groups of children with disabilities and socially deprived children, and intersectoral cooperation. Conclusions It is needed to increase awareness of the community that delivering pediatric health care in emergencies is essential and could be realized if the appropriate number of health care teams is available. Ensuring spatial and all other conditions for their work should be the highest priority in restoration after the earthquake.

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