Access and satisfaction with healthcare services among chronic disease patients during the Sudan armed conflict: a cross-sectional study

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BACKGROUND: The ongoing conflict in Sudan has severely disrupted the healthcare system, leaving millions without access to essential services. Chronic disease patients are among the most affected due to their heightened reliance on consistent and specialized healthcare. This study aimed to assess the level of access to healthcare services and the satisfaction of chronic disease patients during the current war in Sudan. METHODS: A cross-sectional study was conducted among chronic disease patients residing in the safest states of Sudan during the ongoing conflict. Access to healthcare services and patient satisfaction were measured using a structured questionnaire that was specially designed and piloted for the purpose of this study. Descriptive statistics, including median, interquartile range, and percentages, were used to summarize the data. Inferential statistical methods, such as chi-square tests, were then applied to examine associations between socio-demographic factors and healthcare access. Statistical significance was defined as p < 0.05 for all analyses. RESULTS: Among 1116 chronic disease patients, 13.3% never visited a health facility for regular check-ups during the current war, 20.1% reported facilities were over 5 km away by walking distance, 15.9% rarely or never accessed healthcare services during the war, and 22.0% reported a very large effect of the war on their healthcare access. Additionally, 22.3% noted excellent availability of healthcare personnel during the current war, while 18.1% were dissatisfied with the quality of care. Significant associations (p < 0.01) were found between the frequency of health facility visits and factors such as income level, ease of access, availability of personnel, satisfaction with care, confidence in providers, and the war's impact on access. CONCLUSION: Chronic disease patients experienced suboptimal follow-up for their conditions, limited access to healthcare services, and a significant proportion expressed dissatisfaction with the quality of care during the current Sudan war. To mitigate these challenges, coordinated efforts are urgently needed to strengthen Sudan's healthcare system, improve geographic access, and support healthcare providers.

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