Original Research – Special Collection: African Researchers Publication Capacity

Enhancing awareness and uptake of home-based care services during the coronavirus disease 2019 pandemic in Zambia

Kelvin Mwangilwa, Cephas Sialubanje, Nyuma Mbewe, Naeem M.I. Dalal, Oliver Mweso, Stephen Longa Chanda, Musole Chipoya, Roureen P. Landson, Chilufya S.A. Mulenga, Moses Mwale, Moses Banda, Vivian M. Mwale, Priscilla N. Gardner, Geoffrey Mutiti, Lilian Lamba, Charles Chileshe, Peter Funsani, Davie Simwaba, Paul M. Zulu, Raymond Hamoonga, Malambo Mutila, Innocent Hamuganyu, Jonathan Mwanza, Olive Chiboola, Nyambe Sinyange, Muzala Kapin’a, Nkomba Kayeyi, Fred Kapaya, Mazyanga L. Mazaba, Roma Chilengi
Journal of Public Health in Africa | Vol 16, No 4 | a1627 | DOI: https://doi.org/10.4102/jphia.v16i4.1627 | © 2025 Kelvin Mwangilwa, Cephas Sialubanje, Nyuma Mbewe, Naeem M.I. Dalal, Oliver Mweso, Stephen Longa Chanda, Musole Chipoya, Roureen P. Landson, Chilufya S.A. Mulenga, Moses Mwale, Moses Banda, Vivian M. Mwale, Priscilla N. Gardner, Geoffrey Mutiti, Lilian Lam | This work is licensed under CC Attribution 4.0
Submitted: 18 August 2025 | Published: 17 December 2025

About the author(s)

Kelvin Mwangilwa, Zambia National Public Health Institute, Lusaka, Zambia
Cephas Sialubanje, Zambia National Public Health Institute, Lusaka, Zambia; and, School of Public Health, Levy Mwanawasa Medical University, Lusaka, Zambia
Nyuma Mbewe, Zambia National Public Health Institute, Lusaka, Zambia
Naeem M.I. Dalal, Zambia National Public Health Institute, Lusaka, Zambia
Oliver Mweso, Zambia National Public Health Institute, Lusaka, Zambia
Stephen Longa Chanda, Zambia National Public Health Institute, Lusaka, Zambia
Musole Chipoya, Zambia National Public Health Institute, Lusaka, Zambia
Roureen P. Landson, Zambia National Public Health Institute, Lusaka, Zambia
Chilufya S.A. Mulenga, Zambia National Public Health Institute, Lusaka, Zambia
Moses Mwale, World Health Organization, Lusaka, Zambia
Moses Banda, Zambia National Public Health Institute, Lusaka, Zambia
Vivian M. Mwale, Zambia National Public Health Institute, Lusaka, Zambia
Priscilla N. Gardner, Zambia National Public Health Institute, Lusaka, Zambia
Geoffrey Mutiti, Zambia National Public Health Institute, Lusaka, Zambia
Lilian Lamba, Zambia National Public Health Institute, Lusaka, Zambia
Charles Chileshe, Zambia National Public Health Institute, Lusaka, Zambia
Peter Funsani, Zambia National Public Health Institute, Lusaka, Zambia
Davie Simwaba, Zambia National Public Health Institute, Lusaka, Zambia
Paul M. Zulu, Zambia National Public Health Institute, Lusaka, Zambia
Raymond Hamoonga, Zambia National Public Health Institute, Lusaka, Zambia
Malambo Mutila, Zambia National Public Health Institute, Lusaka, Zambia
Innocent Hamuganyu, Zambia National Public Health Institute, Lusaka, Zambia
Jonathan Mwanza, Zambia National Public Health Institute, Lusaka, Zambia
Olive Chiboola, Zambia National Public Health Institute, Lusaka, Zambia
Nyambe Sinyange, Zambia National Public Health Institute, Lusaka, Zambia
Muzala Kapin’a, Zambia National Public Health Institute, Lusaka, Zambia
Nkomba Kayeyi, Southern Africa Institute for Collaborative Research and Innovative Organization (SAICRIO), Lusaka, Zambia
Fred Kapaya, Zambia National Public Health Institute, Lusaka, Zambia
Mazyanga L. Mazaba, Zambia National Public Health Institute, Lusaka, Zambia; and, Africa CDC Eastern Africa Regional Coordinating Centre, National Kenyata Hospital, Nairobi, Kenya
Roma Chilengi, Zambia National Public Health Institute, Lusaka, Zambia

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.


Keywords

home-based care; COVID-19; patient uptake; healthcare utilisation; socio-economic factors; awareness; Zambia

Sustainable Development Goal

Goal 10: Reduced inequalities

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