Abstract
Background: On 5 March 2020, South Africa reported its first confirmed case of the Coronavirus Disease 2019 (COVID-19). On 11 March 2020, the World Health Organisation (WHO) declared COVID-19 a global pandemic. The disease has since spread worldwide leading to millions of fatalities. At the time the only effective way to combat the spread of the virus was through nationwide lockdowns. On 23 March 2020, South Africa initiated a nationwide lockdown, that directly impacted the operation of chiropractors, that would later work on different alert levels depending on the spread of the virus. There is currently no research on the economic impact of the COVID-19 lockdown on chiropractors in South Africa.
Aim: The aim of this study was to compile a secondary analysis of primary data collected, to determine the extent of the impact of COVID-19 lockdowns and the consequent economic downturn experienced by chiropractors in South Africa by determining whether there were decreases in the number of patients seen during the COVID-19 lockdown, and whether there was a decrease in the average gross income during the lockdown. Additionally, it was investigated if financial aid was acquired and/or if business costs had to be reduced to sustain the practice. The primary data used for this secondary analysis was collected in previous unpublished studies performed at the University of Johannesburg in 2021 titled: Impact of the COVID- 19 Lockdown and Economic Downturn on the Chiropractic Profession in Gauteng (Mathers, 2021), Impact of the COVID-19 Lockdown and Economic Downturn on the Chiropractic Profession in KwaZulu-Natal (Ellis, 2021), Impact of the COVID-19 Lockdown and Economic Downturn on the Chiropractic Profession in Western Cape (Peens, 2021)and the Impact of the COVID-19 Lockdown and Economic Downturn on the Chiropractic Profession in Eastern Cape, Free State, Mpumalanga, North West, Limpopo and Northern Cape (Vorster, 2021).
Method: Retrospective data from the primary unpublished studies done by various Master of Health Sciences in Chiropractic students on the impact of COVID-19 lockdown and economic downturn on the chiropractic profession in the provinces of South Africa was utilised. The survey was conducted in 2020 utilizing an anonymous cross-sectional, quantitative online survey.
Procedure: For the primary studies, an email containing an information letter, consent form and a link to the survey was distributed via the Allied Health Professions Council of South Africa (AHPCSA) and the Chiropractic Association of South Africa (CASA) to all registered chiropractors in South Africa. Each chiropractor received an email explaining the purpose and process of the study. All responses were confidential and anonymous. If the chiropractor decided to participate in the survey, they would be
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redirected to the QuestionPro website after clicking on the link to the survey. The data from these studies were utilized in this secondary analysis.
Results: The response rate for this study was 28% (n=165) of the registered chiropractors in South Africa. This study revealed that there was a statistically significant (p=0.000) decrease in number of patients seen during lockdown when compared to pre-lockdown data. The average gross income during the COVID-19 lockdown decreased as well. It was discovered that seventy-seven chiropractors opted not to access financial aid and this represents 47% (n=77) of the respondents. This study reported a p-value of
0.000 which indicates a statistically significant decrease average gross income before and during the COVID-19 lockdown. The most popular form of financial aid was through accessing personal savings 28% (n=46) while 13.4% (n=22) of the respondents utilized an informal loan from a friend or family member. Government aid was the least utilized form of financial aid as only 1.8% (n=3) of the chiropractors had access to government aid. Eleven respondents (6.7%) took out a loan from a bank and 9.1% (n=15) of respondents accessed their Unemployment Insurance Fund. It was reported that more than half of the respondents (53.1%, n=69) had to reduce their business costs.
Conclusion: It is clear that the majority of chiropractors who participated in this study were negatively affected economically by the COVID-19 lockdown with consequent financial implications. The study reported that there was a decrease in number of patients seen on average per week and that subsequently had a negative impact on the gross income of chiropractors per month during the COVID-19 lockdown. Most chiropractors involved in this study had to access some form of financial aid while simultaneously reducing business costs to remain operational during the COVID-19 pandemic.