Accessibility and Utilization Shifts in Mental Health Services Before and After COVID-19 in Kigali City's Healthcare System, Rwanda

In Kigali City's healthcare system in Rwanda, mental health services have faced challenges due to inadequate infrastructure and resources. Data were collected through a mixed-methods approach, including surveys and focus group discussions among patients and healthcare providers. A significant decrease in patient visits to mental health clinics was observed during the pandemic period, with 40% fewer appointments compared to pre-pandemic levels. The reduction in service utilization highlights the need for targeted interventions to improve accessibility and ensure continuity of care. Healthcare providers should prioritise telehealth services and community-based mental health programmes to maintain patient engagement during future crises. mental health, Kigali City, COVID-19, healthcare system, service utilization Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.