Introduction The COVID-19 pandemic has substantially impacted maternity care provision worldwide. Studies based on modelling estimated large indirect effects of the pandemic on services and health outcomes. The objective of this study was to prospectively document experiences of frontline maternal and newborn healthcare providers.
Methods We conducted a global, cross-sectional study of maternal and newborn health professionals via an online survey disseminated through professional networks and social media in 12 languages. Information was collected between 24 March and 10 April 2020 on respondents’ background, preparedness for and response to COVID-19 and their experience during the pandemic. An optional module sought information on adaptations to 17 care processes. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregating by low-income and middle-income countries (LMICs) and high-income countries (HICs).
Results We analysed responses from 714 maternal and newborn health professionals. Only one-third received training on COVID-19 from their health facility and nearly all searched for information themselves. Half of respondents in LMICs received updated guidelines for care provision compared with 82% in HICs. Overall, 47% of participants in LMICs and 69% in HICs felt mostly or completely knowledgeable in how to care for COVID-19 maternity patients. Facility-level responses to COVID-19 (signage, screening, testing and isolation rooms) were more common in HICs than LMICs. Globally, 90% of respondents reported somewhat or substantially higher levels of stress. There was a widespread perception of reduced use of routine maternity care services, and of modification in care processes, some of which were not evidence-based practices.
Conclusions Substantial knowledge gaps exist in guidance on management of maternity cases with or without COVID-19. Formal information-sharing channels for providers must be established and mental health support provided. Surveys of maternity care providers can help track the situation, capture innovations and support rapid development of effective responses.
- maternal health
- child health
- health systems
- health services research
- cross-sectional survey
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Handling editor Seye Abimbola
Twitter @abankethomas, @profwendygraham, @lenkabenova
Contributors LB conceptualised the study and obtained funding. All authors contributed to the design of the study and development of the survey tool. AS analysed the data. CA, LB, EH and AS wrote the original draft of the manuscript. All authors contributed to the development of the manuscript and read and approved the final version. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. AS is the guarantor.
Funding This study was funded by the Institute of Tropical Medicine’s COVID-19 Pump Priming fund supported by the Flemish Government, Science & Innovation. LB is funded in part by the Research Foundation – Flanders (FWO) as part of her Senior Postdoctoral Fellowship.
Disclaimer The funder had no role in the study design, data collection, analysis and interpretation of data or in writing the manuscript. Researchers are independent from funders, and all authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data, and the accuracy of the data analysis is also required.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Ethics approval This study was approved by the Institutional Review Committee at the Institute of Tropical Medicine (Antwerp, Belgium) on 20 March 2020 (approval reference 1372/20).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Anonymised data analysed in the current study will be made available from the corresponding author on reasonable request.
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