PT  - JOURNAL ARTICLE
AU  - Zeus Aranda
AU  - Thierry Binde
AU  - Katherine Tashman
AU  - Ananya Tadikonda
AU  - Bill Mawindo
AU  - Daniel Maweu
AU  - Emma Jean Boley
AU  - Isaac Mphande
AU  - Isata Dumbuya
AU  - Mariana Montaño
AU  - Mary Clisbee
AU  - Mc Geofrey Mvula
AU  - Melino Ndayizigiye
AU  - Meredith Casella Jean-Baptiste
AU  - Prince F Varney
AU  - Sarah Anyango
AU  - Karen Ann Grépin
AU  - Michael R Law
AU  - Jean Claude Mugunga
AU  - Bethany Hedt-Gauthier
AU  - Isabel R Fulcher
ED  - ,
TI  - Disruptions in maternal health service use during the COVID-19 pandemic in 2020: experiences from 37 health facilities in low-income and middle-income countries
AID  - 10.1136/bmjgh-2021-007247
DP  - 2022 Jan 01
TA  - BMJ Global Health
PG  - e007247
VI  - 7
IP  - 1
4099  - http://gh.bmj.com/content/7/1/e007247.short
4100  - http://gh.bmj.com/content/7/1/e007247.full
SO  - BMJ Global Health2022 Jan 01; 7
AB  - The COVID-19 pandemic has heterogeneously affected use of basic health services worldwide, with disruptions in some countries beginning in the early stages of the emergency in March 2020. These disruptions have occurred on both the supply and demand sides of healthcare, and have often been related to resource shortages to provide care and lower patient turnout associated with mobility restrictions and fear of contracting COVID-19 at facilities. In this paper, we assess the impact of the COVID-19 pandemic on the use of maternal health services using a time series modelling approach developed to monitor health service use during the pandemic using routinely collected health information systems data. We focus on data from 37 non-governmental organisation-supported health facilities in Haiti, Lesotho, Liberia, Malawi, Mexico and Sierra Leone. Overall, our analyses indicate significant declines in first antenatal care visits in Haiti (18% drop) and Sierra Leone (32% drop) and facility-based deliveries in all countries except Malawi from March to December 2020. Different strategies were adopted to maintain continuity of maternal health services, including communication campaigns, continuity of community health worker services, human resource capacity building to ensure compliance with international and national guidelines for front-line health workers, adapting spaces for safe distancing and ensuring the availability of personal protective equipment. We employ a local lens, providing prepandemic context and reporting results and strategies by country, to highlight the importance of developing context-specific interventions to design effective mitigation strategies.The data underlying this article will be shared on reasonable request to the corresponding author. We have provided an example dataset with code on our GitHub repository: [https://github.com/isabelfulcher/global_covid19_response].