RT Journal Article
SR Electronic
T1 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
JF BMJ Global Health
JO BMJ Global Health
FD BMJ Publishing Group Ltd
SP e007247
DO 10.1136/bmjgh-2021-007247
VO 7
IS 1
A1 Zeus Aranda
A1 Thierry Binde
A1 Katherine Tashman
A1 Ananya Tadikonda
A1 Bill Mawindo
A1 Daniel Maweu
A1 Emma Jean Boley
A1 Isaac Mphande
A1 Isata Dumbuya
A1 Mariana Montaño
A1 Mary Clisbee
A1 Mc Geofrey Mvula
A1 Melino Ndayizigiye
A1 Meredith Casella Jean-Baptiste
A1 Prince F Varney
A1 Sarah Anyango
A1 Karen Ann Grépin
A1 Michael R Law
A1 Jean Claude Mugunga
A1 Bethany Hedt-Gauthier
A1 Isabel R Fulcher
A1 ,
YR 2022
UL http://gh.bmj.com/content/7/1/e007247.abstract
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].