TY - JOUR T1 - Health service utilisation during the COVID-19 pandemic in sub-Saharan Africa in 2020: a multicountry empirical assessment with a focus on maternal, newborn and child health services JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2021-008069 VL - 7 IS - 5 SP - e008069 AU - Agbessi Amouzou AU - Abdoulaye Maïga AU - Cheikh Mbacké Faye AU - Samuel Chakwera AU - Dessalegn Y Melesse AU - Martin Kavao Mutua AU - Sokhna Thiam AU - Idrissa Boukary Abdoulaye AU - Seth Kwaku Afagbedzi AU - Akory Ag Iknane AU - Odile Sassor Ake-Tano AU - Joshua O Akinyemi AU - Victor Alegana AU - Yakubu Alhassan AU - Arinaitwe Emma Sam AU - Dominic Kwabena Atweam AU - Shraddha Bajaria AU - Luke Bawo AU - Mamadou Berthé AU - Andrea Katryn Blanchard AU - Hamissou Alaji Bouhari AU - Ousmane Maimouna Ali Boulhassane AU - Maio Bulawayo AU - Ovost Chooye AU - Amed Coulibaly AU - Mamatou Diabate AU - Fatou Diawara AU - Ousman Esleman AU - Mulugeta Gajaa AU - Kamil Halimatou Amadou Garba AU - Theodros Getachew AU - Choolwe Jacobs AU - George P Jacobs AU - Femi James AU - Ayodele S Jegede AU - Catherine Joachim AU - Rornald Muhumuza Kananura AU - Janette Karimi AU - Helen Kiarie AU - Denise Kpebo AU - Bruno Lankoandé AU - Akanni Olayinka Lawanson AU - Yahaha Mahamadou AU - Masoud Mahundi AU - Tewabe Manaye AU - Honorati Masanja AU - Modeste Roch Millogo AU - Abdoul Karim Mohamed AU - Mwiche Musukuma AU - Rose Muthee AU - Douba Nabié AU - Mukome Nyamhagata AU - Jimmy Ogwal AU - Adebola Orimadegun AU - Ajiwohwodoma Ovuoraye AU - Adama Sanogo Pongathie AU - Stéphane Parfait Sable AU - Geetor S Saydee AU - Josephine Shabini AU - Brivine Mukombwe Sikapande AU - Daudi Simba AU - Ashenif Tadele AU - Tefera Tadlle AU - Alfred K Tarway-Twalla AU - Mahamadi Tassembedo AU - Bentoe Zoogley Tehoungue AU - Ibrahim Terera AU - Soumaïla Traoré AU - Musu P Twalla AU - Peter Waiswa AU - Naod Wondirad AU - Ties Boerma Y1 - 2022/05/01 UR - http://gh.bmj.com/content/7/5/e008069.abstract N2 - Introduction There are concerns about the impact of the COVID-19 pandemic on the continuation of essential health services in sub-Saharan Africa. Through the Countdown to 2030 for Women’s, Children’s and Adolescents’ Health country collaborations, analysts from country and global public health institutions and ministries of health assessed the trends in selected services for maternal, newborn and child health, general service utilisation.Methods Monthly routine health facility data by district for the period 2017–2020 were compiled by 12 country teams and adjusted after extensive quality assessments. Mixed effects linear regressions were used to estimate the size of any change in service utilisation for each month from March to December 2020 and for the whole COVID-19 period in 2020.Results The completeness of reporting of health facilities was high in 2020 (median of 12 countries, 96% national and 91% of districts ≥90%), higher than in the preceding years and extreme outliers were few. The country median reduction in utilisation of nine health services for the whole period March–December 2020 was 3.9% (range: −8.2 to 2.4). The greatest reductions were observed for inpatient admissions (median=−17.0%) and outpatient admissions (median=−7.1%), while antenatal, delivery care and immunisation services generally had smaller reductions (median from −2% to −6%). Eastern African countries had greater reductions than those in West Africa, and rural districts were slightly more affected than urban districts. The greatest drop in services was observed for March–June 2020 for general services, when the response was strongest as measured by a stringency index.Conclusion The district health facility reports provide a solid basis for trend assessment after extensive data quality assessment and adjustment. Even the modest negative impact on service utilisation observed in most countries will require major efforts, supported by the international partners, to maintain progress towards the SDG health targets by 2030.Data are available on reasonable request. Data analysed in this study was obtained from DHIS-2 from countries that participated in the study. Readers interested in replicating the analysis may contact countries for access to the datasets, on reasonable request. The corresponding authors will provide connection to the country teams for access the data. ER -