Accessing Antenatal Care (ANC) services during the COVID-19 first wave: insights into decision-making in rural India

Bankar, Shweta; Ghosh, D

doi:10.1186/s12978-022-01446-2

Cited by 16 publications

(19 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 29 , 30 However, compared to our sample, utilization of maternal health services was higher in Ethiopia (64.8%) 21 and Malawi during the lockdown. 29 Elsewhere, RMNCH service utilization dipped below pre-COVID levels in India, 31 and in Pakistan, cesarean section rates (57%), hospital deliveries (37%), and postnatal visits (37%) declined. 32 Further, maternal health service utilization decreased in Haiti (18%) and Mexico during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic

Iliyasu

Umar

Gaya

et al. 2023

International Journal of MCH and AIDS

View full text Add to dashboard Cite

Background and Objective: The COVID-19 pandemic response overwhelmed health systems, disrupting other services, including maternal health services. The disruptive effects on the utilization of maternal health services in low-resource settings, including Nigeria have not been well documented. We assessed maternal health service utilization, predictors, and childbirth experiences amidst COVID-19 restrictions in a rural community of Kumbotso, Kano State, in northern Nigeria. Methods: Using an explanatory mixed methods design, 389 mothers were surveyed in January 2022 using validated interviewer-administered questionnaires, followed by in-depth interviews with a sub-sample (n=20). Data were analyzed using logistic regression models and the framework approach. Results: Less than one-half (n=165, 42.4%) of women utilized maternal health services during the period of COVID-19 restrictions compared with nearly two-thirds (n=237, 65.8%) prior to the period (p<0.05). Non-utilization was mainly due to fear of contracting COVID-19 (n=122, 54.5%), clinic overcrowding (n=43, 19.2%), transportation challenges (n=34, 15.2%), and harassment by security personnel (n=24, 10.7%). The utilization of maternal health services was associated with participant’s post-secondary education (aOR=2.06, 95% CI:1.14- 11.40) (p=0.02), and employment type (civil service, aOR=4.60, 95% CI: 1.17-19.74) (p<0.001), business aOR=1.94, 95% CI:1.19- 4.12) (p=0.032) and trading aOR=1.62, 95% CI:1.19-2.94) (p=0.04)). Women with higher household monthly income (≥ N30,000, equivalent to 60 US Dollars) (aOR=1.53, 95% CI:1.13-2.65) (p=0.037), who adhered to COVID-19 preventive measures and utilized maternal health services before the COVID-19 pandemic were more likely to utilize those services during the COVID-19 restrictions. In contrast, mothers of higher parity (≥5 births) were less likely to use maternal health services during the lockdown (aOR=0.30, 95% CI:0.10-0.86) (p=0.03). Utilization of maternal services was also associated with partner education and employment type. Conclusion and Global Health Implications: The utilization of maternal health services declined during the COVID-19 restrictions. Utilization was hindered by fear of contracting COVID-19, transport challenges, and harassment by security personnel. Maternal and partner characteristics, adherence to COVID-19 preventive measures, and pre-COVID maternity service utilization influenced attendance.There is a need to build resilient health systems and contingent alternative service delivery models for future pandemics. Copyright © 2023 Iliyasu et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

show abstract

Section: Discussionmentioning

confidence: 99%

‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic

Iliyasu

Umar

Gaya

et al. 2023

International Journal of MCH and AIDS

View full text Add to dashboard Cite

show abstract

“…The study findings suggest a significant financial burden on low-income households due to the high out-ofpocket expenditure with concomitant loss of wages during the pandemic. Studies from other states of India and also Africa reported the observation of a similar phenomenon [22,23].…”

Section: Discussionmentioning

confidence: 72%

It Cost Us All of Our Savings to Deliver Our Baby: A Qualitative Study to Explore Barriers and Facilitators of Maternal and Child Health Service Access and Utilization in a Remote Rural Region in India During the COVID-19 Pandemic

Manna¹,

Basu²

2023

Cureus

View full text Add to dashboard Cite

Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, rural and geographically isolated regions in lower-middle-income countries (LMICs) encountered major deficits in maternal and child health (MCH) care that were accentuated by pre-existing weak public health infrastructure and diversion of existing health resources for pandemic management purposes. This explorative qualitative study was conducted to assess the barriers, challenges, and facilitators in the access and utilization of essential MCH services among pregnant women during the COVID-19 pandemic in a geographically remote and rural area in India, having nearly 70% rural population.Method: The study was conducted using an ethnographic approach. Three villages were selected purposively from the Purba Medinipur district of the Eastern state of West Bengal, geographically isolated by a local river. Information on challenges of utilization was collected by in-depth interviews (IDI) with a universal sample of 25 mothers who underwent pregnancy after March 2020 and focus group discussions (FGD) with their husbands and mothers-in-laws. Thematic analysis was used to analyze the qualitative data.Results: The median (IQR) age of the mothers that delivered during pregnancy were 23 (18, 28) years and ranging from 18 to 28 years (N=25). All the mothers were married, housewives, literate, and Hindu by religion, while in the accompanying husband cohort, a majority (56 %) had completed high school. Half (52%) were primigravida with at least one living child (60 %). All the mothers had a successful birth outcome and only one had current evidence of mild depression. Low utilization of MCH services during the pandemic in the study area was recognized as an outcome of individual-level, interpersonal-level, and communitylevel barriers. Diversion of routine health staff for COVID-19 related services occasionally compelled pregnant women and children to seek care from unlicensed healthcare providers who remained accessible even during periods of stringent lockdown. Furthermore, the irregular functioning of the local primary health care system translated into missed home visits and disruption of nutritional assistance services. A dual burden of economic loss was reported in most households from loss of livelihood and wages and additional expenditure incurred in underdoing deliveries at private health facilities, thereby potentially translating into catastrophic out-of-pocket costs. The designation of a separate government health facility for delivery due to the unavailability of the local hospital did not mitigate the circumstances due to its lack of utilization by the villagers who encountered difficult access and a lack of trust in an unfamiliar environment. The functioning of a popular conditional cash transfer scheme for promoting safe motherhood was also possibly compromised during the pandemic.Conclusions: Accessibility to MCH services was severely affected during the COVID-19 pandemic, especially during the stringent lockdown periods in remote and rural a...

show abstract

“…De acordo com Bankar & Ghosh (2022), na Índia, devido aos serviços limitados, essa modalidade era a única que, em algumas situações, funcionava. Na Arábia Saudita, os médicos da família contataram as gestantes cadastradas e questionavam sobre movimentação fetal e demais queixas, com objetivo de manter um canal de acesso ao pré-natal e adesão aos planos de tratamentos e intervenções governamentais para segurança durante a pandemia (Chen et al, 2022).…”

Section: Discussionunclassified

“…A rápida mudança ou interrupção do acesso aos serviços de assistência materna em meio a divulgação de informações incompletas ou falsas nas mídias e o medo de contrair a Covid-19 assustou e interferiu na preparação para o parto e puerpério das gestantes (Bankar & Ghosh, 2022). Cerca de 50% das mulheres que tiveram filhos durante a pandemia afirmaram que o acesso às consultas de pré-natal foi dificultado pelo momento.…”

Section: Discussionunclassified

Assistência pré-natal durante a pandemia da Covid-19: uma revisão integrativa

Santos¹,

Moraes²,

Silva³

et al. 2022

RSD

View full text Add to dashboard Cite

Introdução: o acompanhamento pré-natal é essencial para a identificação de possíveis riscos na gestação, estando relacionado à diminuição da morbimortalidade materno-fetal. Durante a pandemia da Covid-19, foram grandes os desafios para a efetividade deste serviço, sendo criadas então diversas estratégias para o aumento da adesão à assistência pré-parto, tendo a telemedicina se destacado nesse cenário. Objetivo: Analisar as medidas adotadas para a manutenção da assistência pré-natal em meio à pandemia da Covid-19. Métodos: Revisão integrativa da literatura, realizado nas bases de dados médicos PubMed, LILACS e Scielo em julho de 2022. Resultados: Foram selecionados 30 artigos com base nos critérios de inclusão e exclusão. Discussão: Com a pandemia da Covid-19 várias estratégias para adesão à assistência pré-parto tiveram que ser criadas, como plataformas de comunicação online, aplicativos, formulação de materiais para serem postados com assuntos propostos por pacientes e pessoas da comunidade. Porém, os métodos digitais para aconselhamento não foram os únicos utilizados, teve-se também consultas presenciais para acompanhamento da gestação, mas com o número reduzido, nas quais eram utilizados todos os equipamentos necessários para um adequado distanciamento social. Conclusão: A pandemia da Covid-19 representou um período de limitações e adequações para que a assistência ao pré-natal se mantivesse adequada. Para isso, os diversos países criaram dispositivos para garantir esse acesso às gestantes, sendo o principal deles, a telessaúde, a qual, apesar de suas diversas restrições, trouxe diversos benefícios para o acompanhamento adequado do pré-natal.

show abstract

Accessing Antenatal Care (ANC) services during the COVID-19 first wave: insights into decision-making in rural India

Cited by 16 publications

References 11 publications

‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic

‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic

It Cost Us All of Our Savings to Deliver Our Baby: A Qualitative Study to Explore Barriers and Facilitators of Maternal and Child Health Service Access and Utilization in a Remote Rural Region in India During the COVID-19 Pandemic

Assistência pré-natal durante a pandemia da Covid-19: uma revisão integrativa

Contact Info

Product

Resources

About