Challenges in Maternal and Child Health Services Delivery and Access during Pandemics or Public Health Disasters in Low-and Middle-Income Countries: A Systematic Review

Sahoo, Krushna Chandra; Negi, Sapna; Patel, KM; Mishra, Bijaya Kumar; Palo, Subrata Kumar

doi:10.3390/healthcare9070828

Cited by 26 publications

(32 citation statements)

References 41 publications

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“…However, studies across Africa continue to reveal very low completion rates for the continuum of care [ 6 , 20 , 23 , 24 ]. These low rates in the trends have been associated with socio-economic factors like educational status, residence, distance from the health facility, woman’s decision making power, early initiation of ANC, wealth index, media access, skills of health workers, health system supports, and presence of delivery fees [ 4 , 6 , 22 , 25 ]. These continue to affect the continuity of the continuum and pose setbacks to the fight against maternal and neonatal mortality especially in low- and middle-income countries.…”

Section: Introductionmentioning

confidence: 99%

Continuum of maternal and newborn health in Sierra Leone: a 2019 national survey

Sserwanja¹,

Mutisya

Nuwabaine³

et al. 2022

Arch Public Health

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Introduction Globally, Sierra Leone has some of the worst maternal and child health indicators. The situation is worsened by a dearth of evidence about the level of continuum of care, an evidence-based intervention aimed at reducing maternal and perinatal morbidity and mortality. Hence this study aimed to assess the level of and factors associated with continuum of maternal and newborn care in Sierra Leone. Method This study analyzed secondary data from the 2019 Sierra Leone Demographic Health Survey. Analysis was restricted to women who had a live birth in the 5 years preceding the survey (n = 7326). Complete continuum of care was considered when a woman reported having had at least eight antenatal care contacts, skilled birth attendance and mother and baby had at least one postnatal check-up. Bi-variable and multivariable logistic regression were performed using the statistical package for the social sciences software version 25. Results Only 17.9% (95% CI: 17.4–19.1) of the women utilized complete continuum of care for maternal and newborn health services in Sierra Leone. About 22% (95% CI: 21.3–23.1) utilized 8 or more antenatal care contacts, 88% (95% CI: 87.9–89.4) had skilled birth attendance while 90.7% (95% CI: 90.2–91.5) and 90.4% (95% CI: 89.9–91.2) of mothers and neonates utilized postnatal care respectively. Having started antenatal care within the first trimester (aOR 1.71, 95% CI: 1.46–2.00), being resident in the Southern region (aOR 1.85, 95% CI: 1.23–2.80), belonging to richer wealth quintile (aOR 1.76, 95% CI: 1.27–2.44), using internet (aOR 1.49, 95% CI: 1.12–1.98) and having no big problems seeking permission to access healthcare (aOR 1.34, 95% CI: 1.06–1.69) were significantly associated with utilization of continuum of care. Conclusion The overall completion of continuum of maternal care is low, with ANC being the lowest utilized component of continuum of care. These findings call for urgent attention for maternal health stakeholders to develop and implement tailored interventions prioritizing women empowerment, access to affordable internet services, timely initiation of ANC contacts, women in developed regions such as the Western and those from poor households.

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Section: Introductionmentioning

confidence: 99%

Continuum of maternal and newborn health in Sierra Leone: a 2019 national survey

Sserwanja¹,

Mutisya

Nuwabaine³

et al. 2022

Arch Public Health

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“…This significant fall could be attributed to improved hand hygiene practices and reduced outdoor exposure due to lockdown and isolation [ 83 ]. Factors such as limited information about the availability of health services at facilities, prevailing rumors about the pandemic, and fear of contracting the infection reduced the uptake and utilization of routine MCH care [ 5 ]. A study conducted in Pakistan found that around 25,000 polio workers were reallocated to assist with the COVID-19 response [ 84 ].…”

Section: Discussionmentioning

confidence: 99%

“…Maternal and child health care is affected due to various factors that influence MCH care administration, service provision, and uptake of the services by the beneficiaries (pregnant women, mothers, and children) [ 4 ]. Previous health emergencies like Ebola and Zika have reported a significant increase in the maternal mortality ratio (MMR) due to decreased approach to health facilities and increased risky home deliveries [ 5 ]. The administrator’s focus will likely to shift from MCH care to the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Effective interventions to ensure MCH (Maternal and Child Health) services during pandemic related health emergencies (Zika, Ebola, and COVID-19): A systematic review

et al. 2022

Self Cite

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Introduction Ensuring accessible and quality health care for women and children is an existing challenge, which is further exacerbated during pandemics. There is a knowledge gap about the effect of pandemics on maternal, newborn, and child well-being. This systematic review was conducted to study maternal and child health (MCH) services utilization during pandemics (Zika, Ebola, and COVID-19) and the effectiveness of various interventions undertaken for ensuring utilization of MCH services. Methodology A systematic and comprehensive search was conducted in MEDLINE/PubMed, Cochrane CENTRAL, Embase, Epistemonikos, ScienceDirect, and Google Scholar. Of 5643 citations, 60 potential studies were finally included for analysis. The included studies were appraised using JBI Critical appraisal tools. Study selection and data extraction were done independently and in duplicate. Findings are presented narratively based on the RMNCHA framework by World Health Organization (WHO). Results Maternal and child health services such as antenatal care (ANC) visits, institutional deliveries, immunization uptake, were greatly affected during a pandemic situation. Innovative approaches in form of health care services through virtual consultation, patient triaging, developing dedicated COVID maternity centers and maternity schools were implemented in different places for ensuring continuity of MCH care during pandemics. None of the studies reported the effectiveness of these interventions during pandemic-related health emergencies. Conclusion The findings suggest that during pandemics, MCH care utilization often gets affected. Many innovative interventions were adopted to ensure MCH services. However, they lack evidence about their effectiveness. It is critically important to implement evidence-based appropriate interventions for better MCH care utilization.

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“…Since urban health systems in Thailand are dominated by hospital-oriented care, private clinics, and hospitals [ 32 ], women with no economic problems might seek services from private hospitals during temporary health services disruption at public hospitals during the pandemic. One study reported a lack of access to maternity care in public facilities during the pandemic, with some women attempting to seek maternity services at expensive private clinics or hospitals, which are unaffordable for the poor [ 33 ]. Although it was reported that the effect of urban–rural residence in PNC utilization was generally moderate in all Asian countries compared with sub-Saharan [ 34 ], our study revealed that those living in urban areas utilized PNC more often.…”

Section: Discussionmentioning

confidence: 99%

Utilization of Postnatal Care Services among Thai Women during the COVID-19 Pandemic: Results of a Web-Based Survey

Aye

Kim

Suriyawongpaisal

et al. 2022

IJERPH

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The postnatal period is an underserved aspect of maternity care, potentially worsened by the COVID-19 pandemic. This study aims to identify postnatal care (PNC) use by health personnel within the 42 days of childbirth among postpartum mothers in Thailand. This web-based, cross-sectional study was conducted from July to October 2021 (n = 840). Multiple binary and ordinal logistic regressions were conducted to predict three outcome variables (≥2 times, ≥3 times, or level of PNC use). Women who received PNC were in low numbers (≥2: 30.7% and (≥3: 12.9%), while 54.4% of women reported no barriers to access PNC, and 31.9% reported barriers, including worries over COVID-19 infection, followed by movement restrictions imposed by the government (11.7%) and the closure of healthcare centers (10%). Women working in a self-employed capacity, living in urban areas, and undergoing a Caesarean section with no/less worry about COVID-19 infection were more likely to utilize postnatal care (≥2 or number of PNC). This study provides timely information, revealing that a relatively low percentage of postpartum women received PNC, particularly among the socially deprived group. Since the fear of COVID infection is listed as a major barrier, the provision of PNC services, including a telehealth program should be considered.

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Challenges in Maternal and Child Health Services Delivery and Access during Pandemics or Public Health Disasters in Low-and Middle-Income Countries: A Systematic Review

Cited by 26 publications

References 41 publications

Continuum of maternal and newborn health in Sierra Leone: a 2019 national survey

Continuum of maternal and newborn health in Sierra Leone: a 2019 national survey

Effective interventions to ensure MCH (Maternal and Child Health) services during pandemic related health emergencies (Zika, Ebola, and COVID-19): A systematic review

Utilization of Postnatal Care Services among Thai Women during the COVID-19 Pandemic: Results of a Web-Based Survey

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