Disruptions in maternal and child health service utilization during COVID-19: analysis from eight sub-Saharan African countries

Shapira, Gil; Ahmed, Tashrik; Drouard, Salomé Henriette Paulette; Fernandez, Pablo Amor; Kandpal, Eeshani; Nzelu, Charles; Wesseh, Chea Sanford; Mohamud, Nur Ali; Smart, Francis; Mwansambo, Charles; Baye, Martina Lukong; Diabate, Mamatou; Yuma, Sylvain; Ogunlayi, Munirat; Rusatira, Rwema Jean De Dieu; Hashemi, Tawab; Vergeer, Petra; Friedman, Jed

doi:10.1093/heapol/czab064

Cited by 146 publications

(253 citation statements)

References 36 publications

Supporting

Mentioning

229

Contrasting

Order By: Relevance

“…The results showed a 30–50% reduction in service utilization for family planning, antenatal, delivery, postnatal care, immunization, and childcare services during the lockdown as compared to the pre-pandemic period. Similar decline in service utilizations has been reported in other settings [ 29 – 31 ]. While service utilization for most components improved after the lockdown, adolescent health services continued to witness reduced counts in all the facilities after the lockdown.…”

Section: Discussionsupporting

confidence: 87%

Effect of COVID-19 pandemic on provision of sexual and reproductive health services in primary health facilities in Nigeria: a cross-sectional study

Adelekan¹,

Goldson²,

Abubakar³

et al. 2021

Reprod Health

View full text Add to dashboard Cite

Background Nigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive, maternal, child, and adolescent health (RMCAH) services in primary health care facilities across the Nigerian States. Methods This was a cross-sectional study of 307 primary health centres (PHCs) in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and provision of RMCAH services before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using frequency and percentage, summary statistics, and Kruskal–Wallis test. Results Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. During the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients’ utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19. Conclusions The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.

show abstract

Section: Discussionsupporting

confidence: 87%

Effect of COVID-19 pandemic on provision of sexual and reproductive health services in primary health facilities in Nigeria: a cross-sectional study

Adelekan¹,

Goldson²,

Abubakar³

et al. 2021

Reprod Health

View full text Add to dashboard Cite

show abstract

“…The magnitude of the declines is similar to those reported in [23]. However, substantially higher as compared to the range of African countries analyzed in [26]. This is perhaps not surprising as the sample was designed to represent the most acutely affected regions of the country, with a majority of the sample coming from Addis Ababa and a majority of the health facilities in the sample (about 60%, see Table A1) are providing care for Covid infected patients.…”

Section: Discussionsupporting

confidence: 75%

“…Comprehensive analyses of changes in health service utilization is provided in [26] [27]. Analysis based on HMIS data from South Africa's KwaZulu Natal province and a pre-post comparison yields sharp and significant declines for clinic attendance (36%) and hospital admissions (50%) for children aged less than 5 years in the period April-June 2020 [28].…”

Section: Introductionmentioning

confidence: 99%

Use of health care services during the Covid-19 pandemic in Ethiopia: Evidence from a health facility survey

Shuka

Mebratie

Alemu

et al. 2021

Preprint

View full text Add to dashboard Cite

Introduction: In recent years Ethiopia has made enormous strides in enhancing access to health care, especially, maternal and child health care (MCH). With the onset and spread of Covid-19, the attention of the health care system has pivoted to handling the disease, potentially at the cost of other health care needs. This paper explores whether this shift has come at the cost of non Covid related health care, especially the use of MCH services. Methods: Graphs, descriptive statistics and paired t-tests of significance are used to compare levels of inpatient and outpatient health care service utilization before and after the onset and spread of the virus. The analysis is based on a survey of 59 health centers and 29 public hospitals located in urban Ethiopia, the most acutely affected region of the country. Data on the use of health care services for a period of 24 months was gathered from the health management information systems (HMIS) of these facilities. Results: There is a sharp reduction in the use of both inpatient (20-27%) and outpatient (27-34%) care, particularly in Addis Ababa, which has been most acutely affected by the virus. However, the decline does not come at the cost of MCH services. The use of several MCH components (skilled birth attendant deliveries, immunization, post-natal care) remains unaffected throughout the period while others (family planning services, ante-natal care) experience a decline (8-17%) in the immediate aftermath but recover soon after. Conclusion: Concerns about the crowding out of MCH services due to the focus on Covid 19 are unfounded. Pro-active measures taken by the government and health care facilities to ring-fence the use of essential health care services have mitigated service disruptions. The results underline the resilience and agility displayed by one of the worlds most resource-constrained health care systems.

show abstract

“…However, contrary to our results, Saphira and colleagues found decreases for these two indicators in Malawi at the national level. 10 As mentioned previously, this may be related to the additional resources that the facilities included in our study have, in the form of training and supplies received from PIH, which may have helped mitigate the effects of the pandemic on maternal health service use locally and may have led to different outcomes from those of other public health facilities or private for-profit facilities in the country. Thus, it is imperative to investigate changes at both the national and local levels during emergencies, such as the COVID-19 pandemic, as these can often tell different stories.…”

Section: Discussionmentioning

confidence: 94%

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

Aranda¹,

et al. 2022

View full text Add to dashboard Cite

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.

show abstract

Disruptions in maternal and child health service utilization during COVID-19: analysis from eight sub-Saharan African countries

Cited by 146 publications

References 36 publications

Effect of COVID-19 pandemic on provision of sexual and reproductive health services in primary health facilities in Nigeria: a cross-sectional study

Effect of COVID-19 pandemic on provision of sexual and reproductive health services in primary health facilities in Nigeria: a cross-sectional study

Use of health care services during the Covid-19 pandemic in Ethiopia: Evidence from a health facility survey

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

Contact Info

Product

Resources

About