Abstract
BackgroundThe Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people’s movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.MethodsMixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March–May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests.We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.ResultsComparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.ConclusionOur results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
Highlights
The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage
We compared maternal and child health care unit statistical indicators from March– May 2019 to the same time-period in 2020. This was followed by interviews of Maternal and child health (MCH) Health care worker (HCW), Traditional birth attendant (TBA) and clients using the system
Quantitative results Comparing the three months of Covid-19 pandemic in Natikiri, Mozambique in 2020, with the same period in 2019, concerning MCH services access indicators, data showed an increase in home deliveries (74%), the number of pregnant women attending their first ante-natal visit (19%), the number of women completing four ante-natal visits (19%), and the number of well-baby visits (14%)
Summary
The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020 This has limited people’s movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. In Mozambique, the President declared the state of emergency at the end of March 2020, when there were no positive cases in the country. This limited travel, reduced all public services and gatherings. A national media information and education campaign, teaching preventive measures, was broadcast on television and radio across the country These preventive measures might have reduced the number of infections: at the writing of this paper, Mozambique is 9th in the number of cases in Africa (3651). The effects on the national health programs are not well known but the negative impacts are documented in a British National Health System research paper, recommending HCWs and local authorities, pay close attention to prevent health care access restrictions [6]
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