Utilization of Maternal, Nutritional and Child Health Care Services Amidst COVID-19 Pandemic in Uttar Pradesh, India

Abstract

Background: All maternal health services are essential to be continued for pregnant mothers during lockdown and avoid COVID infection with awareness of people by following all precautions from COVID-19. We aimed to examine changes in service provision and utilization of MNCH services during the pandemic in Uttar Pradesh, India and identify the factors affecting the utilization and service delivery. Objective: To assess the effects of the COVID-19 pandemic on utilization and delivery of maternal health services at health facilities in Uttar Pradesh, India. Method: COVID -19 pandemic data has been collected form website https://prsindia.org/covid-19/cases which provides the day wise data for four major components such as confirmed cases, active cases, cured/discharged and death and pandemic effects on the maternal services including ANC registration, pregnant women registered for ANC within 1st trimester and home and institutional deliveries during April 2019, April 2020 and April 2021. At the same time, through informal discussion with key healthcare professionals and focused desk reviews of published scientific, grey and media-based information and country-specific healthcare policies. Results and summary: Huge difference in the percent change of the beneficiaries received maternal health services among April 2019, April 2020 and April 2021. It is found that there is 88 percent change in the ANC registration for pregnant women in April 2020 against April 2019. It simple means that 371065 pregnant women registered for ANC in April 2019 whereas only 44987 pregnant women registered in April 2019 which is very less number of pregnant women went for ANC visit in public health facilities in Uttar Pradesh. While, during the 2nd wave of COVID-19 pandemic regarding the ANC service, it reflects only 3 percent change based on government HMIS data set, as 361201 pregnant women registered for ANC in April 2021 and its close to April 2019 i.e. 371065. Similarly, 12 percent change for institutional deliveries was found in April 2020 and no change for the institutional deliveries during April 2021. Moreover, more institutional deliveries are occurred during April 2021 against April 2020 and April 2019. The main reason for delayed health seeking was lockdown in April 2020 due to COVID-19 pandemic. The health situation was very worst in all the public health facilities during April 2021 due to COVID-19. Conclusions: COVID-19 severely affected the provision and use of MNCH services in Uttar Pradesh, India, despite efforts at service restoration and adaptations. Strengthening logistics support, capacity enhancement, performance management, and demand creation are needed to improve service provision and utilization during and post-COVID-19.