Introduction: Very little is known and predictable on how long the COVID-19 pandemic will last, even though dramatic preventive measures to flatten the curve and stop its transmission have been taken worldwide periodically since its start. These preventive measures coupled with people’s fear of COVID-19, significantly altered people’s health-seeking behavior and healthcare accessibility. This study aims to measure the impact of the COVID-19 pandemic on the utilization of reproductive, maternal, newborn, and child health (RMNCH) care services at primary health care (PHC) facilities in Pakistan. Methods: A retrospective study was conducted in 22 districts using data from 1169 primary health care facilities. The District Health Information System (DHIS) was used to retrieve district-wise services utilization data from January to April 2020 i.e. January to February 2020 (pre-COVID-19) and March to April 2020 (during COVID-19). The monthly difference (in percentage change) for selected RMNCH services indicators was calculated using the expected number of clients (January to February average) versus the actual number of clients for March and April 2020. Results: We observed a decrease of 12.5% for March and 33% for April 2020 in the total number of clients who availed of primary health care services in Sindh as compared to the pre-COVID-19 monthly average. A decrease in first antenatal care visits (15.6% and 16.3%), delivery coverage (12.8% and 17.9%) and family planning client visits (31.6% and 36.3%) were observed for March and April 2020 respectively. The pentavalent vaccine results revealed a decrease of 19.3% and 63.1%, while a decrease of 17.3% and 54.3% were observed for children receiving the first dose of measles vaccine in March and April, respectively. Conclusions: Our findings show that the number of clients who avail of routine care or RMNCH services at the primary health care level considerably declined during the initial phase of the first wave of the COVID-19 outbreak in Sindh, Pakistan. These results highlight a rising threat to poor RMNCH and outcomes.

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.

Objective: To assess the nourishment level of married women of reproductive age in a two rural setting. Method: The cross-sectional study was based on secondary data of the Impact Assessment Survey 2019, which was conducted by the People’s Primary Health Care Initiative from January to May, 2019, in Dadu and Jacobabad districts of the province of Sindh, Pakistan. Nutritional status of married women of reproductive age was analysed using mid-upper arm circumference; <23cm being indicative of under-nourishment, and <21cm of severe under-nourishment. Predicting factors were identified using multivariate logistic regression. Data was analysed using STATA 15. Results: Of 10,388 subjects, 5,138(49.5%) were from Dadu and 5,250(50.5%) from Jacobabad. The overall mean age was 32.9+8.1 with 4,739(45.6%) aged 25-35 years. Overall, 2,336(22.5%) subjects were undernourished and 609(5.9%) were severely undernourished. Age, education, socio-economic status and parity were significant predictors of the nourishment status (p<0.05), while location and health facility type were significant predictors of severe undernourishment (p<0.05), but were not related to undernourishment (p>0.05). Conclusion: Overall nutrition status of the married women of reproductive age in the two rural districts of Sindh was less than satisfactory. Key Words: Undernourishment, Underweight, Mid-upper arm circumference, Women of reproductive age, Pakistan. Continues...