Access to reproductive health care services in countries of conflict: the double impact of conflict and COVID-19

McLean, Marcia; Abuelaish, Izzeldin

doi:10.1080/13623699.2020.1832724

Cited by 8 publications

(9 citation statements)

References 10 publications

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“…In terms of existing barriers accentuated by the pandemic, some studies reported a shortage of resources in the services to meet all the incoming healthcare requests [83,85,86,88,89,92,93,95,97,98], which varied according to service and geographical context. One of the most serious problems was the lack of or alterations to the distribution of materials and medical supplies in lowincome countries [83,87,89,93,94,97], an aspect corroborated in other publications, both reports and opinion articles [4,34,104,[120][121][122]. The lack of materials and medical supplies may have contributed to increasing negative perceptions of the quality of the health services, especially in disadvantaged settings or situations with structural difficulties, another barrier to access found by some studies [93,94,97].…”

Section: Discussionmentioning

confidence: 65%

Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review

Pujolar-Díaz

Oliver-Anglès

Vargas

et al. 2022

IJERPH

162

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The COVID-19 pandemic and the measures adopted are having a profound impact on a major goal of public healthcare systems: universal access to health services. The objective is to synthesize the available knowledge on access to health care for non-COVID-19 conditions and to identify knowledge gaps. A scoping review was conducted searching different databases (Medline, Google Scholar, etc.) for original articles published between December 2019 and September 2021. A total of 53 articles were selected and analyzed using the Aday and Andersen framework as a guide. Of these, 37 analyzed changes in levels of use of health services, 15 focused on the influencing factors and barriers to access, and 1 studied both aspects. Most focused on specific diseases and the early stages of the pandemic, based on a review of records. Analyses of the impact on primary care services’ use, unmet needs or inequalities in access were scarce. A generalized reduction in the use of health services was described. The most frequent access barrier described for non-COVID-19 conditions related to the services was a lack of resources, while barriers related to the population were predisposing (fear of contagion, stigma, or anticipating barriers) and enabling characteristics (worse socioeconomic status and an increase in technological barriers). In conclusion, our results show a general reduction in services’ use in the early stages of the pandemic, as well as new barriers to access and the exacerbation of existing ones. In view of these results, more studies are required on the subsequent stages of the pandemic, to shed more light on the factors that have influenced access and the pandemic’s impact on equity of access.

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Section: Discussionmentioning

confidence: 65%

Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review

Pujolar-Díaz

Oliver-Anglès

Vargas

et al. 2022

IJERPH

162

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“…Whether dire predictions based on simulations16 17 19 come to fruition in low-income countries such as Ethiopia or whether concerns such as health worker absenteeism, and reduced uptake of health services, which emerged soon after the imposition of virus-control measures are short-lived, is not yet clear. A search of the literature revealed no dearth of papers20–25 calling for attempts to protect the provision of MCH in low-income countries, particularly in sub-Saharan Africa (SSA) but evidence on prepandemic and postpandemic use of health services in Ethiopia and more generally in SSA was more limited.…”

Section: Introductionmentioning

confidence: 99%

Use of healthcare services during the COVID-19 pandemic in urban Ethiopia: evidence from retrospective health facility survey data

et al. 2022

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ObjectivesIn recent years, Ethiopia has made enormous strides in enhancing access to healthcare, especially, maternal and child healthcare. With the onset and spread of COVID-19, the attention of the healthcare system has pivoted to handling the disease, potentially at the cost of other healthcare needs. This paper explores whether this shift has come at the cost of non-Covid related healthcare, especially the use of maternal and child health (MCH) services.SettingData covering a 24-month period are drawn from 59 health centres and 29 public hospitals located in urban Ethiopia.Primary and secondary outcomes measuresThe primary outcome measures are the use of MCH services including family planning, antenatal and postnatal care, abortion care, delivery and immunisation. The secondary outcome measures are the use of health services by adults including antiretroviral therapy (ART), tuberculosis (TB) and leprosy and dental servicesResultsThere is a sharp reduction in the use of both inpatient (20%–27%, p<0.001) and outpatient (27%–34%, p<0.001) care, particularly in Addis Ababa, which has been most acutely affected by the virus. This decline does not come at the cost of MCH services. The use of several MCH components (skilled birth attendant deliveries, immunisation, postnatal care) remains unaffected throughout the period while others (family planning services, antenatal care) experience a decline (8%–17%) in the immediate aftermath but recover soon after.ConclusionConcerns about the crowding out of MCH services due to the focus on COVID-19 are unfounded. Proactive measures taken by the government and healthcare facilities to ring-fence the use of essential healthcare services have mitigated service disruptions. The results underline the resilience and agility displayed by one of the world’s most resource-constrained healthcare systems. Further research on the approaches used to mitigate disruptions is needed.

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“…In addition, the study found that the institutional delivery across the 6 years appears to decrease. The conflict or any political instability could negatively affect the maternal and child health care services ( 39 – 41 ) and mothers receive fewer ANC check-ups during political instability which hindered them not delivering t health facility ( 42 ). Thus, the decreasing level of institutional delivery in this study could be related to the political instability that happened in our country since 2016 and there is also the effect of the COVID-19 pandemic which has been happening worldwide.…”

Section: Discussionmentioning

confidence: 99%

Magnitude, Trends, and Determinants of Institutional Delivery Among Reproductive Age Women in Kersa Health and Demographic Surveillance System Site, Eastern Ethiopia: A Multilevel Analysis

Raru

Ayana

Yuya

et al. 2022

Front. Glob. Womens Health

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BackgroundInstitutional delivery service utilization is a critical and proven intervention for reducing maternal and neonatal mortality. Institutional delivery service utilization can improve maternal health and wellbeing by ensuring safe delivery and reducing problems occurring during childbirth. In Ethiopia, almost all previous researches were cross-sectional studies and most of them were based on small sample sizes and there are no sufficient reports for the trends. Therefore, this study aimed to assess the magnitude, trends, and determinants of institutional delivery using surveillance data from the Kersa Health and Demographic Surveillance System (HDSS), in Eastern Ethiopia from 2015 to 2020.MethodsThe study was conducted among reproductive-aged women selected from the Kersa HDSS site, Eastern Ethiopia for the duration of 2015 to 2020. Data were extracted from the Kersa HDSS database system. After coding and recoding, the data was exported to R software for further analysis. A chi-squared test was used for trends to examine the significance of the change. A multilevel logistic regression model was fitted to identify determinants of institutional delivery. An adjusted odds ratio with a 95% confidence interval (CI) was used to measure the strength of the associations. Statistical significance was declared at a p-value < 0.05.ResultsA total of 20,033 reproductive age women were employed for analysis. The overall magnitude of institutional delivery was 45.03% with 95% CI (44.33–45.72). The institutional delivery has shown a decreasing trend over the 6 years' and there is statistical significance for the declining. Semi-urban resident [AOR = 2.33, 95% CI: 1.37–4.48], urban resident [AOR = 7.18, 95% CI: 5.24, 8.71], read and write [AOR = 1.54, 95% CI: 1.18, 2.01], literate [AOR = 1.46, 95% CI: 1.34–1.59], and antenatal care [AOR = 1.73, 95% CI: 1.58–1.88] were significantly associated with institutional delivery.ConclusionThe magnitude of institutional delivery was relatively low and has shown a decreasing trend. Community-based interventions should be strengthened to reverse the decreasing trend of institutional delivery. Targeted information dissemination and communication should be provided to those mothers who have no formal education and attention should be given to rural residents.

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Access to reproductive health care services in countries of conflict: the double impact of conflict and COVID-19

Cited by 8 publications

References 10 publications

Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review

Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review

Use of healthcare services during the COVID-19 pandemic in urban Ethiopia: evidence from retrospective health facility survey data

Magnitude, Trends, and Determinants of Institutional Delivery Among Reproductive Age Women in Kersa Health and Demographic Surveillance System Site, Eastern Ethiopia: A Multilevel Analysis

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