Antenatal care utilization during the COVID-19 pandemic: an online cross-sectional survey among Filipino women

Abstract

Background The COVID-19 pandemic resulted in unprecedented challenges to healthcare systems worldwide, including interruption of antenatal care services. The study aimed to determine the utilization of antenatal care services of Filipino women during the COVID-19 pandemic. Methods A cross-sectional study was conducted among postpartum women using an online self-administered survey in the Philippines from January 1 to March 31, 2022. The questionnaire used to assess health-seeking behavior was validated before the survey proper. Women aged 18 to 45 years who delivered in 2021 were recruited. The participants answered a structured questionnaire to assess their access, perceptions, and utilization of antenatal care. Utilization of antenatal care was evaluated using standard measures, including the timing of initiation of antenatal care, number of subsequent visits, and place of consults. The factors affecting the adequacy of antenatal care were determined for each variable through simple logistic regression. Results A total of 318 women were enrolled in the study. All the respondents agreed on the necessity of antenatal care. However, only 46.37% had six or more in-person antenatal visits, with the majority attended to by midwives at community health centers. Most respondents (71.38%) initiated antenatal care during the first trimester. Almost half reported deferrals of visits mainly due to lockdown restrictions, transportation problems, and financial issues. Positive predictors of adequate antenatal care were prior pregnancies (OR 1.80, 95% CI 1.11–9.20 for 2–3 prior pregnancies; OR 3.02, 95% CI 1.45–6.29 for 4 or more prior pregnancies), live births (OR 1.67, 95% CI 1.04–2.69 for 2–3 prior live births; OR 2.46, 95% CI 1.17–5.16 for 4 or more prior live births), having living children (OR 1.74, 95% CI 1.09–2.79), spousal support (OR 1.75, 95% CI 1.01–3.03 for married women; OR 1.89, 95% CI 1.09–3.28 for women with common-law partners), history of obstetric complications (OR 2.82, 95% CI 1.33–5.97), and use of private vehicles (OR 2.65, 95% CI 1.05–6.68). Negative predictors were employment (OR 0.37, 95% CI 0.22–0.63) and medical examination prior to pregnancy (OR 0.36, 95% CI 0.23–0.58). Conclusion Despite an overall positive perception of the necessity of antenatal care, utilization has been inadequate in more than half of the respondents. Various individual, facility, and policy-level factors affected the utilization of services during the pandemic. There is a need to augment antenatal care services in the country by mitigating barriers to access. The public health response should strengthen collaborative efforts with primary-level healthcare to increase service provision, especially to more vulnerable populations.

Effect of COVID-19 Pandemic on Knowledge, Attitude and Practices Towards Antenatal Care Among Antenatal Women: A Study From a Tertiary Care Hospital in Delhi, India

“…The participants were well-versed in the significance of diagnostic procedures for feto-maternal monitoring, the necessity of iron and calcium supplements; thus reflecting a comprehensive understanding of the essential obstetric care required by them. This sentiment echoed the findings of a systematic review from South America [17] Another remarkable finding is that the awareness was put very well into practice by women in the study, which was similar to a cross-sectional study conducted in the Philippines, establishing prior pregnancy experiences as the positive predictors of adequate ANC [18]. This suggests a general adherence to the importance of seeking prenatal care, despite the challenges posed by any restrictive future health condition.…”

“…Another remarkable finding is that the awareness was put very well into practice by women in the study, which was similar to a cross-sectional study conducted in the Philippines, establishing prior pregnancy experiences as the positive predictors of adequate ANC [ 18 ]. This suggests a general adherence to the importance of seeking prenatal care, despite the challenges posed by any restrictive future health condition.…”

Meta-Analysis the Effects of Education, Pregnancy Planning, Husband Support, and Distance to Health Facilities on the Utilization of Antenatal Care Service

“…Research by Kaphle et al, (2018) shows that as many as 87% of highly educated mothers use ANC. Educated mothers who can access and obtain information about their pregnancies have a better understanding of the benefits of ANC and are confident in making decisions (De Guzman et al, 2022). A similar study was conducted based on a health survey in Ethiopia that showed that >50% of highly educated mothers took advantage of ANC (Tsegaye et al, 2021).…”

COVID-19 Distribution in Pregnancy, Drug Use Patterns and COVID-19 Medication during the Pandemic in Spain: Data from Real-World Electronic Health Records

“…In addition to this increased risk, during the COVID-19 pandemic, pregnant women and their offspring might have experienced more difficulties in accessing clinical services, including monitoring, antenatal visits and pharmacological treatment, among others, due to several factors such as lockdown, travel restrictions and fear of infection. Prior studies have found an inadequate utilization of healthcare services and a delay in the initiation of antenatal care visits [ 6 , 7 , 8 ]. This fact might be of special relevance as the potential cause of increasing maternal mental health problems, such as clinical depression or anxiety, inadequate pharmacological treatment for chronic antenatal conditions and pregnancy undermonitoring.…”