Assessment of maternal and child health care services performance in the context of COVID-19 pandemic in Addis Ababa, Ethiopia: evidence from routine service data

Abstract

Background In many settings, health care service provision has been modified to managing COVID-19 cases, and this has been affecting the provision of maternal and child health services. The aim of this study was to assess trends in selected maternal and child health services performance in the context of COVID-19 pandemic. Methods A cross-sectional data review was conducted in Addis Ababa, Ethiopia from April to May 2021. Routine health management information system database was reviewed from Addis Ababa Health Bureau for the period from July 2019 to March 2021 across all quarters. Proportion and mean with standard deviation were computed. T-test was used to assess statistically significant differences in services mean performance. Results Postnatal care visit, new contraceptives accepters, safe abortion care and number of under-5 years old children treated for pneumonia significantly decreased by 9.3% (p-value 0.04), 20.3% (p-value 0.004), 23.7% (p-value 0.01) and 77.2% (p-value < 0.001), respectively during the first 8 months of the COVID-19 pandemic compared to the previous 8 months’ average performance. The trends in Antenatal care first visit, new contraceptive accepters, pentavalent-3 vaccination and under-five children treated for pneumonia began to decline in January to March 2020, a quarter when the COVID-19 pandemic began; with accelerated declines in April to June 2020 following national lockdown. The trends for the stated services began to increase during July–September 2020, the last quarter of national lockdown. Contraceptive accepters and pentavalent-1 vaccination continued to decline and showed no recovery until January–March 2021 when this study was completed. Conclusions Most of the maternal and child health services performance declined following the onset of COVID-19 pandemic and national lockdown, and most of the services began recovering during July–September 2020, the last quarter of national lockdown. However, new and repeat contraceptive accepters and pentavalent-1 recipients continue to decline and show no recovery during end of the study period. Implementing COVID-19 prevention measures and assuring the community about the safety of service delivery is imperative to ensure continuity of the maternal and child health services. Regular monitoring and evaluation of services performance is required to identify slowly recovering services and respond to potentially volatile changes during the COVID-19 pandemic.

Impact of the COVID-19 pandemic on utilisation of facility-based essential maternal and child health services from March to August 2020 compared with pre-pandemic March–August 2019: a mixed-methods study in North Shewa Zone, Ethiopia

“…Globally, contraception services were shut down or inaccessible22 and service provision declined 23 24. In Addis Ababa, FP service utilisation declined for new users and repeat users 18. In our study, health centre and hospital-based FP service utilisation decreased, but this may have been balanced by services provided by health extension workers at health posts in villages which when combined shows that repeat FP service utilisation was better maintained although still with a modest decline.…”

“…In African countries, ANC, PNC visits and facility deliveries were reduced 14–17. In Addis Ababa, COVID-19-confirmed cases and public panic were higher than in other areas of Ethiopia, and women and children’s facility-based service utilisation declined 18. Similarly, a significant reduction of essential MNCH service utilisation was observed from March to June 2020 in Southwest Ethiopia 19.…”

Utilization of Postnatal Care Services among Thai Women during the COVID-19 Pandemic: Results of a Web-Based Survey

“…A recent study from Ethiopia reported that early PNC checkups decreased by 9.3% in the period from March to October 2020 (the first eight months of the pandemic) compared with the period from July 2019 to February 2020 [ 13 ]. Thailand still lacks nationally representative data in relation to PNC health checkups [ 21 ].…”

“…Moreover, the coronavirus disease (COVID-19), emerging from the Hubei Province in the People’s Republic of China in December 2019 and subsequently spreading throughout the world, has resulted in alterations to healthcare structures and processes, such as reduced maternity service provision, including PNC [ 7 , 8 , 9 , 10 , 11 , 12 ]. However, to our knowledge, only a few studies have examined the PNC uptake using a quantitative approach during the pandemic in Ethiopia [ 13 ], Bangladesh [ 14 ], and the UK [ 15 ].…”

COVID-19 vaccine acceptability and determinants among pregnant mothers attending antenatal care services at Debre Markos town public health institutions, Debre Markos Northwest Ethiopia: mixed study

“…Currently, the COVID-19 vaccine acceptability in pregnant mothers is also varied from country to country [ 14 , 15 ]. Ethiopia uses the World Health Organization´s recommendation for COVID-19 vaccine utilization and the Ethiopian ministry of health has identified maternal services to improve maternal and child health and decrease COVID-19 infections [ 16 ]. Despite the Ethiopian ministry of health allowing and using the World Health Organization´s recommendation, the level of COVID vaccine acceptability, determinants, and reasons for COVID vaccine hesitancy is not well known.…”