Challenges in Accessing and Delivering Maternal and Child Health Services during the COVID-19 Pandemic: A Cross-Sectional Rapid Survey from Six States of India

Abstract

Background/Objectives: Globally, the COVID-19 pandemic and its prevention and control policies have impacted maternal and child health (MCH) services. This study documents the challenges faced by patients in accessing MCH services, and the experiences of health care providers in delivering those services during the COVID-19 outbreak, explicitly focusing on the lockdown period in India. Methods: A cross-sectional study (rapid survey) was conducted in 18 districts from 6 states of India during March to June, 2020. The sample size included 540 MCH patients, 18 gynaecologists, 18 paediatricians, 18 district immunisation officers and 108 frontline health workers. Bivariate analysis and multivariable analysis were used to assess the association between sociodemographic characteristics, and challenges faced by the patients. Results: More than one-third of patients (n = 212; 39%) reported that accessing MCH services was a challenge during the lockdown period, with major challenges being transportation-related difficulties (n = 99; 46%) unavailability of hospital-based services (n = 54; 23%) and interrupted outreach health services (n = 39; 18.4%). The supply-side challenges mainly included lack of infrastructural preparedness for outbreak situations, and a shortage of human resources. Conclusions/Recommendations: A holistic approach is required that focuses on both preparedness and response to the outbreak, as well reassignment and reinforcement of health care professionals to continue catering to and maintaining essential MCH services during the pandemic.

Impact of COVID-19 on essential service provision for reproductive, maternal, neonatal, and child health in the Southeast Asia region: a systematic review

“…This aligns with recent qualitative analyses. 58 , 59 , 60 Other published evidence has also shed light on the myriad supply side factors that negatively impact the provision of essential healthcare services, including staff absenteeism; shortages in medicines and health supplies; and pivoting for human resources, supplies, and infrastructure for COVID-19 cases. 61 , 62 The negative impact of these barriers was demonstrated immediately with reductions in antenatal care, facility-based deliveries, immunisation provisions, and elevated rates of high-risk pregnancies.…”

The Impact of the COVID-19 Pandemic on Neonatal Services: A Review Article

“…The pandemic has overwhelmed many hospitals and clinics, reducing essential maternal and newborn health services. This has resulted in an increase in maternal and neonatal mortality rates (18).…”