Impact of COVID‐19 pandemic on reproductive, maternal, newborn, and child health care services in Phuentsholing General Hospital: A retrospective descriptive study

Abstract

Background COVID‐19 pandemic has derailed health care services. The health resources and manpower were prioritized and diverted to curb the COVID‐19 infections at the cost of routine medical services to the people. The impact of the COVID‐19 pandemic on maternal and child health is unknown. This study aimed to assess the impact of the Covid‐19 pandemic on maternal and child health care services in Phuentsholing General Hospital. Methods A descriptive retrospective study was conducted at Phuentsholing General Hospital from January 1 to June 30, 2022. The patient medical records were reviewed for the prepandemic years 2018, and 2019, and the pandemic years 2020, and 2021. The medical records of all the female patients and newborns who came to the Maternal and Child Health Unit (MCH), those who were admitted to the gynecology ward, and who underwent obstetrical and gynecological surgeries were reviewed. The data were analyzed using SPSS version 23. Descriptive statistics such as frequencies and percentages were used to describe the study variables. The line graph and bar graph were used to determine the trends and to compare the impact of COVID‐19 on MCH services between the pre‐pandemic and pandemic years. Results During the COVID‐19 pandemic, the total admission dropped by 10% to 14.4%; the total deliveries dropped by 16.1%; Cesarean section rate dropped to 12.9%; and fewer gynecological surgeries were performed (13.9% from 20.6%). There was a significant drop in antenatal and postnatal follow‐up visits (31.5% and 24.51%) respectively; Pap smear dropped by 93% and colposcopy by 52%. The overall immunization coverage has dropped drastically during the pandemic period. Conclusion The pregnant mothers and newborn babies missed antenatal and postnatal follow‐up visits, missed immunization, and women were not able to be screened for cervical cancers during the pandemic. These negative impacts of the COVID‐19 pandemic on maternal and child health care were profound.

Measles Vaccine Coverage and Disease Outbreaks: A Systematic Review of the Early Impact of COVID-19 in Low and Lower-Middle Income Countries

“…Contrarily, studies in Pakistan, Ghana and Sierra Leone identified a greater reduction in doses given at the start of the childhood schedule and attributed this as due to a reduction in births in hospitals [ 26 , 43 , 46 , 48 ]. Dorjey et al [ 30 ] identified an overall drop of in-hospital deliveries of 16% in pandemic years in Bhutan. Kissi et al [ 44 ] reported in Ghana that, prior to COVID-19, “children delivered by traditional birth attendants outside the healthcare sector are more likely to miss immunization because their mothers become hesitant to immunize their children.” COVID-19-related disruption and fewer in-hospital births may combine to hinder EPI coverage due to a relative reduction of healthcare contact.…”

“…[63] "Reports for seven (23%) of 30 countries indicated challenges with vaccine supply" [21] Lockdowns 14 "Immunisation of new-borns were temporarily deferred in Bhutan during nationwide lockdown periods." [30] "Reduced urban vaccination because needed public transport [to access vaccination centre], which was cancelled due to COVID." [48] "Ban on interstate movement reduced access to healthcare facilities."…”

Achieving Surgical, Obstetric, Trauma, and Anesthesia (SOTA) care for all in South Asia

“…For instance, early on in the pandemic, volumes of emergency surgery were reduced to lockdowns, elective surgeries, and outpatient appointments were canceled followed by delays ( 124 ). At the Phuentsholing General Hospital in Bhutan, cesarean section deliveries dropped by 6.6% and gynecological surgeries dropped to 13.9% of the total gynecological services from 20.6% during the pandemic years (2020–21) compared to 2019 ( 125 ). Across cancer, cardiovascular, respiratory, and other conditions, surgical treatments during COVID-19 (2020–21) were reduced by 4 to 97% across different studies for India compared to 2019 and previous years ( 126 ).…”

Assessing the hidden burden and costs of COVID-19 pandemic in South Asia: Implications for health and well-being of women, children and adolescents

“…Evidence from past crises, such as the 1997 East Asian financial crisis, the 2008 global financial and food price increase crises, and the 2013-16 Ebola outbreak in West Africa, underscore the vulnerability of women and children, through reduced access to antenatal care, immunizations and schooling [5][6][7][8][9][10]. Evidence from the COVID-19 pandemic paints a similar picture, including deferral or non-receipt of antenatal care visits due to lockdowns and lack of transport, decrease in facility-based deliveries, and child growth monitoring and immunizations by up to 50%, especially in the early months of the pandemic [11][12][13][14][15][16].…”