The impact of covid-19 on midwives’ practice in Kenya, Uganda and Tanzania: A reflective account

Pallangyo, Eunice; Nakate, Mary Grace; Maina, Rose; Fleming, Valerie

doi:10.1016/j.midw.2020.102775

Cited by 69 publications

(67 citation statements)

References 10 publications

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“…The world's largest condom manufacturer (Malaysia's Karex Bhd), which produces one in every five condoms in the world, was forced to close in March, thereby limiting the export of condoms [32]. Closure of borders and travel restrictions also affect the distribution of contraceptive medications and devices [33]. A report from the UN regarding the impact of COVID-19 on reproductive health states that national members of the International Planned Parenthood Federation (IPPF) also face commodity and supply shortages, with 59 members reporting delays in moving goods within countries, and 29 facing a shortage of contraceptives [26].…”

Section: Barriers To Access To Contraception In Developing Countries mentioning

confidence: 99%

“…Another factor affecting contraceptive provision is the availability of health care workers to physically staff clinics. A study regarding the impact of COVID-19 in Kenya, Uganda, and Tanzania reports that prior to the pandemic, there was a longstanding shortage of health professionals, in addition to overloaded health facilities [33]. As such, midwives play a pivotal role in care provision, by delivering contraception and obstetric care to women and families in remote areas or overwhelmed systems [34].…”

Section: Barriers To Access To Contraception In Developing Countries mentioning

confidence: 99%

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Contraception access during the COVID-19 pandemic

Aly

Haeger

Christy

et al. 2020

Contracept Reprod Med

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, over 7 million confirmed cases and over 400,000 deaths had been recorded across 213 countries and territories [3]. In outbreaks, epidemics, and pandemics, epidemiologists aim to quantify the spread of a disease within a population across space and time. In addition, epidemiologists aim to quantify the rate of disease transmission. This information is then used to inform prevention and mitigation strategies. Although aggressive prevention strategies may be disruptive and costly, such measures may ultimately reduce the burden of morbidity and mortality within a population, as has been demonstrated in previous pandemics, such as the 1918-1920 influenza and the 2009 influenza A (H1N1) pandemics [4, 5]. The first tier of response is containment to prevent the spread of disease before it has a chance to take hold in the community [6]. This may include contact tracing, surveillance in the community through widespread testing, and quarantine measures. However, once a disease has spread through the community, the second tier, mitigation strategies, are necessary to reduce transmission. Interventions include social distancing measures; closure of schools, workplaces, and community facilities; travel restrictions; and individual-level hygiene measures, such as wearing a mask and washing hands [6]. Without mitigation efforts in place, healthcare systems risk being stretched beyond capacity in, for example, intensive care unit (ICU) beds, personal protective equipment (PPE), and ventilators for treating patients with COVID-19. This is why countries who were in the mitigation phase of the pandemic conducted communication campaigns imploring individuals to engage in behaviors to "flatten the curve." Beyond the mitigation tier, state-level actors may put lockdowns in place to further curb transmission. Scope of the problem Asia Countries across Asia were some of the first to experience the outbreak of COVID-19. Many had already had previous experiences dealing with epidemics, including severe acute respiratory syndrome (SARS) from 2002 to 2003, H1N1 flu in 2009, and Middle East Respiratory Syndrome (MERS) in 2014, 2015 and 2018 [7]. Such experiences had prepared governments to respond and made their populations more receptive to restrictive public health measures. Some entities, including South Korea, Mongolia, Hong Kong, and Singapore, initially succeeded in containing the virus through aggressive preemptive measures: transparency in communication, ubiquitous testing, strict quarantine, and thorough disinfectant protocols [7, 8]. South Korea used such measures without ever putting a lockdown in place. After failures in communication during the MERS epidemic in 2015, new standard operating procedures were put in place. By the time COVID-19 arrived, Koreans were willing to

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Section: Barriers To Access To Contraception In Developing Countries mentioning

confidence: 99%

Section: Barriers To Access To Contraception In Developing Countries mentioning

confidence: 99%

Contraception access during the COVID-19 pandemic

Aly

Haeger

Christy

et al. 2020

Contracept Reprod Med

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“…In Kenya, there have been reports of decreased antenatal attendance, immunisations, and hospital deliveries, along with an increase in stillbirths during COVID-19 [17][18][19]. This decline may be attributable to restricted access to health facilities arising from city lockdowns and curfews imposed by the government, where pregnant women and their companions fear harassment and arrest by the police.…”

Section: Impact Of Covid-19 On Maternal and Newborn Carementioning

confidence: 99%

Maternal and newborn care during the COVID-19 pandemic in Kenya: re-contextualising the community midwifery model

et al. 2020

Self Cite

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Peripartum deaths remain significantly high in low- and middle-income countries, including Kenya. The COVID-19 pandemic has disrupted essential services, which could lead to an increase in maternal and neonatal mortality and morbidity. Furthermore, the lockdowns, curfews, and increased risk for contracting COVID-19 may affect how women access health facilities. SARS-CoV-2 is a novel coronavirus that requires a community-centred response, not just hospital-based interventions. In this prolonged health crisis, pregnant women deserve a safe and humanised birth that prioritises the physical and emotional safety of the mother and the baby. There is an urgent need for innovative strategies to prevent the deterioration of maternal and child outcomes in an already strained health system. We propose strengthening community-based midwifery to avoid unnecessary movements, decrease the burden on hospitals, and minimise the risk of COVID-19 infection among women and their newborns.

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“…58 Maternal health workers, such as midwives in Kenya, Uganda and Tanzania, reported low numbers attending maternal health clinics, and more women coming into hospitals late, without su cient antenatal care. 59 A survey by the Population Council sampling heads of households across ve Nairobi urban slums found that 9% of participants forewent health services such as antenatal care and immunization/nutrition services for children. 60 Further, a rapid gender analysis by CARE West Africa found consistent reports of false rumors about the virus and a general mistrust of health workers, leading to some men, especially in rural areas, forbidding their wives from seeking health services.…”

Section: Prenatal Carementioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Maternal and Perinatal Health: A Scoping Review

Kotlar

Gerson

Petrillo

et al. 2020

Preprint

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Introduction: Maternal health is a critical public health issue, and the Coronavirus Disease 2019 (COVID-19) pandemic has had a multifaceted impact on the health and wellbeing of pregnant individuals and mothers. Methods: A scoping review was conducted to compile evidence on direct and indirect impacts of the pandemic on maternal health and provide an overview of the most significant outcomes thus far. Working papers and news articles were considered appropriate evidence along with peer-reviewed publications in order to capture rapidly evolving updates. Narrative descriptions were written about subject areas for which the authors found the most evidence.Results: While the search yielded numerous publications, most studies were methodologically weak. Pregnant individuals were not found to experience more severe symptoms than the general population, and intrauterine, vertical, and breastmilk transmission were unlikely. Labor, delivery, and breastfeeding guidelines for COVID-19 positive patients varied. Severe increases in maternal mental health issues, such as clinically relevant anxiety and depression, were reported. Domestic violence appeared to spike. Prenatal care visits decreased, healthcare infrastructure was strained, and potentially harmful policies implemented with little evidence. Women were more vulnerable to losing their income due to the pandemic than men, and working mothers struggled with increased childcare demands. Conclusion:Pregnant women and mothers were not found to be at higher risk for COVID-19 than the general population, however they seem to face disproportionate adverse socio-economic consequences. High income and low- and middle-income countries alike faced significant struggles. Further resources should be directed towards quality epidemiological studies.

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The impact of covid-19 on midwives’ practice in Kenya, Uganda and Tanzania: A reflective account

Cited by 69 publications

References 10 publications

Contraception access during the COVID-19 pandemic

Contraception access during the COVID-19 pandemic

Maternal and newborn care during the COVID-19 pandemic in Kenya: re-contextualising the community midwifery model

The Impact of the COVID-19 Pandemic on Maternal and Perinatal Health: A Scoping Review

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