The impacts of COVID-19 and its policy response on access and utilization of maternal and child health services in Tanzania: a mixed methods study

Abstract

The SARS-Cov-2 virus (COVID-19) has had a global social and economic impact. Despite the growing evidence, its effects on access and delivery of maternal and child health services in low-income countries are still unclear. This cross-sectional case study was conducted in Mjini Magharibi, Chake Chake, and Ilala districts in Tanzania to help fill this gap. The study combined qualitative and quantitative data collection methods, providing an account of the evolution of the pandemic and the associated control measures in Tanzania. We drew from 34 in-depth interviews, 60 semi-structured interviews, and 14 focus group discussions with key informants, patients, and health providers, and complemented the findings with a review of pandemic reports and health facility records. We followed the Standards for Reporting Qualitative Research to provide an account of the findings. Our account of the pandemic shows that there was a non-linear policy response in Tanzania, with diverse control measures adopted at various stages of the epidemic. There was a perception that COVID-19 services were prioritized during the epidemic at the expense of regular ones. There were reports of reorganisation of health facilities, reallocation of staff, rescheduled antenatal and postnatal clinics, and reduced time for health education and child monitoring. Scarcity of essential commodities was reported, such as vaccines, equipment, and medical supplies. Such perceptions were in part supported by the routine utilization evidence in the three districts, showing a lower uptake of antenatal, postnatal, family planning, and immunization services, as well as fewer institutional deliveries. Our findings suggest that, despite the erratic policy response in Tanzania, fear caused by the pandemic and the diversion of resources to control COVID-19 may have contributed most to lower the utilization of mother and child services. For future emergencies, it will be crucial to ensure the policy response does not weaken the population’s demand for services.

Determining the Impact of the COVID-19 Pandemic on Availability, Use, and Readiness of Family Planning and Contraceptive Services at Selected Primary Health Care Facilities in Africa and Asia: Protocol for a Mixed Methods Study

“…A rapid qualitative study among young men and couples in 2 districts from 2 states of India (Bihar and Uttar Pradesh) showed a marked increase in the demand and use of condoms compared to pre–COVID-19 times, while women avoided the use of oral contraceptive pills due to the misperception of its ill effects on their health [ 19 ]. A mixed methods study in 3 purposively selected districts from 3 regions of Tanzania (Unguja, Pemba, and Dar es Salaam) revealed low uptake of FP services because of changes in clinic schedules, fear of COVID-19 infection, and unavailability of contraceptives [ 20 ]. Additionally, the quantitative analysis of FP use between January and March in 2019, 2020, and 2021 showed a decrease in FP use in 2020 for continuing clients, whereas an increased trend was noted for new clients in 2020 and 2021.…”

Assessing System Performance of Maternal and Child Health Care During Covid-19 Pandemic in Community Health Center- Comoro Dili Timor-Leste

“…[27] Study from Tanzania suggest that a part erratic political response, it was rather fear of the pandemic itself and diversion of resources to control COVID-19, that may have contributed most to lower the utilization of mother and child services. [28] The Availability of Health Care Workers,…”

Análisis de la Situación: Enfermedad por el Virus de Marburg en Guinea Ecuatorial y Tanzania

“…This perception may have led to underutilisation of primary care services, particularly by vulnerable groups. 54 This perception may also have exacerbated existing barriers to care-seeking, which were already influenced by concerns about cost and quality of care prior to the pandemic. 55 Much like Equatorial Guinea, there is some evidence that typical initial responses to febrile illness in Tanzania are to self-treat with remedies sourced from pharmacies and dispensaries.…”