Disruptions in Maternal and Child Health Service Utilization during COVID-19 : Analysis from Eight Sub-Saharan African Countries
The coronavirus-19 pandemic and its secondary effects threaten the continuity of essential health services delivery, which may lead to worsened population health and a protracted public health crisis. We quantify such disruptions, focusing on maternal and child health, in eight sub-Saharan countries. Service volumes are extracted from administrative systems for 63 954 facilities in eight countries: Cameroon, Democratic Republic of Congo, Liberia, Malawi, Mali, Nigeria, Sierra Leone and Somalia. Using an interrupted time series design and an ordinary least squares regression model with facility-level fixed effects, we analyze data from January 2018 to February 2020 to predict what service utilization levels would have been in March–July 2020 in the absence of the pandemic, accounting for both secular trends and seasonality. Estimates of disruption are derived by comparing the predicted and observed service utilization levels during the pandemic period. All countries experienced service disruptions for at least 1 month, but the magnitude and duration of the disruptions vary. Outpatient consultations and child vaccinations were the most commonly affected services and fell by the largest margins. We estimate a cumulative shortfall of 5 149 491 outpatient consultations and 328 961 third-dose pentavalent vaccinations during the 5 months in these eight countries. Decreases in maternal health service utilization are less generalized, although significant declines in institutional deliveries, antenatal care and postnatal care were detected in some countries. There is a need to better understand the factors determining the magnitude and duration of such disruptions in order to design interventions that would respond to the shortfall in care. Service delivery modifications need to be both highly contextualized and integrated as a core component of future epidemic response and planning.
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Format: | Journal Article biblioteca |
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Oxford University Press
2021-06-19
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Subjects: | ESSENTIAL HEALTH SERVICE, SERVICE DISRUPTION, MATERNAL HEALTH, REPRODUCTIVE HEALTH, HEALTH MANAGEMENT INFORMATION SYSTEM, CORONAVIRUS, COVID-19, CHILD HEALTH, HEALTH SERVICE DELIVERY, PRENATAL CARE, |
Online Access: | http://hdl.handle.net/10986/36730 |
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dig-okr-10986367302022-01-28T16:21:42Z Disruptions in Maternal and Child Health Service Utilization during COVID-19 : Analysis from Eight Sub-Saharan African Countries Shapira, Gil Ahmed, Tashrik Drouard, Salome Henriette Paulette Fernandez, Pablo Amor Kandpal, Eeshani Nzelu, Charles Sanford Wesseh, Chea Mohamud, Nur Ali Smart, Francis Mwansambo, Charles Baye, Martina L Diabate, Mamatou Yuma, Sylvain Ogunlayi, Munirat De Dieu Rusatira, Rwema Jean Hashemi, Tawab Vergeer, Petra Friedman, Jed ESSENTIAL HEALTH SERVICE SERVICE DISRUPTION MATERNAL HEALTH REPRODUCTIVE HEALTH HEALTH MANAGEMENT INFORMATION SYSTEM CORONAVIRUS COVID-19 CHILD HEALTH HEALTH SERVICE DELIVERY PRENATAL CARE The coronavirus-19 pandemic and its secondary effects threaten the continuity of essential health services delivery, which may lead to worsened population health and a protracted public health crisis. We quantify such disruptions, focusing on maternal and child health, in eight sub-Saharan countries. Service volumes are extracted from administrative systems for 63 954 facilities in eight countries: Cameroon, Democratic Republic of Congo, Liberia, Malawi, Mali, Nigeria, Sierra Leone and Somalia. Using an interrupted time series design and an ordinary least squares regression model with facility-level fixed effects, we analyze data from January 2018 to February 2020 to predict what service utilization levels would have been in March–July 2020 in the absence of the pandemic, accounting for both secular trends and seasonality. Estimates of disruption are derived by comparing the predicted and observed service utilization levels during the pandemic period. All countries experienced service disruptions for at least 1 month, but the magnitude and duration of the disruptions vary. Outpatient consultations and child vaccinations were the most commonly affected services and fell by the largest margins. We estimate a cumulative shortfall of 5 149 491 outpatient consultations and 328 961 third-dose pentavalent vaccinations during the 5 months in these eight countries. Decreases in maternal health service utilization are less generalized, although significant declines in institutional deliveries, antenatal care and postnatal care were detected in some countries. There is a need to better understand the factors determining the magnitude and duration of such disruptions in order to design interventions that would respond to the shortfall in care. Service delivery modifications need to be both highly contextualized and integrated as a core component of future epidemic response and planning. 2021-12-14T20:04:58Z 2021-12-14T20:04:58Z 2021-06-19 Journal Article Health Policy and Planning http://hdl.handle.net/10986/36730 CC BY-NC-ND 3.0 IGO http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank Oxford University Press Publications & Research Publications & Research :: Journal Article Africa Africa Eastern and Southern (AFE) Africa Western and Central (AFW) Sub-Saharan Africa |
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ESSENTIAL HEALTH SERVICE SERVICE DISRUPTION MATERNAL HEALTH REPRODUCTIVE HEALTH HEALTH MANAGEMENT INFORMATION SYSTEM CORONAVIRUS COVID-19 CHILD HEALTH HEALTH SERVICE DELIVERY PRENATAL CARE ESSENTIAL HEALTH SERVICE SERVICE DISRUPTION MATERNAL HEALTH REPRODUCTIVE HEALTH HEALTH MANAGEMENT INFORMATION SYSTEM CORONAVIRUS COVID-19 CHILD HEALTH HEALTH SERVICE DELIVERY PRENATAL CARE |
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ESSENTIAL HEALTH SERVICE SERVICE DISRUPTION MATERNAL HEALTH REPRODUCTIVE HEALTH HEALTH MANAGEMENT INFORMATION SYSTEM CORONAVIRUS COVID-19 CHILD HEALTH HEALTH SERVICE DELIVERY PRENATAL CARE ESSENTIAL HEALTH SERVICE SERVICE DISRUPTION MATERNAL HEALTH REPRODUCTIVE HEALTH HEALTH MANAGEMENT INFORMATION SYSTEM CORONAVIRUS COVID-19 CHILD HEALTH HEALTH SERVICE DELIVERY PRENATAL CARE Shapira, Gil Ahmed, Tashrik Drouard, Salome Henriette Paulette Fernandez, Pablo Amor Kandpal, Eeshani Nzelu, Charles Sanford Wesseh, Chea Mohamud, Nur Ali Smart, Francis Mwansambo, Charles Baye, Martina L Diabate, Mamatou Yuma, Sylvain Ogunlayi, Munirat De Dieu Rusatira, Rwema Jean Hashemi, Tawab Vergeer, Petra Friedman, Jed Disruptions in Maternal and Child Health Service Utilization during COVID-19 : Analysis from Eight Sub-Saharan African Countries |
description |
The coronavirus-19 pandemic and its secondary effects threaten the continuity of essential health services delivery, which may lead to worsened population health and a protracted public health crisis. We quantify such disruptions, focusing on maternal and child health, in eight sub-Saharan countries. Service volumes are extracted from administrative systems for 63 954 facilities in eight countries: Cameroon, Democratic Republic of Congo, Liberia, Malawi, Mali, Nigeria, Sierra Leone and Somalia. Using an interrupted time series design and an ordinary least squares regression model with facility-level fixed effects, we analyze data from January 2018 to February 2020 to predict what service utilization levels would have been in March–July 2020 in the absence of the pandemic, accounting for both secular trends and seasonality. Estimates of disruption are derived by comparing the predicted and observed service utilization levels during the pandemic period. All countries experienced service disruptions for at least 1 month, but the magnitude and duration of the disruptions vary. Outpatient consultations and child vaccinations were the most commonly affected services and fell by the largest margins. We estimate a cumulative shortfall of 5 149 491 outpatient consultations and 328 961 third-dose pentavalent vaccinations during the 5 months in these eight countries. Decreases in maternal health service utilization are less generalized, although significant declines in institutional deliveries, antenatal care and postnatal care were detected in some countries. There is a need to better understand the factors determining the magnitude and duration of such disruptions in order to design interventions that would respond to the shortfall in care. Service delivery modifications need to be both highly contextualized and integrated as a core component of future epidemic response and planning. |
format |
Journal Article |
topic_facet |
ESSENTIAL HEALTH SERVICE SERVICE DISRUPTION MATERNAL HEALTH REPRODUCTIVE HEALTH HEALTH MANAGEMENT INFORMATION SYSTEM CORONAVIRUS COVID-19 CHILD HEALTH HEALTH SERVICE DELIVERY PRENATAL CARE |
author |
Shapira, Gil Ahmed, Tashrik Drouard, Salome Henriette Paulette Fernandez, Pablo Amor Kandpal, Eeshani Nzelu, Charles Sanford Wesseh, Chea Mohamud, Nur Ali Smart, Francis Mwansambo, Charles Baye, Martina L Diabate, Mamatou Yuma, Sylvain Ogunlayi, Munirat De Dieu Rusatira, Rwema Jean Hashemi, Tawab Vergeer, Petra Friedman, Jed |
author_facet |
Shapira, Gil Ahmed, Tashrik Drouard, Salome Henriette Paulette Fernandez, Pablo Amor Kandpal, Eeshani Nzelu, Charles Sanford Wesseh, Chea Mohamud, Nur Ali Smart, Francis Mwansambo, Charles Baye, Martina L Diabate, Mamatou Yuma, Sylvain Ogunlayi, Munirat De Dieu Rusatira, Rwema Jean Hashemi, Tawab Vergeer, Petra Friedman, Jed |
author_sort |
Shapira, Gil |
title |
Disruptions in Maternal and Child Health Service Utilization during COVID-19 : Analysis from Eight Sub-Saharan African Countries |
title_short |
Disruptions in Maternal and Child Health Service Utilization during COVID-19 : Analysis from Eight Sub-Saharan African Countries |
title_full |
Disruptions in Maternal and Child Health Service Utilization during COVID-19 : Analysis from Eight Sub-Saharan African Countries |
title_fullStr |
Disruptions in Maternal and Child Health Service Utilization during COVID-19 : Analysis from Eight Sub-Saharan African Countries |
title_full_unstemmed |
Disruptions in Maternal and Child Health Service Utilization during COVID-19 : Analysis from Eight Sub-Saharan African Countries |
title_sort |
disruptions in maternal and child health service utilization during covid-19 : analysis from eight sub-saharan african countries |
publisher |
Oxford University Press |
publishDate |
2021-06-19 |
url |
http://hdl.handle.net/10986/36730 |
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