Impact of COVID-19 on Maternal and Perinatal Care at Public Hospitals in the Sidama Region, Southern Ethiopia: A Mixed Methods Study

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๐—•๐—ฎ๐—ฐ๐—ธ๐—ด๐—ฟ๐—ผ๐˜‚๐—ป๐—ฑ: The novel coronavirus disease 2019 (COVID-19) continues to pose a global public health threat. ๐—”๐—ถ๐—บ: The aim of this study is to explore the impact of the COVID-19 pandemic on antenatal care uptake, access, provision, and intrapartum care in public hospitals in the Sidama Region, Southern Ethiopia. ๐— ๐—ฒ๐˜๐—ต๐—ผ๐—ฑ๐˜€: A concurrent mixed methods study was conducted at fifteen public hospitals in the Sidama region. Data were extracted from the hospital management information system before the pandemic, 12 months of data (March 2019-Feb 2020) and during the pandemic, six months of data, (March to August 2020). The data from all women and neonates who utilised the aforementioned health services from March 2019 to August 2020 were included in the quantitative component of this study. The Poisson regression model was used to estimate incidence rates of maternal and perinatal uptake before and during the pandemic. Qualitative data were derived from in-depth interviews with twenty-eight health professionals and seventeen women. Four focus group discussions (N=25) were conducted with women to build dynamic interactions among participants, leading to a more nuanced understanding of the topic and revealing aspects that might not surface in one-on-one interviews. Thematic analysis was applied to analyse qualitative data. The joint display technique was applied to integrate quantitative and qualitative data. ๐—ฅ๐—ฒ๐˜€๐˜‚๐—น๐˜๐˜€: This study demonstrated that maternal and perinatal care access, uptake and provision were affected by the pandemic, as explained in the qualitative results with the themes โ€˜Delays in maternity care uptake during COVID-19โ€™, โ€˜Shortage of resources during COVID-19โ€™, โ€˜Barriers to maternity care uptake during COVID-19โ€™, and โ€˜Mistreatment of women during maternity care during COVID-19โ€™. 'Discrimination', 'Delays in care', โ€™Disrespectful careโ€™ and 'Suboptimal care' may have led to neonatal and maternal mortality during the COVID-19 pandemic. ๐—–๐—ผ๐—ป๐—ฐ๐—น๐˜‚๐˜€๐—ถ๐—ผ๐—ป: It was evident from this study that maternity care was severely disrupted by the COVID-19 pandemic in 2020. Governments, hospitals and health care professionals were challenged in their provision of adequate maternity care, and at the community and individual level, women faced numerous challenges in accessing timely and adequate maternal health services. To restore disrupted services, government provision of supplies to fully equip antenatal care clinics and sufficient numbers of healthcare providers to staff clinics is vital. On-site training for maternity care providers to offer respectful care and for women to receive a minimum standard of optimal care, would lead to ensuring a better outcome for women and perinatal care.
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