Maternal health care services utilization amidst Covid-19 lockdown: retrospective study
Abstract
Objective: The objective was to find the changes in maternal health care utilization.
Design: Retrospective design was adopted.
Setting: Study was conducted in Damak, Nepal.
Methods: Data from four hospitals was retrieved for fiscal year 2076/77 (July 14,2019 - June 14 2020). Trend analysis was done.
Results : Study showed a decline in utilization of overall maternal health care during the months of Lockdown The utilization of antenatal care services has declined in the beginning of Lockdown but shows an increasing trend in the month of May-June. The number of Normal deliveries has declining trend since the beginning of Lockdown. The number of Caeserean Section declined during (March 14- April 12) and slightly increased in Bhaishak (April 13-May 13), but reduced again in the month of Jestha (may13-June14). The number of permanent family planning service use reduced in Chaitra (March 14-April 12), increased very slightly in Bhaishak(April 13-May 13), and declined again in the month of Jestha(may13-June14). The utilization of temporary family planning method and immunization has increased in the later month of Lockdown.
Conclusion: This decline in utilization may increase the maternal morbidity and mortality rates.
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Introduction
Corona virus is the ongoing international pandemic which started at Wuhan City, Hubei province of china on December. The number of infected people with Corona virus worldwide as of July, 2020 is 6,421,255 with mortality up to 3,79,055.1 In Nepal, first case of Corona Virus was detected in January with increasing cases up to 13248 as of June, 2020.2 As a preventive measure, Nepal has been in lockdown since the month of Chaitra,2076 (March,2020).
Maternal Mortality before the pandemic was 229 women/100,000 births according to the 2019 data of Family Welfare Division of Department of Health Services in Nepal. Even with decreasing MMR from 539 in 1996 to 239 in 2016, still 58 per cent of births in Nepal were attended by skilled health personnel before the lockdown. 2,3Now, due to movement restrictions, transportation disruptions, and fear of being exposed to the virus, women are facing even more barriers to accessing maternal health care.3
Only around one fourth of women are seeking maternity services at Kathmandu Model Hospital after the lockdown started.
Conclusion
Since the beginning of Lockdown, the utilization of ANC services, institutional deliveries has been on a declining trend. The utilization of temporary family planning services has shown an increasing trend on the month of Jestha (May 14, 2020- June 14,2020), whereas permanent family planning method has a declining trend. Immunization services, though was completely unused when COVID-19 began, has shown an increasing trend on the later months of Lockdown.