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Women and children first?

ITM researchers study the impact of COVID-19 on maternal and newborn health care worldwide

13-05-20

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Researchers from the Institute of Tropical Medicine (ITM) in Antwerp are studying the effects the COVID-19 pandemic is having on maternal and newborn health care worldwide. Maternal and newborn health professionals are asked to complete a recurring online survey with various questions specific to the stage of the pandemic. The first findings show an alarming decline in the use of services, and the availability and quality of maternal and newborn care. In addition, the progress made in recent decades is in danger of being reversed. These findings, ahead of peer review, were made available this week. 

A range of maternal and newborn health professionals, such as midwives, obstetricians, gynaecologists and doctors of other specialisations, nurses, other clinical staff, and community health workers, worldwide are reporting about the effects of the COVID-19 outbreak on the provision of maternal and newborn health care by filling in an online survey. The first round of the survey was launched on 24 March in three languages (English, French and Arabic). The survey is currently available in 13 languages. To date, the researchers have received submissions from more than 1,500 health professionals in nearly 100 countries at various stages of the pandemic.

ITM’s Prof Lenka Beňová, the principal researcher of this study, explains: “Keeping in mind that maternal and child services are often severely disrupted during outbreaks, when the coronavirus disease was developing into a pandemic, we realised that we have to keep track of what exactly is happening across the many countries worldwide. The aim is to understand the impact on the provision and use of maternal and newborn health services, but we also want to understand how we can prevent and address such disruptions in the future, including by collecting examples of innovations and solutions developed locally.”

Prof Beňová continues: “The first findings tell us that most health care professionals have received information about COVID-19, but that they lack practical training and guidance on how to deal with patients who are showing symptoms of COVID-19. The availability of care personnel has decreased dramatically and there is less support and follow-up for mothers during personal consultations.  Where possible, this is compensated by online or telephone communication tools. Healthcare professionals experience more stress and some women are afraid to come to health facilities for fear of getting infected there.”

Prof. Andrea B. Pembe from Muhimbili University of Health and Allied Sciences in Tanzania added that “During this epidemic some countries have changed the way pregnant women are managed during pregnancy, labour, and after childbirth. Some of the measures in the context of COVID-19 include not allowing birth companions, separating newborns from mothers after birth, increase in labour inductions, and potentially increasing caesarean section rates. These changes are not evidence-based and may have short- and long-term negative consequences for mothers and newborns. It is therefore essential to carefully consider implementing any drastic changes, but maintain and ensure proper infection prevention and control measures in maternity and newborn wards. Our approaches also must take into account the capability and resources of the health system in a given country."

"Healthcare professionals fear long lasting effects on women and their newborns due to the disruption in routine care in the future: less requests for antenatal follow-ups, negative effects on mothers’ mental health, and other hidden consequences that will arise in the aftermath of the pandemic. Both patients and healthcare workers will be heavily impacted by the pandemic," says ITM researcher Constance Audet, who is focussing on understanding the impact of COVID-19 on maternal and newborn health in Belgium.

“It is absolutely vital that as many different maternal and newborn health care professionals as possible take part in this study. Our primary issue is that our target group is obviously very busy at the moment. But still people are filling in the survey, even the open questions that take some time, which indicates that health professionals are keen to have their experiences documented and understood. We are very grateful for all their efforts as they support women, babies and their families with good care during this challenging time” concludes Prof Beňová.

The findings will give the scientists an idea of the impact the pandemic has on maternal and newborn health care worldwide. The study started at the end of March and will last until after the pandemic in order to fully comprise the impact.

Online survey: https://bit.ly/2UhW68U

Pre-print manuscript: Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

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