MATCO: Global study of MATernal health provision during the COVID-19 pandemic

Study objective

To understand the effect of the COVID-19 pandemic on health care available to pregnant, labouring and postpartum women and their newborns, and to mitigate against the negative consequences by extracting and sharing solutions developed.

The ITM Sexual and Reproductive Health Group has been at the forefront of COVID-19 research as a lead of a large consortium of partner organisations on research aiming to understand the impact of COVID-19 on the provision of essential maternal and newborn care globally. The study has been ongoing since mid-March, and comprises three main sub-studies.

  1. A global online survey of maternal and newborn health professionals, aiming to understand how health professionals and health facilities prepare and respond to COVID-19 in regard to the care provided to women and their babies during antenatal, intrapartum and postnatal care. This is a repeat cross-sectional study with an embedded longitudinal cohort. Round 1 was collected between March and June 2020, Round 2 between July and December 2020, and Round 3 between December 2020 and April 2021. For research outputs and findings, please see links to papers below.
  2. A mixed-methods, longitudinal in-depth case study of preparedness and response to COVID-19 in seven large maternity/newborn hospital wards in four countries in sub-Saharan Africa (Guinea, Nigeria, Uganda, Tanzania). This study also serves as a platform for exchange of information and experiences across the contexts studied. We started this study in May 2020, relying on semi-structured interviews, visual data documentation, and routine health records analysis.
  3. A qualitative study of postnatal care (PNC) in the French-speaking part of Belgium: implementation and adaptations in the aftermath of the COVID-19 pandemic. We are documenting the adaptations and the responses of the different health structures to the ongoing COVID-19 pandemic in regard to organization of PNC. We want to understand the changes in the care processes, before and after discharge from a health facility, applicable to every postpartum woman, and also specifically for parturient women suspected or confirmed positive for a COVID-19. By interviewing midwives, we aim to understand how the measures taken affected their day-to-day work, what challenges arose and how it affected both mothers’ health and their own.


Research outputs

  • Our team presented three posters at the October 2021 World Congress of Gynecology and Obstetrics (FIGO) from the MATCO study, including:
  • We have completed the analysis of data within the in-depth qualitative study of the experiences of midwives during the first wave of the COVID-19 pandemic in Brussels and Wallonia (Belgium). To read this analysis, please see the pre-print 'How COVID-19 challenged care for women and their newborns: a qualitative case study of the experience of Belgian midwives during the first wave of the pandemic' (not yet peer-reviewed). 
  • Lenka Benova organised a session at the October ITM Colloquium titled 'Innovations in delivering healthcare during COVID-19: Case study of maternal and newborn health (recorded session)'. The session was composed of three dialogues among experts globally on the following themes:
    • How do we provide safe, effective, good quality and compassionate care to pregnant and birthing women with suspected or confirmed COVID-19?
    • How do we ensure that maternal and neonatal care continues to be available and accessed during COVID-19 to all women and newborns who need it?
    • How have ongoing and planned research studies in maternal and newborn health been adapted to COVID-19 in the short- and long-term?
  • Ms Aline Semaan and Dr Lenka Benova presented the findings from the MATCO online survey of maternal and newborn health providers on the impact of COVID-19 on respectful care to women and newborns during the Global Respectful Maternity Care Council quarterly meeting on October 21, 2020.
  • Our team took part in the session on "Respectful care in the age of COVID-19: implications for mothers, newborns, and health workers" at the GLOW conference in September 2020. The session was organised by Professor Wendy Graham (London School of Hygiene and Tropical Medicine). Ms Aline Semaan presented the findings from the MATCO online survey on adaptation of care services reported in light of COVID-19 and the implication for respectful care to women and newborns. Dr Lenka Benova was a part of the panel discussing the implications of COVID-19 on continued provision of high quality maternal and newborn care. A recording of this session is available.
  • Benova L. September 3 2020. Recording of the "Healthworkers' perspectives, challenges and solutions", the fifth webinar in the series on ‘Delivering quality essential maternal, newborn and child health services during COVID-19’. Quality of care experts share global guidance and country experiences around quality of care for maternal, newborn and child health in the context of COVID-19, co-hosted by the Network for Improving Quality of Care for Maternal, Newborn and Child Health and the QoC subgroup of the Child Health Task Force, with the support of UNICEF and the World Health Organization.
  • Graham et al 2020: Protecting hard-won gains for mothers and newborns in low-income and middle-income countries in the face of COVID-19: call for a service safety net in BMJ Global Health
  • Audet C 2020: Giving birth amid a pandemic in Belgium: the challenges faced by mothers and midwives in BMJ Global Health blogs
  • Semaan A and Audet C. 2020: The “great forgotten” of the COVID-19 pandemic: Health providers’ insights on maternal and newborn care. ITM website and Healthy Newborns Network blog.
  • Online survey Round 1 (March - June 2020) country reports:
    • India (EN), Uganda (EN), Kenya (EN), Bangladesh (EN), Democratic Republic of Congo (EN / FR), Ethiopia (EN)
    • Nigeria (EN), Tanzania (EN)
  • Online survey Round 2 (July - November 2020) country reports:
    • Morocco (EN)
    • Nigeria (EN)
    • DRC (EN)
  • Tools:
    • Round 1 survey questionnaire (EN)
    • Round 2 survey questionnaire (EN)
    • Round 3 survey questionnaire (EN)

MATCO study in the news


This study was funded by the Institute of Tropical Medicine’s COVID-19 Pump Priming fund supported by the Flemish Government - Department of Economy, Science & Innovation - and by the Embassy of the United Kingdom in Belgium. Dr Benova is funded in part by the Research Foundation – Flanders (FWO) as part of her Senior Postdoctoral Fellowship.

Study team


Stay updated with our publications and findings on Twitter @SRHgroup_ITM