MATCO

Our objective
The Sexual and Reproductive Health (SRH) Research Group of ITM has been at the forefront of COVID-19 research. We lead 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 in the world. The study has been ongoing since mid-March 2020.
Funding
This study was funded by the COVID-19 Pump Priming fund of ITM, supported by the Flemish Department of Economy, Science and Innovation of the Flemish Government and the Embassy of the United Kingdom in Belgium.
Dr Benova is partially funded by the Research Foundation – Flanders (FWO) as part of her senior postdoctoral fellowship.
Research team
Contact
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The project is comprised of three substudies:
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.
Publications:
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 - Aline Semaan et al., published in BMJ Global Health (2020)
We analysed responses on the online survey Round 2 regarding the use of telemedicine to provide maternal healthcare during the COVID-19 pandemic: 'A double-edged sword - Telemedicine for maternal care during COVID-19: Findings from a global mixed methods study of healthcare providers' - published in BMJ Global Health (2021)
We analysed responses on the online survey Round 2 regarding ability of health workers to provide respectful maternity care during the COVID-19 pandemic: 'The impact of COVID-19 on the provision of respectful maternity care: Findings from a global survey of health workers' - published in Women and Birth (2021)
We analysed the many impacts of the COVID-19 pandemic on the work of maternal and newborn health care workers globally. They were deeply interlinked with pre-existing suboptimal functioning of health systems: ‘Maternal and newborn healthcare providers’ work-related experiences during the COVID-19 pandemic, and their physical, psychological, and economic impacts: Findings from a global online survey’ - published in PLOS Global Public Health (2022)
We applied machine learning approaches to the survey responses to understand the main drivers of healthcare workers’ feeling of safety at work during the pandemic. The three key issues were accessibility, clarity and quality of information provided to them; availability of support and personal protective equipment; and the epidemiology of COVID-19 in their country: ‘Can machine learning models predict maternal and newborn healthcare providers’ perception of safety during the COVID-19 pandemic? A cross-sectional study of a global online survey’ - published by Human Resources in Health
We analysed the responses of healthcare workers to the second round of the survey to understand how provision of postnatal care was affected. Already before the COVID-19 pandemic, postnatal care coverage was among the lowest across the continuum of maternal and newborn healthcare, and issues with poor care quality were identified. In this paper we found that postnatal care continued to be disrupted beyond the early phase of the pandemic, with issues such as maternal mental health, postnatal length-of-stay, visitors and companions, and non-separation of babies from mothers negatively affected: "Separated during the first hours”—Postnatal care for women and newborns during the COVID-19 pandemic: A mixed-methods cross-sectional study from a global online survey of maternal and newborn healthcare providers" - published in PLOS Global Public Health
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.
Publications:
‘We are not going to shut down, because we cannot postpone pregnancy’: a mixed-methods study of the provision of maternal healthcare in six referral maternity wards in four sub-Saharan African countries during the COVID-19 pandemic - published in BMJ Global Health (2022)
A mixed-methods study of maternal health care utilisation in six referral hospitals in four sub-Saharan African countries before and during the COVID-19 pandemic - published in BMJ Global Health (2022)
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
Members of our Group (Lenka Benova and Elise Huysmans) completed a scoping review commissioned by the World Health Organization (WHO) Department of Maternal, Newborn, Child and Adolescent Health and Ageing to support countries in adapting their response to different COVID-19 scenarios. The objective was to identify interventions implemented to maintain the provision and use of essential services for MNCAAH during disruptive events (Ebola, SARS, natural disasters, humanitarian emergencies, and COVID-19) and to summarize lessons learned during these interventions.
Our team, together with collaborators across the world, have published a commentary in the Sexual and Reproductive Health Matters Journal calling for a global effort to document and share solutions and adaptations in sexual, reproductive, maternal and newborn health care provision during the COVID-19 pandemic. If you would like to contribute ideas and suggestions to this repository, please complete a simple form in your chosen language. The repository website is available at www.covidadaptations.org.
Our team presented three posters at the October 2021 World Congress of Gynecology and Obstetrics (FIGO) from the MATCO study, including:
Postnatal care for women and newborns beyond the early phase of the COVID-19 pandemic by Aline Semaan
The Impact of COVID-19 on the provision of respectful maternity care by Anteneh Asefa
A Qualitative Case Study of the Experience of Belgian Midwives during the First Wave of the Pandemic by Elise Huysmans
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, 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?
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 quarterly meeting of the Global Respectful Maternity Care Council on 21 October 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 of the London School of Hygiene and Tropical Medicine. 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 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.
Healthworkers' perspectives, challenges and solutions (recording) by Lenka Benova (3 September 2020), 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.
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 (Graham et al., 2020), published in BMJ Global Health
Giving birth amid a pandemic in Belgium: the challenges faced by mothers and midwives (Audet, 2020), published on BMJ Global Health blogs
The “great forgotten” of the COVID-19 pandemic: Health providers’ insights on maternal and newborn care (Semaan and Audet, 2020), published on the ITM website and the Healthy Newborns Network blog
Online survey Round 1 (March - June 2020) country reports:
Online survey Round 2 (July - November 2020) country reports:

MATCO in the news
La Libre (in French) with Constance Audet and Elise Huysmans: Ce que c’est que d’être sage-femme durant la pandémie de coronavirus (July 2020)
RTBF (in French): Accoucher et vivre l'arrivée du nouveau-né ne fut pas un long fleuve tranquille pendant la crise du coronavirus (July 2020)
RTBF (in French): Coronavirus et maternité dans le monde : les grossesses et les soins néonataux sont beaucoup moins bien suivis (May 2020)
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