Paper: Antenatal Care Service Utilization of Pregnant Women Attending Antenatal Care in Public Hospitals During the COVID-19 Pandemic Period

 Reference:

Tadesse, E. (2020). Antenatal care service utilization of pregnant women attending antenatal care in public hospitals during the COVID-19 pandemic period. International Journal of Women's Health, 12, 1181.

Abstract

Background

The recent coronavirus disease (COVID-19) pandemic has had a disastrous effect on the health-care delivery system, of mainly pregnancy-related healthcare. In order to fill the information gap in the scientific literature and in response to the limited evidence in the country, this study aims to assess the impact of the COVID-19 pandemic on antenatal care utilization among pregnant women attending public facilities in Northeast Ethiopia. Therefore, the result will be beneficial to design strategies for prioritizing maternal healthcare even with the COVID-19 pandemic period.

Methods

A facility-based cross-sectional study was conducted from February 2 to August 30, 2020 among pregnant women attending ANC services at public hospitals in Northeast Ethiopia. Thus, a total of 389 women were included in the study with a simple random sampling technique. The bi-variable and multi-variable logistic regression models were employed to identify factors significantly associated with ANC utilization. Adjusted odds ratio (AOR) with 95% CI was estimated to show the strength of association. Finally, a P-value of <0.05 in the multivariable logistic regression analysis was used to identify predictors of antenatal care utilization.

Results

Overall, 114 (29.3%) pregnant women had fully utilized antenatal care services during the pandemic period. Mother age ≥35 years (AOR=11.79, 95% CI=1.18– 117.8), secondary education and above (AOR=4.74, 95% CI=1.04– 21.61), history of stillbirth before recent pregnancy (AOR=0.007, 95% CI=0.001–0.12), interruption and diversion of services due to COVID-19 response (AOR=0.675, 95% CI=0.142–0.742), fear of COVID-19 (AOR=0.13, 95% CI=0.06–0.31), and lack of transport access (AOR=4.15, 95% CI=1.04–16.54) were predictors of full antenatal care service utilization.

Conclusion

Three of every ten pregnant women who attended the obstetric outpatient clinics have fully utilized the antenatal care services. Encouraging women’s educational status, prioritizing maternal health services during COVID-19, and improving the quality of ANC service should be emphasized more.

Keywords: antenatal care, prenatal care, utilization, coronavirus disease, pregnant women, Ethiopia

Conclusion and Recommendation

The findings of this study showed the pandemic reduced the utilization of antenatal care services among pregnant women in the study area. Thus, the age of the mother, residency, educational status, history of still birth, interruption, and diversion of maternity health-care service, fear of COVID-19 pandemic, and transport inaccessibility were significant factors which contributed to the low antenatal care service utilization of pregnant women.

Thus, efforts to enhancing maternal health services should be recommended. Various IEC (Information, Education and Communication) materials will be produced to raise awareness regarding the protection of pregnant women during the COVID-19 pandemic. It is also better to start phone-in services to help with transportation to pregnant women. In addition, virtual consultation with obstetricians will be provided via telemedicine services, to women seeking maternal health services.

Implications of the Study

COVID-19 has caused disruption of health services on the global scale, including MHS (maternal health services). Due to this pandemic, women are facing more barriers to accessing maternal healthcare, including restrictions, transport challenges, anxiety, and fear over possibly being exposed to coronavirus. This study demonstrates addressing the identified factors would help to design appropriate strategies to improve MHS utilization during the pandemic. Effective preventive and clinical strategies are needed to control COVID-19 infection among pregnant women. Governments also need to make sure that women can access basic information to protect the health of themselves and their babies. Additionally, arrangements should be made for assuring proper means of transportation and availability of MHS (maternal health services) during lockdown.