Uptake of reproductive, maternal and child health services during the first year of the COVID-19 pandemic in Uganda: A mixed methods study.
Use of reproductive health (RH), maternal, newborn and child health (MNCH) services in Uganda is suboptimal. Reasons for this are complex; however, service-delivery factors such as availability, quality, staffing, and supplies, contribute substantially to low uptake. The COVID-19 pandemic threatened...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0001619 |
| _version_ | 1797696397081837568 |
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| author | Simon P S Kibira Emily Evens Lilian Giibwa Doreen Tuhebwe Andres Martinez Rogers Kagimu Charles Olaro Frederick Mubiru Samantha Archie Rawlance Ndejjo Noel Namuhani Martha Akulume Sarah Nabukeera Rhoda K Wanyenze Fredrick E Makumbi |
| author_facet | Simon P S Kibira Emily Evens Lilian Giibwa Doreen Tuhebwe Andres Martinez Rogers Kagimu Charles Olaro Frederick Mubiru Samantha Archie Rawlance Ndejjo Noel Namuhani Martha Akulume Sarah Nabukeera Rhoda K Wanyenze Fredrick E Makumbi |
| author_sort | Simon P S Kibira |
| collection | DOAJ |
| description | Use of reproductive health (RH), maternal, newborn and child health (MNCH) services in Uganda is suboptimal. Reasons for this are complex; however, service-delivery factors such as availability, quality, staffing, and supplies, contribute substantially to low uptake. The COVID-19 pandemic threatened to exacerbate existing challenges to delivery and use of high-quality RH and MNCH services. We conducted a mixed methods study, combining secondary analysis of routine electronic health management information system (eHMIS) data with exploratory key informant interviews (KII) to examine changes in health service uptake over the course of the pandemic and to understand service delivery adaptations implemented in response. We analyzed eHMIS data for four services (family planning, facility-based deliveries, antenatal visits, and immunization for children by one year), comparing them across four time periods: pre-COVID-19, partial lockdown, total lockdown and post lockdown. Additionally, KIIs were used to document adaptations made for continuity of health services. Use of services declined substantially during total lockdown; however, rebounded quickly to earlier observed levels, during the post lockdown for all four services, especially for immunization for children by one year. KIIs identified several health services delivery adaptations. At the community level, these included: community outreaches, training some mothers as community liaisons to encourage others to seek health services, and support from local leaders to create call centers to facilitate clients transport during travel restrictions. Health facilities creatively used space to accommodate social distancing and shifted providers' roles. District leadership reassigned health workers to facilities closest to their homes, provided vehicle passes to staff, and ambulances to transport pregnant women in critical need. WhatsApp groups facilitated communication at district level and enabled redistribution of supplies. Ministry of Health produced critical guidelines for continuity of health services. Implementing partners provided and redistributed commodities and personal protective equipment, and provided technical support, training and transport. |
| first_indexed | 2024-03-12T03:25:47Z |
| format | Article |
| id | doaj.art-3a3a611df6a54dd59acce6f07de6feba |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T03:25:47Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-3a3a611df6a54dd59acce6f07de6feba2023-09-03T13:36:48ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0134e000161910.1371/journal.pgph.0001619Uptake of reproductive, maternal and child health services during the first year of the COVID-19 pandemic in Uganda: A mixed methods study.Simon P S KibiraEmily EvensLilian GiibwaDoreen TuhebweAndres MartinezRogers KagimuCharles OlaroFrederick MubiruSamantha ArchieRawlance NdejjoNoel NamuhaniMartha AkulumeSarah NabukeeraRhoda K WanyenzeFredrick E MakumbiUse of reproductive health (RH), maternal, newborn and child health (MNCH) services in Uganda is suboptimal. Reasons for this are complex; however, service-delivery factors such as availability, quality, staffing, and supplies, contribute substantially to low uptake. The COVID-19 pandemic threatened to exacerbate existing challenges to delivery and use of high-quality RH and MNCH services. We conducted a mixed methods study, combining secondary analysis of routine electronic health management information system (eHMIS) data with exploratory key informant interviews (KII) to examine changes in health service uptake over the course of the pandemic and to understand service delivery adaptations implemented in response. We analyzed eHMIS data for four services (family planning, facility-based deliveries, antenatal visits, and immunization for children by one year), comparing them across four time periods: pre-COVID-19, partial lockdown, total lockdown and post lockdown. Additionally, KIIs were used to document adaptations made for continuity of health services. Use of services declined substantially during total lockdown; however, rebounded quickly to earlier observed levels, during the post lockdown for all four services, especially for immunization for children by one year. KIIs identified several health services delivery adaptations. At the community level, these included: community outreaches, training some mothers as community liaisons to encourage others to seek health services, and support from local leaders to create call centers to facilitate clients transport during travel restrictions. Health facilities creatively used space to accommodate social distancing and shifted providers' roles. District leadership reassigned health workers to facilities closest to their homes, provided vehicle passes to staff, and ambulances to transport pregnant women in critical need. WhatsApp groups facilitated communication at district level and enabled redistribution of supplies. Ministry of Health produced critical guidelines for continuity of health services. Implementing partners provided and redistributed commodities and personal protective equipment, and provided technical support, training and transport.https://doi.org/10.1371/journal.pgph.0001619 |
| spellingShingle | Simon P S Kibira Emily Evens Lilian Giibwa Doreen Tuhebwe Andres Martinez Rogers Kagimu Charles Olaro Frederick Mubiru Samantha Archie Rawlance Ndejjo Noel Namuhani Martha Akulume Sarah Nabukeera Rhoda K Wanyenze Fredrick E Makumbi Uptake of reproductive, maternal and child health services during the first year of the COVID-19 pandemic in Uganda: A mixed methods study. PLOS Global Public Health |
| title | Uptake of reproductive, maternal and child health services during the first year of the COVID-19 pandemic in Uganda: A mixed methods study. |
| title_full | Uptake of reproductive, maternal and child health services during the first year of the COVID-19 pandemic in Uganda: A mixed methods study. |
| title_fullStr | Uptake of reproductive, maternal and child health services during the first year of the COVID-19 pandemic in Uganda: A mixed methods study. |
| title_full_unstemmed | Uptake of reproductive, maternal and child health services during the first year of the COVID-19 pandemic in Uganda: A mixed methods study. |
| title_short | Uptake of reproductive, maternal and child health services during the first year of the COVID-19 pandemic in Uganda: A mixed methods study. |
| title_sort | uptake of reproductive maternal and child health services during the first year of the covid 19 pandemic in uganda a mixed methods study |
| url | https://doi.org/10.1371/journal.pgph.0001619 |
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