Early effects of COVID-19 on maternal and child health service disruption in Mozambique
This article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'IntroductionAfter the World Health Organization declared COVID-19 a pandemic, more than 184 million cases and 4 million deaths had been recorded worldwide by July 2021. These a...
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| Format: | Article |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1075691/full |
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| author | Orvalho Augusto Orvalho Augusto Timothy Roberton Quinhas Fernandes Quinhas Fernandes Sérgio Chicumbe Ivan Manhiça Stélio Tembe Stélio Tembe Bradley H. Wagenaar Bradley H. Wagenaar Laura Anselmi Jon Wakefield Jon Wakefield Kenneth Sherr Kenneth Sherr Kenneth Sherr |
| author_facet | Orvalho Augusto Orvalho Augusto Timothy Roberton Quinhas Fernandes Quinhas Fernandes Sérgio Chicumbe Ivan Manhiça Stélio Tembe Stélio Tembe Bradley H. Wagenaar Bradley H. Wagenaar Laura Anselmi Jon Wakefield Jon Wakefield Kenneth Sherr Kenneth Sherr Kenneth Sherr |
| author_sort | Orvalho Augusto |
| collection | DOAJ |
| description | This article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'IntroductionAfter the World Health Organization declared COVID-19 a pandemic, more than 184 million cases and 4 million deaths had been recorded worldwide by July 2021. These are likely to be underestimates and do not distinguish between direct and indirect deaths resulting from disruptions in health care services. The purpose of our research was to assess the early impact of COVID-19 in 2020 and early 2021 on maternal and child healthcare service delivery at the district level in Mozambique using routine health information system data, and estimate associated excess maternal and child deaths.MethodsUsing data from Mozambique's routine health information system (SISMA, Sistema de Informação em Saúde para Monitoria e Avaliação), we conducted a time-series analysis to assess changes in nine selected indicators representing the continuum of maternal and child health care service provision in 159 districts in Mozambique. The dataset was extracted as counts of services provided from January 2017 to March 2021. Descriptive statistics were used for district comparisons, and district-specific time-series plots were produced. We used absolute differences or ratios for comparisons between observed data and modeled predictions as a measure of the magnitude of loss in service provision. Mortality estimates were performed using the Lives Saved Tool (LiST).ResultsAll maternal and child health care service indicators that we assessed demonstrated service delivery disruptions (below 10% of the expected counts), with the number of new users of family planing and malaria treatment with Coartem (number of children under five treated) experiencing the largest disruptions. Immediate losses were observed in April 2020 for all indicators, with the exception of treatment of malaria with Coartem. The number of excess deaths estimated in 2020 due to loss of health service delivery were 11,337 (12.8%) children under five, 5,705 (11.3%) neonates, and 387 (7.6%) mothers.ConclusionFindings from our study support existing research showing the negative impact of COVID-19 on maternal and child health services utilization in sub-Saharan Africa. This study offers subnational and granular estimates of service loss that can be useful for health system recovery planning. To our knowledge, it is the first study on the early impacts of COVID-19 on maternal and child health care service utilization conducted in an African Portuguese-speaking country. |
| first_indexed | 2024-04-09T17:41:14Z |
| format | Article |
| id | doaj.art-f21e651747fa4e6f86c62c3b2e8ab9f8 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-09T17:41:14Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-f21e651747fa4e6f86c62c3b2e8ab9f82023-04-17T05:36:38ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-04-011110.3389/fpubh.2023.10756911075691Early effects of COVID-19 on maternal and child health service disruption in MozambiqueOrvalho Augusto0Orvalho Augusto1Timothy Roberton2Quinhas Fernandes3Quinhas Fernandes4Sérgio Chicumbe5Ivan Manhiça6Stélio Tembe7Stélio Tembe8Bradley H. Wagenaar9Bradley H. Wagenaar10Laura Anselmi11Jon Wakefield12Jon Wakefield13Kenneth Sherr14Kenneth Sherr15Kenneth Sherr16Department of Global Health, School of Public Health, University of Washington, Seattle, WA, United StatesDepartment of Community Health, Faculdade de Medicina, Eduardo Mondlane University, Maputo, MozambiqueJohns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United StatesDepartment of Global Health, School of Public Health, University of Washington, Seattle, WA, United StatesNational Directorate of Public Health, Ministry of Health, Maputo, MozambiqueNational Institute of Health, Ministry of Health, Marracuene, MozambiqueNational Directorate of Public Health, Ministry of Health, Maputo, MozambiqueDepartment of Global Health, School of Public Health, University of Washington, Seattle, WA, United StatesDirecção Provincial de Inhambane, Inhambane, MozambiqueDepartment of Global Health, School of Public Health, University of Washington, Seattle, WA, United StatesDepartment of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United StatesHealth Organization, Policy and Economics, Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United KingdomDepartment of Biostatistics, School of Public Health, University of Washington, Seattle, WA, United States0Department of Statistics, University of Washington, Seattle, WA, United StatesDepartment of Global Health, School of Public Health, University of Washington, Seattle, WA, United StatesDepartment of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States1Department of Industrial and Systems Engineering, University of Washington, Seattle, WA, United StatesThis article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'IntroductionAfter the World Health Organization declared COVID-19 a pandemic, more than 184 million cases and 4 million deaths had been recorded worldwide by July 2021. These are likely to be underestimates and do not distinguish between direct and indirect deaths resulting from disruptions in health care services. The purpose of our research was to assess the early impact of COVID-19 in 2020 and early 2021 on maternal and child healthcare service delivery at the district level in Mozambique using routine health information system data, and estimate associated excess maternal and child deaths.MethodsUsing data from Mozambique's routine health information system (SISMA, Sistema de Informação em Saúde para Monitoria e Avaliação), we conducted a time-series analysis to assess changes in nine selected indicators representing the continuum of maternal and child health care service provision in 159 districts in Mozambique. The dataset was extracted as counts of services provided from January 2017 to March 2021. Descriptive statistics were used for district comparisons, and district-specific time-series plots were produced. We used absolute differences or ratios for comparisons between observed data and modeled predictions as a measure of the magnitude of loss in service provision. Mortality estimates were performed using the Lives Saved Tool (LiST).ResultsAll maternal and child health care service indicators that we assessed demonstrated service delivery disruptions (below 10% of the expected counts), with the number of new users of family planing and malaria treatment with Coartem (number of children under five treated) experiencing the largest disruptions. Immediate losses were observed in April 2020 for all indicators, with the exception of treatment of malaria with Coartem. The number of excess deaths estimated in 2020 due to loss of health service delivery were 11,337 (12.8%) children under five, 5,705 (11.3%) neonates, and 387 (7.6%) mothers.ConclusionFindings from our study support existing research showing the negative impact of COVID-19 on maternal and child health services utilization in sub-Saharan Africa. This study offers subnational and granular estimates of service loss that can be useful for health system recovery planning. To our knowledge, it is the first study on the early impacts of COVID-19 on maternal and child health care service utilization conducted in an African Portuguese-speaking country.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1075691/fullCOVID-19MCHMozambiqueinterrupted time-series analysisseasonalityLMIC |
| spellingShingle | Orvalho Augusto Orvalho Augusto Timothy Roberton Quinhas Fernandes Quinhas Fernandes Sérgio Chicumbe Ivan Manhiça Stélio Tembe Stélio Tembe Bradley H. Wagenaar Bradley H. Wagenaar Laura Anselmi Jon Wakefield Jon Wakefield Kenneth Sherr Kenneth Sherr Kenneth Sherr Early effects of COVID-19 on maternal and child health service disruption in Mozambique Frontiers in Public Health COVID-19 MCH Mozambique interrupted time-series analysis seasonality LMIC |
| title | Early effects of COVID-19 on maternal and child health service disruption in Mozambique |
| title_full | Early effects of COVID-19 on maternal and child health service disruption in Mozambique |
| title_fullStr | Early effects of COVID-19 on maternal and child health service disruption in Mozambique |
| title_full_unstemmed | Early effects of COVID-19 on maternal and child health service disruption in Mozambique |
| title_short | Early effects of COVID-19 on maternal and child health service disruption in Mozambique |
| title_sort | early effects of covid 19 on maternal and child health service disruption in mozambique |
| topic | COVID-19 MCH Mozambique interrupted time-series analysis seasonality LMIC |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1075691/full |
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