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Early indirect impact of COVID-19 pandemic on utilisation and outcomes of reproductive, maternal, newborn, child and adolescent health services in Kenya: A cross-sectional study

Duncan N. Shikuku, Irene K. Nyaoke, Lucy N. Nyaga, Charles A. Ameh

Abstract

The paper determined the initial impact of COVID-19 pandemic on reproductive, maternal, newborn, child and adolescent health (RMNCAH) services in Kenya. Hospital data for the first four months (March-June 2020) of the pandemic and the equivalent period in 2019 were compared using two-sample test of proportions. Despite the global projections for worse indicators, there were no differences in monthly mean (±SD) attendance between March-June 2019 vs 2020 for antenatal care (400,191.2±12,700.0 vs 384,697.3±20,838.6), hospital births (98,713.0±4,117.0 vs 99,634.5±3,215.5), family planning attendance (431,930.5±19,059.9 vs 448,168.3±31,559.8), post-abortion care (3,206.5±111.7 vs 448,168.3±31,559.8) and pentavalent 1 immunisation (114,701.0±3,701.1 vs 110,915.8±7,209.4), p>0.05. However, there were significant increases in FP utilisation among young people (25.7% to 27.0%), injectable (short-term) FP method uptake (58.2% to 62.3%), caesarean section rate (14.6% to 15.8%), adolescent maternal deaths (6.2% to 10.9%) and fresh stillbirths (0.9% to 1.0%) with a reduction in implants (long-term) uptake (16.5% to 13.0%) (p<0.05). With uncertainty around the duration of the pandemic, strategies to mitigate against catastrophic indirect maternal health outcomes are urgently needed. (Afr J Reprod Health 2021; 25[6]: 76-87).

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References

World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. Geneva: World Health Organization. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.

World Health Organization. Coronavirus disease (COVID-19) Situation Report – 162 World Health Organization; 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/20200630-covid-19-sitrep-162.pdf?sfvrsn=e00a5466_2.

Euronews. Coronavirus second wave? Which countries in Europe are experiencing a resurgence of cases? 2020. Available from: https://www.euronews.com/2020/08/27/is-europe-having-a-covid-19-second-wave-country-by-country-breakdown.

DW. Coronavirus pandemic: Is the second wave already here? 2020. Available from: https://www.dw.com/en/coronavirus-second-wave/a-54429614.

New Scientist. Coronavirus: Second wave hits Asia as global cases continue to soar 2020. Available from: https://www.newscientist.com/article/2249982-coronavirus-second-wave-hits-asia-as-global-cases-continue-to-soar/.

World Health Organization. Maintaining essential health services: operational guidance for the COVID-19 context: Interim guidance 1 June 2020: World Health Organization; 2020. Available from: https://www.who.int/publications/i/item/covid-19-operational-guidance-for-maintaining-essential-health-services-during-an-outbreak.

Vindegaard Nina and Benros Michael Eriksen. COVID-19 pandemic and mental health consequences: systematic review of the current evidence. Brain, Behavior, and Immunity. 2020.

United Nations Educational SaCOU. Taking action to end domestic violence during pandemics 2020. Available from: https://en.unesco.org/news/taking-action-end-domestic-violence-during-pandemics.

World Health Organization. Managing epidemics: Key facts about major deadly diseases. Geneva: World Health Organization 2018. Available from: https://www.who.int/emergencies/diseases/managing-epidemics/en/.

World Health Organization. Strategy and planning: strategic preparedness and response plan. Geneva: World Health Organization; 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/strategies-and-plans.

World Health Organization. COVID-19: Operational guidance for maintaining essential health services during an outbreak: interim guidance, 25 March 2020. Geneva: World Health Organization; 2020. Available from: https://apps.who.int/iris/handle/10665/331561.

World Health Organization. Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic: interim guidance, May 2020. Geneva: World Health Organization, United Nations Children’s Fund; 2020. Available from: https://apps.who.int/iris/handle/10665/331975.

Elston JWT, Cartwright C, Ndumbi P and Wright J. The health impact of the 2014–15 Ebola outbreak. Public health. 2017;143:60-70.

Elston JWT, Moosa AJ, Moses F, Walker G, Dotta N, Waldman Ronald J and Wright J. Impact of the Ebola outbreak on health systems and population health in Sierra Leone. Journal of Public Health. 2016;38(4):673-8.

Sochas L, Channon AA and Nam S. Counting indirect crisis-related deaths in the context of a low-resilience health system: the case of maternal and neonatal health during the Ebola epidemic in Sierra Leone. Health policy and planning. 2017;32(suppl_3):iii32-iii9.

Bietsch K, Williamson J and Reeves M. Family planning during and after the West African Ebola crisis. Studies in Family Planning. 2020;51(1):71-86.

Camara BS, Delamou A, Diro E, Béavogui AH, El Ayadi AM, Sidibé S, Grovogui FM, Takarinda KC, Bouedouno P and Sandouno SD. Effect of the 2014/2015 Ebola outbreak on reproductive health services in a rural district of Guinea: an ecological study. Transactions of The Royal Society of Tropical Medicine and Hygiene. 2017;111(1):22-9.

Roberton T, Carter ED, Chou VB, Stegmuller AR, Jackson

BD, Tam Y, Sawadogo-Lewis T and Walker N. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. The Lancet Global Health. 2020.

Riley T, Sully E, Ahmed Z and Biddlecom A. Estimates of the potential impact of the COVID-19 pandemic on sexual and reproductive health in low-and middle-income countries. Int Perspect Sex Reprod Health. 2020;46:46.

Polit DF and Beck CT. Nursing research: Principles and methods: Lippincott Williams & Wilkins; 2004.

Ministry of Health (Kenya). COVID-19 OUTBREAK IN KENYA: DAILY SITUATION REPORT - 105: Ministry of Health (Kenya); 2020. Available from: https://www.health.go.ke/wp-content/uploads/2020/07/Kenya-COVID-19-SITREP-0105-30-Jun-2020.pdf.

World Medical Association. World medical association declaration of helsinki: Ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191 - 4.

Kenya Health Information System [Internet]. 2020 [cited 3rd Aug 2020]. Available from: https://hiskenya.org/dhis-web-pivot/.

London School of Hygiene & Tropical Medicine. COVID-19: Tackling the Novel Coronavirus 2020. Available from: https://www.futurelearn.com/courses/covid19-novel-coronavirus/1.

World Health Organization. Maintaining essential health services: operational guidance for the COVID-19 context: Interim guidance 1st June 2020. Geneva: World Health Organization; 2020. Available from: https://apps.who.int/iris/handle/10665/332240.

Melka AS, Tekelab T and Wirtu D. Determinants of long acting and permanent contraceptive methods utilization among married women of reproductive age groups in western Ethiopia: a cross-sectional study. Pan African Medical Journal. 2015;22(1).

Teferra AS and Wondifraw AA. Determinants of long acting contraceptive use among reproductive age women in Ethiopia: evidence from EDHS 2011. 2015.

Habtamu A, Tesfa M, Kassahun M and Animen S. Determinants of long-acting contraceptive utilization among married women of reproductive age in Aneded district, Ethiopia: a case–control study. BMC Research Notes. 2019;12(1):433.

United Nations, Department of Economic and Social Affairs, Population Division. Contraceptive Use by Method 2019: Data Booklet 2019. Available from: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/Jan/un_2019_contraceptiveusebymethod_databooklet.pdf.

Ross JA, and Agwanda AT. Increased use of injectable contraception in sub-Saharan Africa. African journal of reproductive health. 2012;16(4):68-80.

World Health Organization Department of Reproductive Health and Research (WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP) KfHP. Family Planning: A Global Handbook for Providers (2018 update). Baltimore and Geneva: WHO and CCP; 2018. Available from: https://www.fphandbook.org/sites/default/files/global-handbook-2018-full-web.pdf.

Radovich E, Dennis ML, Wong KL, Ali M, Lynch CA, Cleland J, Owolabi O, Lyons-Amos M and Benova L. Who meets the contraceptive needs of young women in sub-Saharan Africa? Journal of Adolescent Health. 2018;62(3):273-80.

Chris P. Opinion: how will COVID-19 affect global access to contraceptives—and what can we do about it? Devex. 2020.

UNFPA. Impact of the COVID-19 Pandemic on Family Planning and Ending Gender-based Violence, Female Genital Mutilation and Child Marriage 2020. Available from: https://www.unfpa.org/sites/default/files/resource-pdf/COVID-19_impact_brief_for_UNFPA_24_April_2020_1.pdf.

Plan International. COVID-19: LOCKDOWN LINKED TO HIGH NUMBER OF UNINTENDED TEEN PREGNANCIES IN KENYA 2020. Available from: https://plan-international.org/news/2020-06-25-covid-19-lockdown-linked-high-number-unintended-teen-pregnancies-kenya.

UNICEF W, UNESCO, UNFPA, UNDP, UNAIDS, WFP and the World Bank,. Facts for life: United Nations Children’s Fund, New York; 2010. Available from: http://www.factsforlifeglobal.org/resources/factsforlife-en-full.pdf.

World Health Organization. WHO Statement on Caesarean Section Rates. Geneva: World Health Organization; 2015. Available from: https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1.

Smith V, Seo D, Warty R, Payne O, Salih M, Chin KL, Ofori-Asenso R, Krishnan S, da Silva Costa F and Vollenhoven B. Maternal and neonatal outcomes associated with COVID-19 infection: A systematic review. Plos one. 2020;15(6):e0234187.

Royal College of Obstetricians and Gynaecologists (RCOG). Coronavirus (COVID-19) Infection in Pregnancy: Information for healthcare professionals. London: Royal College of Obstetricians and Gynaecologists (RCOG); 2020. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/2020-07-24-coronavirus-covid-19-infection-in-pregnancy.pdf.

Ministry of Health (Kenya). KENYA COVID19 RMNH GUIDELINES: A Kenya Practical Guide for Continuity of Reproductive, Maternal, Newborn and Family Planning Care and Services in the Background of COVID-19 Pandemic MOH, April 2020. Nairobi: Ministry of Health (Kenya); 2020. Available from: https://www.health.go.ke/wp-content/uploads/2020/04/KENYA-COVID19-RMNH.pdf.pdf.pdf.

Alliance TWR. COVID-19 Curfew Restrictions Impact Reproductive, Maternal, and Newborn Health and Rights Worldwide. News [Internet]. 2020 20th August 2020. Available from: https://www.whiteribbonalliance.org/2020/06/08/covid-19-curfew-restrictions-impact-women-and-newborns-worldwide/.

AP News. Pregnant women at risk of death in Kenya’s COVID-19 curfew20th August 2020. Available from: https://apnews.com/2e1a7d8b8401e4c06df52085994cf4ba.

Pallangyo E, Nakate MG, Maina R and Fleming V. The impact of covid-19 on midwives’ practice in Kenya, Uganda and Tanzania: A reflective account. Midwifery. 2020.

Delamou A, Hammonds RM, Caluwaerts S, Utz B and Delvaux T. Ebola in Africa: beyond epidemics, reproductive

health in crisis. Lancet. 2014;384(2105):62364-3.

Wilhelm JA and Helleringer S. Utilization of non-Ebola health care services during Ebola outbreaks: a systematic review and meta-analysis. Journal of global health. 2019;9(1).

World Health Organization. Pregnant women must be able to access the right care at the right time, says WHO. WHO Newsroom [Internet]. 20th August 2020. Available from: https://www.who.int/en/news-room/detail/07-11-2016-pregnant-women-must-be-able-to-access-the-right-care-at-the-right-time-says-who.

Hall KS, Samari G, Garbers S, Casey SE, Diallo DD, Orcutt M, Moresky RT, Martinez ME and McGovern T. Centring sexual and reproductive health and justice in the global COVID-19 response. The Lancet. 2020;395(10231):1175-7.

Rowe AK, Kachur SP, Yoon SS, Lynch M, Slutsker L and Steketee RW. Caution is required when using health facility-based data to evaluate the health impact of malaria control efforts in Africa. Malaria journal. 2009;8(1):209.

Bhattacharya AA, Umar N, Audu A, Felix H, Allen E, Schellenberg JR and Marchant T. Quality of routine facility data for monitoring priority maternal and newborn indicators in DHIS2: A case study from Gombe State, Nigeria. PLoS One. 2019;14(1):e0211265.

Hagel C, Paton C, Mbevi G and English M. Data for tracking SDGs: challenges in capturing neonatal data from hospitals in Kenya. BMJ Global Health. 2020;5(3):e002108.

Nielsen P. Advancing health information systems: Experiences from implementing DHIS 2 in Africa. 2013.

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