The impact of the COVID-19 pandemic on reproductive, maternal, neonatal, and child health care services in Kiambu County, Kenya

Davis Kamondo, Magoma Mwancha-Kwasa, Moses Kamita, Caroline Mwangi, Maxwell Murage, Prabhjot K. Juttla, Daniel Gicheru, Jesse Gitaka


The global response to COVID-19 undermined established public health goals. This study investigated the impact of COVID-19 on reproductive, maternal, neonatal, and child health (RMNCH) services in Kiambu County, Kenya. It was a retrospective crosssectional study, where data on antenatal care (ANC), delivery, postnatal care (PNC), and family planning (FP) before and after COVID-19 was retrieved and compared. New ANC clients and 4th ANC visits decreased by 2.9% and 17% respectively. New clients attending PNC increased by 13.3% (p = 0.007). Skilled deliveries reduced by 0.3%, maternal, neonatal deaths, and fresh stillbirths reduced by 0.7%, 23.9%, and 15.8% respectively. Caesarean sections rose by 12.7% (p=0.001). New clients and revisits for family planning reduced by 15.4% and 6.6% respectively. The pandemic adversely affected most of the RMNCH services. There is a need for health departments to institute robust strategies to recover the gains lost during COVID-19. (Afr J Reprod Health 2024; 28 [3]: 20-29).

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Akinyemi JO, Afolabi RF and Awolude OA. Patterns and

determinants of dropout from maternity care

continuum in Nigeria. BMC Pregnancy Childbirth.

;16(1). doi:10.1186/s12884-016-1083-9

World Health Organization. WHO recommendations on

antenatal care for a positive pregnancy experience.

Accessed March 10, 2022.

Yasuoka J, Nanishi K, Kikuchi K, et al. Barriers for

pregnant women living in rural, agricultural villages

to accessing antenatal care in Cambodia: A

community-based cross-sectional study combined

with a geographic information system. PLoS One.

;13(3). doi:10.1371/journal.pone.0194103

Warren C, Daly P, Toure L and Mongi P. Postnatal care. In:

Opportunities for Africa’s Newborns.

Mansour Z, Arab J, Said R, et al. Impact of COVID-19

pandemic on the utilization of routine immunization

services in Lebanon. PLoS One. 2021;16(2

Febuary). doi:10.1371/journal.pone.0246951

Mallah SI, Ghorab OK, Al-Salmi S, et al. COVID-19:

breaking down a global health crisis. Ann Clin

Microbiol Antimicrob. 2021;20(1).


Republic of Kenya. 62 more new cases of Covid 19 Nairobi,

Tuesday May 26, 2020 – MINISTRY OF HEALTH.

Published May 26, 2020. Accessed March 8, 2022.

Kenya: Ministry of Health. KENYA COVID19 RMNH

GUIDELINES: A Kenya Practical Guide for

Continuity of Reproductive, Maternal, Newborn and

Family Planning Care and Services in the

Background of COVID19 Pandemic.; 2020.

Kadambari S, Goldacre R, Morris E, Goldacre MJ and

Pollard AJ. Indirect effects of the covid-19

pandemic on childhood infection in England:

population based observational study. The BMJ.

;376. doi:10.1136/bmj-2021-067519

Baloch AA, Baig N, Baloch F and Suhag Z. Impact on the

Utilization of Reproductive, Maternal, Newborn and

Child Health Care Services at Primary Health Care

Level During First Wave of COVID-19 Outbreak in

Pakistan. Cureus. Published online August 25, 2021.


Burt JF, Ouma J, Lubyayi L, et al. Indirect effects of

COVID-19 on maternal, neonatal, child, sexual and

reproductive health services in Kampala, Uganda.

BMJ Glob Health. 2021;6(8). doi:10.1136/bmjgh2021-006102

Singh A, Jain P, Singh N, et al. Impact of COVID-19

pandemic on maternal and child health services in

Uttar Pradesh, India. J Family Med Prim Care.

;10(1):509. doi:10.4103/jfmpc.jfmpc_1550_20

Ahmed T, Rahman AE, Amole TG, et al. The effect of

COVID-19 on maternal newborn and child health

(MNCH) services in Bangladesh, Nigeria and South

Africa: call for a contextualised pandemic response

in LMICs. Int J Equity Health. 2021;20(1).


Roberton T, Carter ED, Chou VB, et al. 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. Lancet

Glob Health. 2020;8(7):e901-e908.


Desta AA, Woldearegay TW, Gebremeskel E, et al.

Impacts of COVID-19 on essential health services in

Tigray, Northern Ethiopia: A prepost study. PLoS

One. 2021;16(8 August).


United Nations. Rapid Assessment of Ebola Impact on

Reproductive Health Services and Service Seeking

Behaviour in Sierra Leone March2015.; 2015.

Corbett GA, Milne SJ, Hehir MP, Lindow SW and

O’connell MP. Health anxiety and behavioural

changes of pregnant women during the COVID-19

pandemic. European Journal of Obstetrics and

Gynecology and Reproductive Biology.

;249:96-97. doi:10.1016/j.ejogrb.2020.04.022

Hassan R, Bhatia A, Zinke-Allmang A, et al. Navigating

family planning access during Covid-19: A

qualitative study of young women’s access to

information, support and health services in periurban Nairobi. SSM - Qualitative Research in

Health. 2022;2:100031.


Shikuku DN, Nyaoke IK, Nyaga LN and Ameh CA. 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. Afr J Reprod

Health. 2021;25(6):76.


Ministry of Health. Kenya COVID-19 RMNH Guidelines.

Published online 2020. Accessed March 10, 2022.


Plotkin MK, Williams KM, Mbinda A, et al. Keeping

essential reproductive, maternal and child health

services available during COVID-19 in Kenya,

Mozambique, Uganda and Zimbabwe: analysis of

early-pandemic policy guidelines. BMC Public

Health. 2022;22(1):577. doi:10.1186/s12889-022-


Kiambu C: County Health Sector Annual Performance

Review Report.; 2018.

World Health Organization. Case Study from Kenya

PRIMARY HEALTH CARE SYSTEMS (PRIMASYS) Abridged Version.; 2017. Accessed March 10, 2022.

Aranda Z, Binde T, Tashman K, et al. Disruptions in

maternal health service use during the COVID-19

pandemic in 2020: Experiences from 37 health

facilities in low-income and middle-income

countries. BMJ Glob Health. 2022;7(1).


Meaney S, Leitao S, Olander EK, Pope J and MatvienkoSikar K. The impact of COVID-19 on pregnant

womens’ experiences and perceptions of antenatal

maternity care, social support, and stress-reduction

strategies. Women and Birth. 2022;35(3):307-316.


PATH. RMNCAH-N Services During COVID-19: A

spotlight on Kenya’s policy responses to maintain

and adapt essential health services. 2021. Accessed

May 19, 2022.


Chmielewska B, Barratt I, Townsend R, et al. Effects of

the COVID-19 pandemic on maternal and perinatal

outcomes: a systematic review and meta-analysis.

Lancet Glob Health. 2021;9(6):e759-e772.


Oluoch-Aridi J, Chelagat T, Nyikuri MM, et al. COVID19 Effect on Access to Maternal Health Services in

Kenya. Front Glob Womens Health. 2020;1:19.


Bikwa Y, Murewanhema G, Kanyangarara M, Madziyire

MG and Chirenje ZM. Impact of COVID-19 on

maternal and perinatal outcomes in Harare,

Zimbabwe: a comparative maternal audit. J Glob

Health Rep. Published online November 24, 2021.


Eleje GU, Ugwu EO, Enebe JT, et al. Cesarean section rate

and outcomes during and before the first wave of

COVID-19 pandemic. SAGE Open Med. 2022;10.


Abdela SG, Berhanu AB, Ferede LM and van Griensven J.

Essential healthcare services in the face of COVID19 prevention: Experiences from a referral hospital

in Ethiopia. American Journal of Tropical Medicine

and Hygiene. 2020;103(3):1198-1200.


Leight J, Hensly C, Chissano M and Ali L. Short-term

effects of the COVID-19 state of emergency on

contraceptive access and utilization in Mozambique.

PLoS One. 2021;16(3 March).


Keesara SR, Juma PA and Harper CC. Why do women

choose private over public facilities for family

planning services? A qualitative study of postpartum women in an informal urban settlement in

Kenya. BMC Health Serv Res. 2015;15(1).


Kasim J, Kalu A, Kamara B and Alema HB. Cervical

Cancer Screening Service Utilization and

Associated Factors among Women in the Shabadino

District, Southern Ethiopia. J Cancer Epidemiol.

;2020. doi:10.1155/2020/6398394.


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