Impact of COVID-19 on intrapartum care at public hospitals in the Sidama region, Ethiopia: A mixed-methods study.

Kassa, ZY; Scarf, V; Turkmani, S; Fox, D

Impact of COVID-19 on intrapartum care at public hospitals in the Sidama region, Ethiopia: A mixed-methods study.

Kassa, ZY Scarf, V

Turkmani, S

Fox, D

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Publisher:: SAGE PUBLICATIONS LTD
Publication Type:: Journal Article
Citation:: Womens Health (Lond), 2024, 20, pp. 17455057241296614
Issue Date:: 2024

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Field	Value	Language
dc.contributor.author	Kassa, ZY
dc.contributor.author	Scarf, V https://orcid.org/0000-0003-3503-9610
dc.contributor.author	Turkmani, S https://orcid.org/0000-0001-7819-5061
dc.contributor.author	Fox, D https://orcid.org/0000-0002-8032-8633
dc.date.accessioned	2025-01-20T04:28:32Z
dc.date.available	2025-01-20T04:28:32Z
dc.date.issued	2024
dc.identifier.citation	Womens Health (Lond), 2024, 20, pp. 17455057241296614
dc.identifier.issn	1745-5057
dc.identifier.issn	1745-5065
dc.identifier.uri	http://hdl.handle.net/10453/183865
dc.description.abstract	BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the health of pregnant women and their unborn babies. OBJECTIVE: To explore the impact of COVID-19 on intrapartum care in Ethiopia. DESIGN: A concurrent mixed-methods design was employed. METHODS: An interrupted time series analysis was implemented using a Poisson regression model to estimate monthly changes in the incidence rates of institutional childbirth, instrumental vaginal birth, caesarean section, stillbirth, institutional neonatal death, institutional maternal death and availability of essential medical supplies before and during COVID-19. The dataset included data from all women who gave birth in 15 public hospitals, and the total number of childbirths in the cohort study before COVID-19 (12 months of data from March 2019 to February 2020) was 24,478, while during COVID-19 (6 months of data from March to August 2020), the total number of childbirths in the cohort study was 11,966, forming a combined final dataset of 36,444. Simultaneously, a descriptive qualitative study using a purposive sampling technique was conducted through in-depth interviews until data saturation was reached, with data were collected from 14 February to 10 May 2022. Data from the interviews were imported into NVivo 12 Plus to perform an inductive thematic analysis. Quantitative and qualitative data were integrated using joint display methods to identify corroboration or contradiction between the different forms of evidence. RESULTS: Our findings indicate that the incidence rates of caesarean sections and instrumental vaginal births significantly increased in the first 6 months of COVID-19. Three themes were identified: 'Barriers to providing intrapartum care during COVID-19', 'Delays to provision of intrapartum care during COVID-19' and 'Inadequate COVID-19 preventive measures'. CONCLUSION: In combination, the three themes contributed to a considerable increase in neonatal and maternal deaths. Interventions such as fully equipped labour wards and obstetric triage systems are needed to restore disrupted maternal and perinatal care during the ongoing and future pandemics. In addition, stakeholders should inform the public that blood donations can help the community recover from recent shocks in emergency health and future pandemics. Further research should investigate the long-term impact of COVID-19 on maternity care and maternal and infant outcomes.
dc.format	Print
dc.language	eng
dc.publisher	SAGE PUBLICATIONS LTD
dc.relation.ispartof	Womens Health (Lond)
dc.relation.isbasedon	10.1177/17455057241296614
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.classification	3215 Reproductive medicine
dc.subject.classification	4206 Public health
dc.subject.mesh	Humans
dc.subject.mesh	COVID-19
dc.subject.mesh	Female
dc.subject.mesh	Ethiopia
dc.subject.mesh	Pregnancy
dc.subject.mesh	Hospitals, Public
dc.subject.mesh	Adult
dc.subject.mesh	Delivery, Obstetric
dc.subject.mesh	SARS-CoV-2
dc.subject.mesh	Interrupted Time Series Analysis
dc.subject.mesh	Perinatal Care
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Maternal Mortality
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Young Adult
dc.subject.mesh	Humans
dc.subject.mesh	Perinatal Care
dc.subject.mesh	Delivery, Obstetric
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Maternal Mortality
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Pregnancy
dc.subject.mesh	Adult
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Hospitals, Public
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.subject.mesh	Young Adult
dc.subject.mesh	Interrupted Time Series Analysis
dc.subject.mesh	COVID-19
dc.subject.mesh	SARS-CoV-2
dc.subject.mesh	Humans
dc.subject.mesh	COVID-19
dc.subject.mesh	Female
dc.subject.mesh	Ethiopia
dc.subject.mesh	Pregnancy
dc.subject.mesh	Hospitals, Public
dc.subject.mesh	Adult
dc.subject.mesh	Delivery, Obstetric
dc.subject.mesh	SARS-CoV-2
dc.subject.mesh	Interrupted Time Series Analysis
dc.subject.mesh	Perinatal Care
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Maternal Mortality
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Young Adult
dc.title	Impact of COVID-19 on intrapartum care at public hospitals in the Sidama region, Ethiopia: A mixed-methods study.
dc.type	Journal Article
utslib.citation.volume	20
utslib.location.activity	United States
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/UTS Groups
pubs.organisational-group	University of Technology Sydney/UTS Groups/Women & Children’s Health Research Collaborative (WCHC)
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0/
dc.date.updated	2025-01-20T04:28:31Z
pubs.publication-status	Published
pubs.volume	20

Abstract:

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the health of pregnant women and their unborn babies. OBJECTIVE: To explore the impact of COVID-19 on intrapartum care in Ethiopia. DESIGN: A concurrent mixed-methods design was employed. METHODS: An interrupted time series analysis was implemented using a Poisson regression model to estimate monthly changes in the incidence rates of institutional childbirth, instrumental vaginal birth, caesarean section, stillbirth, institutional neonatal death, institutional maternal death and availability of essential medical supplies before and during COVID-19. The dataset included data from all women who gave birth in 15 public hospitals, and the total number of childbirths in the cohort study before COVID-19 (12 months of data from March 2019 to February 2020) was 24,478, while during COVID-19 (6 months of data from March to August 2020), the total number of childbirths in the cohort study was 11,966, forming a combined final dataset of 36,444. Simultaneously, a descriptive qualitative study using a purposive sampling technique was conducted through in-depth interviews until data saturation was reached, with data were collected from 14 February to 10 May 2022. Data from the interviews were imported into NVivo 12 Plus to perform an inductive thematic analysis. Quantitative and qualitative data were integrated using joint display methods to identify corroboration or contradiction between the different forms of evidence. RESULTS: Our findings indicate that the incidence rates of caesarean sections and instrumental vaginal births significantly increased in the first 6 months of COVID-19. Three themes were identified: 'Barriers to providing intrapartum care during COVID-19', 'Delays to provision of intrapartum care during COVID-19' and 'Inadequate COVID-19 preventive measures'. CONCLUSION: In combination, the three themes contributed to a considerable increase in neonatal and maternal deaths. Interventions such as fully equipped labour wards and obstetric triage systems are needed to restore disrupted maternal and perinatal care during the ongoing and future pandemics. In addition, stakeholders should inform the public that blood donations can help the community recover from recent shocks in emergency health and future pandemics. Further research should investigate the long-term impact of COVID-19 on maternity care and maternal and infant outcomes.

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http://hdl.handle.net/10453/183865