Covid-19 pandemic impact on maternal and child health services access in Nampula, Mozambique: a mixed methods research.
Covid-19 pandemic impact on maternal and child health services access in Nampula, Mozambique: a mixed methods research.
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DOI：
10.1186/s12913-021-06878-3
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发表时间：
2021-08-23
影响因子：
2.8
通讯作者：
Belo CF
中科院分区：
文献类型：
--
作者：
das Neves Martins Pires PH;Macaringue C;Abdirazak A;Mucufo JR;Mupueleque MA;Zakus D;Siemens R;Belo CF
迄今为止，Covid-19 大流行已感染全球超过 3000 万人，对全球健康产生重大影响并造成附带损害。莫桑比克于2020年3月下旬宣布进入公共紧急状态。这限制了人们的行动，减少了公共服务，导致前往医疗机构就诊的人数减少。过去四年来，一个名为“准备医院警报社区”的实施研究项目一直在楠普拉省纳蒂基里促进妇幼保健服务的普及。楠普拉的 Covid-19 发病率位居第二。本研究的目的是评估 Covid-19 大流行政府限制对获得妇幼保健服务的影响。我们将楠普拉市的医疗中心与我们研究区域的医疗中心进行了比较。我们想看看我们之前的研究干预是否引起了社区更有弹性的反应。混合方法研究，描述性、横断面、回顾性，使用患者就诊文件的审查。我们将2019年3月至5月妇幼保健单位统计指标与2020年同期进行比较。我们使用KrushKall Wallis、单因素方差分析以及均值和标准差检验检验了妇幼保健服务可及性的显着变化。我们比较了对这两个地区的卫生专业人员、传统助产士和患者的采访。我们从可比较的城市卫生中心和主要城市转诊医院收集了数据。马雷雷卫生中心和马雷雷综合医院是两个警报社区，准备医院干预地点。将 2019 年孕产妇保健服务获取量化指标与 2020 年相比，最重要的指标均有所下降：计划生育就诊和选择性剖腹产下降了 28%；发生在妊娠早期的首次产前检查下降了 26%；医院分娩量下降了 4%，具有统计学意义（p = 0.046），而家庭分娩量则上升了 74%；儿童接种疫苗的人数下降了20%。我们的结果证明了Covid-19大流行政府的限制对获得妇幼保健服务产生了负面的附带影响，并强调了改善莫桑比克卫生信息系统的必要性。在线版本包含可在 10.1186/s12913-021-06878-3 获取的补充材料。
The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people’s movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community. Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March–May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites. Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%. Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique. The online version contains supplementary material available at 10.1186/s12913-021-06878-3.
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