We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The COVID-19 Pandemic's Impact on Health Service Utilization Among Pregnant Women in Three Nigerian States: A Mixed Methods Study.
- Authors
Orji, Bright; Bryce, Emily; Odio, Bartholomew; Onuoha, Herbert; Njoku, Elizabeth; Anoke, Charity; Ugwa, Emmanuel; Enne, Joseph; Oniyire, Adetiloye; Ibrahim, Idris; Otolorin, Emmanuel; Afolabi, Kayode; Ogbulafor, Nnenna C.; Oliveras, Elizabeth
- Abstract
Objective: COVID-19 disrupted health service delivery and weakened global and national health systems. The objective of this study was to describe the changes in health service utilization in three local government areas (LGAs) in Nigeria and examine factors involved. Methods: A cross-sectional mixed-methods approach was used. A total of 315 pregnant women seen for antenatal care in 80 health facilities in three LGAs between October 1 and November 30, 2020, participated in exit interviews; 93 women participated in focus group discussions (FGDs). Descriptive analyses and a multivariable logistic analysis were conducted to examine associations between characteristics and decreased service utilization. Content analysis was used to identify the emerging themes related to health service utilization during the pandemic. Results: One quarter of women reported that they reduced or ceased health service. The biggest reported changes were in immunization (47 to 30%, p < 0.001) and a small but statistically significant decline in antenatal care (98.7 to 93.8%, p < 0.001) was observed. Qualitative findings show that lockdowns, transportation issues, increased costs and fear of contracting COVID-19 or being labeled as COVID-positive were the most common reasons for not seeking care during this period of the pandemic. Conclusions: The pandemic negatively impacted health service utilization amongst pregnant women in Nigeria. A better understanding of differences in state response could help inform future actions. The findings highlight the need for health systems to consider how to facilitate service utilization during a pandemic, such as providing safe transport or increasing outreach, and to minimize stigma for those seeking care. Significance: What is already known on this subject? The COVID-19 pandemic has disrupted health systems worldwide and service utilization decreased as a result, including the utilization of maternal and child health services. What this study adds? This study shows that there were significant declines in service utilization and provides insight into why pregnant woman did or did not alter their care-seeking for antenatal care and immunizations services. The qualitative results indicate that pregnant women responded to or interpreted State and facility-level responses differently, which resulted in increased or decreased utilization. These insights can inform future emergency responses and policies to build more resilient health systems and communities.
- Subjects
NIGERIA; MEDICAL care use; CROSS-sectional method; IMMUNIZATION; FEAR; HEALTH services accessibility; FOCUS groups; RESEARCH funding; MEDICAL care; INTERVIEWING; MULTIPLE regression analysis; CONTENT analysis; DESCRIPTIVE statistics; MULTIVARIATE analysis; THEMATIC analysis; PRENATAL care; STAY-at-home orders; ODDS ratio; RESEARCH methodology; CONFIDENCE intervals; COVID-19 pandemic; PREGNANCY
- Publication
Maternal & Child Health Journal, 2024, Vol 28, Issue 2, p294
- ISSN
1092-7875
- Publication type
Article
- DOI
10.1007/s10995-023-03820-3