Singh Tejbeer, Kaur Ravneet, Kant Shashi, Mani Kalaivani, Yadav Kapil, Gupta Sanjeev Kumar
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Indian J Community Med. 2023 Sep-Oct;48(5):715-720. doi: 10.4103/ijcm.ijcm_43_23. Epub 2023 Sep 7.
It is well documented that the utilization of maternal healthcare services during pregnancy and childbirth plays a significant role in reducing maternal morbidity and mortality. Disruptions in maternal healthcare services during the coronavirus disease 2019 (COVID-19) pandemic have been reported. However, there is a paucity of literature from rural areas, as most of the previous studies are either record-based or conducted in tertiary care centers. This study aimed to determine the proportion of women who received the recommended maternal healthcare services during the COVID-19 pandemic and to study various factors associated with the utilization of services.
In this community-based study, we assessed the utilization of maternal healthcare services among 520 women residing in the Ballabgarh Block of District Faridabad, Haryana, whose antenatal, intrapartum, and postnatal period coincided with the first wave of COVID-19 pandemic. Domiciliary visits were made, and women were interviewed retrospectively regarding maternal healthcare services utilized by them. The antenatal care (ANC) cards were reviewed, and details were corroborated.
Full ANC was received by 15.3% of women, and 45% of women had less than four antenatal visits. 30.9% of participants had cesarean delivery. The proportion of cesarean delivery in private facilities was significantly higher than in government facilities [Odds Ratio (OR) (95% Confidence intervals (CI)) =10.04 (5.87-17.19); < 0.001]. In multivariate logistic regression, gravidity was negatively associated with full ANC [OR (95% CI) =0.43 (0.25-0.74); = 0.002].
Fewer women received the recommended maternal healthcare services during the COVID-19 pandemic. Detailed assessment of health systems and factors affecting routine healthcare services, during the pandemic, can help improve the readiness and response in the future.
有充分记录表明，孕期和分娩期间孕产妇保健服务的利用在降低孕产妇发病率和死亡率方面发挥着重要作用。据报道，2019年冠状病毒病（COVID-19）大流行期间孕产妇保健服务受到干扰。然而，农村地区的文献较少，因为之前的大多数研究要么基于记录，要么在三级护理中心进行。本研究旨在确定在COVID-19大流行期间接受推荐孕产妇保健服务的女性比例，并研究与服务利用相关的各种因素。
在这项基于社区的研究中，我们评估了居住在哈里亚纳邦法里达巴德区巴拉加尔街区的520名女性的孕产妇保健服务利用情况，她们的产前、产时和产后时期与COVID-19大流行的第一波相吻合。进行了家访，并就她们利用的孕产妇保健服务对女性进行了回顾性访谈。审查了产前保健（ANC）卡，并核实了细节。
15.3%的女性接受了全程ANC，45%的女性产前检查次数少于四次。30.9%的参与者进行了剖宫产。私立机构的剖宫产比例显著高于政府机构[优势比（OR）（95%置信区间（CI））=10.04（5.87-17.19）；P<0.001]。在多因素逻辑回归中，孕次与全程ANC呈负相关[OR（95%CI）=0.43（0.25-0.74）；P=0.002]。
在COVID-19大流行期间，接受推荐孕产妇保健服务的女性较少。在大流行期间对卫生系统和影响常规医疗服务的因素进行详细评估，有助于提高未来的准备和应对能力。
