Gadsden Thomas, Sood Tushar, Purwar Parnika, Peiris David, Nambiar Devaki, Downey Laura E
The George Institute for Global Health, Sydney, Australia.
The George Institute for Global Health, UNSW Sydney, Sydney, Australia.
Lancet Reg Health Southeast Asia. 2024 Feb 12;25:100357. doi: 10.1016/j.lansea.2024.100357. eCollection 2024 Jun.
There is increasing evidence that the COVID-19 pandemic has impacted adversely on the provision of essential health services globally. The Southeast Asia region (SEAR) has experienced extremely high rates of COVID-19 infection, with potential adverse impacts on provision of reproductive, maternal, neonatal, and child health (RMNCH) services.
We conducted a systematic literature review of quantitative evidence to characterise the impact of COVID-19 on the provision of essential RMNCH services across the SEAR. Studies published between December 2019 and May 2022 were included in the study. The quality of studies was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist.
We reviewed 1924 studies and analysed data from 20 peer-reviewed studies and three reports documenting quantitative pre-post estimates of RMNCH service disruption because of the COVID-19 pandemic. Eleven studies were of low methodological quality, in addition to seven and five studies of moderate and high methodological qualities respectively. Six countries in the region were represented in the included studies: India (11 studies), Bangladesh (4), Nepal (3), Sri Lanka (1), Bhutan (1) and Myanmar (1). These countries demonstrated a wide reduction in antenatal care services (-1.6% to -69.6%), facility-based deliveries (-2.3% to -52.4%), child immunisation provision (-13.5% to -87.7%), emergency obstetric care (+4.0% to -76.6%), and family planning services (-4.2% to -100%).
There have been large COVID-19 pandemic related disruptions for a wide range of RMNCH essential health service indicators in several SEAR countries. Notably, we found a higher level of service disruption than the WHO PULSE survey estimates. If left unaddressed, such disruptions may set back hard-fought gains in RMNCH outcomes across the region. The absence of studies in five SEAR countries is a priority evidence gap that needs addressing to better inform policies for service protection.
WHO Sri Lanka Country Office.
越来越多的证据表明，新冠疫情对全球基本卫生服务的提供产生了不利影响。东南亚地区（SEAR）的新冠感染率极高，对生殖、孕产妇、新生儿和儿童健康（RMNCH）服务的提供可能产生不利影响。
我们对定量证据进行了系统的文献综述，以描述新冠疫情对东南亚地区基本RMNCH服务提供的影响。纳入研究的时间范围为2019年12月至2022年5月发表的研究。使用乔安娜·布里格斯研究所的批判性评价清单对研究质量进行评估。
我们审查了1924项研究，并分析了20项同行评审研究和三份报告中的数据，这些报告记录了因新冠疫情导致的RMNCH服务中断的定量前后估计。除了分别有7项和5项方法学质量中等和高的研究外，11项研究的方法学质量较低。纳入研究涵盖了该地区的6个国家：印度（11项研究）、孟加拉国（4项）、尼泊尔（3项）、斯里兰卡（1项）、不丹（1项）和缅甸（1项）。这些国家的产前护理服务大幅减少（-1.6%至-69.6%）、设施分娩（-2.3%至-52.4%）、儿童免疫接种服务（-13.5%至-87.7%）、急诊产科护理（+4.0%至-76.6%）和计划生育服务（-4.2%至-100%）。
在东南亚地区的几个国家，与新冠疫情相关的基本RMNCH卫生服务指标出现了大幅中断。值得注意的是，我们发现服务中断程度高于世界卫生组织的PULSE调查估计。如果不加以解决，此类中断可能会使该地区在RMNCH成果方面来之不易的进展受挫。东南亚地区五个国家缺乏相关研究是一个需要填补的重要证据空白，以便更好地为服务保护政策提供信息。
世界卫生组织斯里兰卡国家办事处
