Maïga Abdoulaye, Bougma Moussa, Wilson Emily, Kaboré Théodore S, Tou Gildas G, Munos Melinda K, Kanté Almamy M, Jiwani Safia S, Zack Kelsey, Akum Aveika, Walker Neff, Black Robert E, Amouzou Agbessi
Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Institut Supérieur des Sciences de la Population, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso.
J Glob Health. 2024 Dec 20;14:05037. doi: 10.7189/jogh.14.05037.
While countries' coronavirus disease 2019 (COVID-19) emergency contingency and response plans aimed to prevent and control the spread of the virus, they also caused major disruptions to health services. We assessed the effects of COVID-19 on coverage and inequalities in select maternal, newborn, and child health services in Burkina Faso.
We analysed data from two cross-sectional household surveys conducted in two provinces, one rural and one urban. The first survey of 3375 households was conducted immediately before the pandemic (February to March 2020) and the second survey in the same areas two years after the pandemic (May to June 2022) using a similar methodology. We compared the coverage of maternal, newborn, and child health interventions and care-seeking between the two surveys to assess the effects of the pandemic on maternal, newborn, and child health services.
Our findings did not show significant disruptions in coverage of antenatal service, postnatal care for mothers and babies, child routine vaccination, and care-seeking for sick children during the pandemic. However, there was a dramatic drop of the number of women (23 percentage points) accompanied by their partners for delivery as well as the number of caesarean-section deliveries in urban areas. The shortage of health staff, facility congestion, fear of getting COVID-19 after a caesarean-section admission, and prioritisation of critical health services such as emergency caesarean-section to the detriment of elective cases may explain the decline of caesarean-section rates.
COVID-19 did not cause major reversals in the coverage of maternal, newborn, and child health services in Burkina Faso, except for caesarean sections. We also saw no substantial increases in service coverage. In the absence of a counterfactual, we could not attribute the stagnation to the pandemic. However, the very low proportion of women reporting disruption in care-seeking suggests some resilience of the health systems to mitigate the negative impacts of the pandemic.
虽然各国的2019冠状病毒病(COVID-19)应急和应对计划旨在预防和控制病毒传播,但它们也对卫生服务造成了重大干扰。我们评估了COVID-19对布基纳法索部分孕产妇、新生儿和儿童健康服务的覆盖情况及不平等现象的影响。
我们分析了在两个省份(一个农村省份和一个城市省份)进行的两次横断面家庭调查的数据。第一次对3375户家庭的调查在疫情爆发前(2020年2月至3月)立即进行,第二次调查在疫情爆发两年后(2022年5月至6月)在相同地区采用类似方法进行。我们比较了两次调查中孕产妇、新生儿和儿童健康干预措施的覆盖情况以及就医情况,以评估疫情对孕产妇、新生儿和儿童健康服务的影响。
我们的研究结果显示,在疫情期间,产前服务、母婴产后护理、儿童常规疫苗接种以及患病儿童的就医情况的覆盖范围没有出现显著中断。然而,在城市地区,陪同分娩的女性及其伴侣的数量(下降了23个百分点)以及剖宫产分娩的数量都出现了大幅下降。卫生工作人员短缺、设施拥挤、剖宫产入院后担心感染COVID-19,以及将诸如紧急剖宫产等关键卫生服务置于优先地位而牺牲择期手术病例,可能解释了剖宫产率的下降。
除剖宫产外,COVID-19并未导致布基纳法索孕产妇、新生儿和儿童健康服务的覆盖范围出现重大逆转。我们也没有看到服务覆盖范围有大幅增加。由于缺乏对照情况,我们无法将这种停滞归因于疫情。然而,报告就医受到干扰的女性比例非常低,这表明卫生系统具有一定的恢复力,能够减轻疫情的负面影响。