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Marwah S, Sharma P, Tripathi S, Arora D, Agarwal A, Malik A, Gaikwad H, Bajaj B. Effect of COVID-19 Pandemic on Knowledge, Attitude and Practices Towards Antenatal Care Among Antenatal Women: A Study From a Tertiary Care Hospital in Delhi, India. Cureus 2024; 16:e52618. [PMID: 38374850 PMCID: PMC10875906 DOI: 10.7759/cureus.52618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVE Effect of the COVID-19 pandemic on knowledge, attitude, and practices toward antenatal care among antenatal women. DESIGN Prospective observational study. METHOD After taking written and informed consent, 3000 term/near-term SARS CoV2-negative antenatal women admitted to the hospital for emergency were enrolled; excluding those in advance labour or critically ill. An interview was conducted and a knowledge, attitude, and practices (KAP) questionnaire was filled out based on verbatim answers. All women were then given individualized antenatal and postnatal care as per hospital protocols and discharged accordingly. The data obtained during the study was recorded on predesigned case proforma and analysed at the end of the study using the SPSS v. 23 software, after the application of appropriate statistical tests. MAIN RESULT All women knew about the pandemic and its signs and symptoms along with precautions to be taken. Most of the women 2652 (88.4%) thought that they were at increased risk of contracting an infection during pregnancy and 2208 (73.6%) thought that coronavirus can harm the baby and will increase the risk of pregnancy. Awareness of nearby health facilities providing antenatal care was in 71.2% and 94% were aware of functional outpatient department services but only 1.4% were aware of teleconsultation services. About 2094 women have had any ANC visits. All of them knew that taking iron, Ca and vitamin supplements and getting an ultrasound and investigations were necessary but only 1524 (50.8%) took these supplements regularly, 1752 (58.4%) got their ultrasound done and 41.6% got investigations done. Two thousand four hundred thirty-six (81.2%) women had this fear that they would contract COVID-19 infection during their visit to the hospital. All the respondents of our study wanted to have hospital delivery and knew that it was necessary to have ANC registration and none of them wanted to have home delivery. CONCLUSION Mastering correct knowledge will foster a positive attitude among antenatal women and will not only prevent disease transmission but also improve pregnancy outcomes.
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Affiliation(s)
- Sheeba Marwah
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Poornima Sharma
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Shiwani Tripathi
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Divya Arora
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Ambika Agarwal
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Abhigya Malik
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Harsha Gaikwad
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Bindu Bajaj
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
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McGowan CR, Gokulakrishnan D, Monaghan E, Abdelmagid N, Romig L, Gallagher MC, Meyers J, Cummings R, Cardinal LJ. Measuring supply-side service disruption: a systematic review of the methods for measuring disruption in the context of maternal and newborn health services in low and middle-income settings. BMJ Open 2023; 13:e077583. [PMID: 38072479 PMCID: PMC10729240 DOI: 10.1136/bmjopen-2023-077583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES During the COVID-19 pandemic, most essential services experienced some level of disruption. Disruption in LMICs was more severe than in HICs. Early reports suggested that services for maternal and newborn health were disproportionately affected, raising concerns about health equity. Most disruption indicators measure demand-side disruption, or they conflate demand-side and supply-side disruption. There is currently no published guidance on measuring supply-side disruption. The primary objective of this review was to identify methods and approaches used to measure supply-side service disruptions to maternal and newborn health services in the context of COVID-19. DESIGN We carried out a systematic review and have created a typology of measurement methods and approaches using narrative synthesis. DATA SOURCES We searched MEDLINE, EMBASE and Global Health in January 2023. We also searched the grey literature. ELIGIBILITY CRITERIA We included empirical studies describing the measurement of supply-side service disruption of maternal and newborn health services in LMICs in the context of COVID-19. DATA EXTRACTION AND SYNTHESIS We extracted the aim, method(s), setting, and study outcome(s) from included studies. We synthesised findings by type of measure (ie, provision or quality of services) and methodological approach (ie, qualitative or quantitative). RESULTS We identified 28 studies describing 5 approaches to measuring supply-side disruption: (1) cross-sectional surveys of the nature and experience of supply-side disruption, (2) surveys to measure temporal changes in service provision or quality, (3) surveys to create composite disruption scores, (4) surveys of service users to measure receipt of services, and (5) clinical observation of the provision and quality of services. CONCLUSION Our review identified methods and approaches for measuring supply-side service disruption of maternal and newborn health services. These indicators provide important information about the causes and extent of supply-side disruption and provide a useful starting point for developing specific guidance on the measurement of service disruption in LMICs.
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Affiliation(s)
- Catherine R McGowan
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Emily Monaghan
- Humanitarian Department, Save the Children International, London, UK
- Croydon University Hospital, Croydon, UK
| | - Nada Abdelmagid
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Laura Romig
- Department of Humanitarian Response, Save the Children Federation, District of Columbia, Washington, USA
| | - Meghan C Gallagher
- Department of Humanitarian Response, Save the Children Federation, District of Columbia, Washington, USA
| | - Janet Meyers
- Department of Humanitarian Response, Save the Children Federation, District of Columbia, Washington, USA
| | - Rachael Cummings
- Humanitarian Department, Save the Children International, London, UK
- Department of Publiic Health & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Laura J Cardinal
- Humanitarian Department, Save the Children International, London, UK
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Singh T, Kaur R, Kant S, Mani K, Yadav K, Gupta SK. Maternal Healthcare Services in a Rural Area of Haryana during the COVID-19 Pandemic: A Community-Based Study. Indian J Community Med 2023; 48:715-720. [PMID: 37970159 PMCID: PMC10637588 DOI: 10.4103/ijcm.ijcm_43_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/30/2023] [Indexed: 11/17/2023] Open
Abstract
Background 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. Material and Methods 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. Results 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); P < 0.001]. In multivariate logistic regression, gravidity was negatively associated with full ANC [OR (95% CI) =0.43 (0.25-0.74); P = 0.002]. Conclusion 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.
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Affiliation(s)
- Tejbeer Singh
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ravneet Kaur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Kumar Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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Dhillon P, Unisa S, Gupta A, Saraswat A, Km S, Pedgaonkar S. Utilisation of ANC services before and after the COVID-19 pandemic in selected resource-poor blocks of India: role of community health workers in Swabhimaan programme area. BMC Health Serv Res 2023; 23:864. [PMID: 37580689 PMCID: PMC10426095 DOI: 10.1186/s12913-023-09781-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/03/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION COVID-19 has disrupted maternal and child health services. Community Health Workers (CHWs) supported the women by visiting pregnant women's homes and providing the MCH services as required. This study attempts to understand the role of CHW and its impact on the Ante-Natal Care (ANC) services pre-pandemic and post-Pandemic in the poor resource setting. METHODS The Swabhimaan programme interventions were carried out in the selected blocks in the Indian States of Bihar, Odisha and Chhattisgarh with the objective to improve the nutritional status of mothers, pregnant women and adolescents living in resource-poor blocks of three selected states during 2016-2022. Cross-sectional surveys, namely pre-pandemic (2018-19) and post-pandemic (2021-22) of pregnant and mothers of under two children, utilised to fulfil the objectives of this study. These surveys are part of Swabhimaan evaluation, a community-based non-randomised controlled study. RESULTS The ANC services received by women have increased over time from 2015 to 2022. Our findings confirm that the ground-level community and health systems were active during the pandemic, and the results show significant improvement. Additionally, the women supported by the CHW have substantially improved pregnancy registration, first ANC, Tetanus injection, consumption of Iron Folic Acid, Calcium and deworming tablets than those who did not. Propesnsity Score Matching analysis shows that the average treatment effect on the various ANC services of having the support of CHW is significant. CONCLUSION This study shows the vital role of CHWs in utilising various Maternal and Child Health services. Better linkage and networking of the CHWs with the community will ensure health service delivery regularly and in an emergency like a pandemic and develop resilience.
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Affiliation(s)
- Preeti Dhillon
- Department of Survey Research & Data Analystics, International Institute for Population Sciences, Mumbai, India
| | - Sayeed Unisa
- Department of Bio-Statistics and Epidemiology, International Institute for Population Sciences, Mumbai, India.
| | - Ajay Gupta
- Swabhimaan Project, International Institute for Population Sciences, Mumbai, India
| | - Abhishek Saraswat
- Swabhimaan Project, International Institute for Population Sciences, Mumbai, India
| | - Sulaiman Km
- Swabhimaan Project, International Institute for Population Sciences, Mumbai, India
| | - Sarang Pedgaonkar
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
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Khanam A, Vohra K, Achary MG T, Ranjith A, Bharti H, Ghosh R, Kaur R, Yadav K. A Systematic review of factors affecting compliance toward oral iron-folic acid supplementation among pregnant women in India. INDIAN JOURNAL OF COMMUNITY HEALTH 2022. [DOI: 10.47203/ijch.2022.v34i04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background: Iron-folic acid deficiency is the most common complication during pregnancy. Iron deficiency is responsible for various health complications among pregnant women. Compliance with IFA supplementation is variable across India several factors are associated with compliance with IFA supplementation. Objective: The objective of this systematic review is to assess the factors affecting compliance toward oral iron-folic acid supplementation among pregnant women in India. Methods: The primary search was carried out using PubMed, Google scholar, the WHO website, and Research Gate which provide access to full?text research articles from January 2012 to 25th January 2022 published data were searched. Result: A total of 74 studies were identified, and 20 were included in this review. Out of the 20 studies, sixteen were cross-sectional, two mixed methods, and two randomized control trials. knowledge of IFA, education, socioeconomic status, the timing of registration and number of antenatal visits, type of family, and age of the pregnant women were the factors that affect the compliance of IFA supplementation. Conclusion: Knowledge of iron-folic acid supplementation, Timing of registration and number of Antenatal Care visits, educational level of the pregnant women, and age of the pregnant women were factors associated with the compliance of IFA supplementation among pregnant women in India.
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Khandelwal S, Mehra M, Singh A. Impact on Public Health Nutrition Services Due to COVID-19 Pandemic in India: A Scoping Review of Primary Studies on Health and Social Security Determinants Affecting the First 1000 Days of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113973. [PMID: 36360851 PMCID: PMC9656542 DOI: 10.3390/ijerph192113973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/10/2022] [Accepted: 10/21/2022] [Indexed: 06/01/2023]
Abstract
CONTEXT COVID-19 was declared 'a global pandemic' by the World Health Organization in March 2020. India's lockdown, one of the harshest in the world, came with additional challenges for women. This paper aims to assess the impact of COVID-19 pandemic-related pathways on the first thousand days of life in the Integrated Child Development Scheme and the public distribution ecosystem in India. DATA SOURCES Using Cochrane guidelines, electronic databases, namely Google Scholar and PubMed-NCBI, were searched for evidence between 1 March 2020 and 1 May 2022. A total of 73 studies were identified in initial search; 20 met the inclusion criteria and, thus, were included in the research analysis. Primary studies were conducted throughout pan-India in rural, urban, and semi-urban areas to study the impact of COVID-19 pandemic-related pathways on the first 1000 days of life. The impact of social security, food insecurity, service delivery, nutrition of pregnant and nursing mothers (P&NMs), and infant and young child feeding (IYCF) varied between geographies and within geographies. Most of the primary studies were conducted at small scale, while only three studies were pan-Indian. The majority of studies were conducted on the mental health of P&NMs and pre-natal and post-natal service delivery disruption. The paucity of the available literature highlights the need to undertake research on the impact of the COVID-19 pandemic-related pathways on 1000 days of life in India and worldwide. The best implementation practices were observed where cross-sectional programs were carried out in relation to health services and social security for P&NMs and children.
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Affiliation(s)
| | | | - Ayushi Singh
- ASER Centre—Pratham Education Foundation, New Delhi 110029, India
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Mishra BK, Kanungo S, Patel K, Swain S, Dwivedy S, Panda S, Karna S, Bhuyan D, Som M, Merta BR, Bhattacharya D, Kshatri JS, Palo SK, Pati S. Resolution of Resilience: Empirical Findings on the Challenges Faced and the Mitigation Strategies Adopted by Community Health Workers (CHWs) to Provide Maternal and Child Health (MCH) Services during the COVID-19 Pandemic in the Context of Odisha, India. Healthcare (Basel) 2022; 10:healthcare10010088. [PMID: 35052251 PMCID: PMC8775981 DOI: 10.3390/healthcare10010088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/14/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
Community health workers (CHW) faced increased challenges in delivering maternal and child health services during the current COVID-19 pandemic. In addition to routine services, they were also engaged in pandemic management. In view of a dearth of evidence, the current study explores the challenges faced by CHWs while rendering maternal and child health services. A qualitative study through in-depth interviews (IDI) and focus group discussions (FGD) in six districts of Odisha was conducted from February to April 2021. Data were analyzed using MAXQDA software. Personal-level challenges, like lack of family support, stress, and fear of contracting COVID-19; facility-level challenges, like transportation problems and inadequate personal protective measures; and community-level challenges, like stigma, resistance, and lack of community support were major hindrances in provisioning routine MCH services. Prevailing myths and misconceptions concerning COVID-19 were factors behind stigma and resistance. Sharing experiences with family, practicing yoga and pranayam, engaging ambulance bikes, financial assistance to mothers, counseling people, and involving community leaders were some effective strategies to address these challenges. Development and implementation of appropriate strategy guidelines for addressing the challenges of frontline warriors will improve their work performance and achieve uninterrupted MCH services during pandemics or similar health emergencies.
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Affiliation(s)
- Bijaya Kumar Mishra
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
| | - Srikanta Kanungo
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
| | - Kripalini Patel
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
| | - Swagatika Swain
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
| | - Subhralaxmi Dwivedy
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
| | - Subhashree Panda
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
| | - Sonam Karna
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
| | - Dinesh Bhuyan
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
| | - Meena Som
- United Nation Children’s Fund, Surya Nagar, Bhubaneswar 751003, India; (M.S.); (B.R.M.)
| | - Brajesh Raj Merta
- United Nation Children’s Fund, Surya Nagar, Bhubaneswar 751003, India; (M.S.); (B.R.M.)
| | - Debdutta Bhattacharya
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
| | - Jaya Singh Kshatri
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
| | - Subrata Kumar Palo
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
- Correspondence: (S.K.P.); (S.P.)
| | - Sanghamitra Pati
- ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India; (B.K.M.); (S.K.); (K.P.); (S.S.); (S.D.); (S.P.); (S.K.); (D.B.); (D.B.); (J.S.K.)
- Correspondence: (S.K.P.); (S.P.)
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