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Healthcare practitioners battle to restore maternal services after disruption due to covid-19

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There has been concern about the uptake of maternal healthcare services’ after the disruption caused by the outbreak of the coronavirus pandemic. The onset of the pandemic saw countries reporting unusually low levels of patients seeking maternity services.

The low numbers have seen health officials across Africa struggle to bring the services back up to speed after degradation of the critical care.

In Kenya, the World Health Organisation (WHO) reported a drastic decline in the number of hospital visits during the early months of the coronavirus pandemic outbreak before a gradual recovery.

At least 1.8 million lesser hospital facility visits were recorded in Kenya, between January to June 2020, reflecting the huge impact of the coronavirus lockdowns on the ability of patients in need of maternity services to seek them, WHO stated.

There were reports of maternity wings in referral facilities in different parts of the country being turned into isolation wards, and maternal and other services being suspended in the process.

In addition, the night curfews introduced in Kenya as a measure of addressing Covid-19 transmission restricted movement, forcing many pregnant women to seek services from traditional birth attendants or give birth with the help of relatives.

This increased their risk of dying from postpartum haemorrhage and other complications, according to reproductive health rights activists.

New guidelines

The WHO issued new guidelines to the healthcare authorities, urging proper record-keeping to measure the exact impact of the coronavirus pandemic on various healthcare services.

On its part, the African Union’s Centre for Disease Control and Prevention, Africa CDC, convened a series of meetings following the outbreak of the pandemic to urge authorities to prioritise maternal healthcare services.

Dr Mervyn Venge, a Zimbabwean Obstetrician and gynaecologist with the Parirenyatwa Group of Hospitals, said during a webinar by Africa CDC, the outbreak of Covid-19 altered the way critical care was being provided to women in need, and urged authorities to look for solutions to maintain infrastructure around maternal healthcare.

Professional medical bodies also joined in, calling for the urgent improvement of maternal, neonatal and postnatal care.

The easing of certain restrictions around access to medical services allowing the carrying out of elective surgeries also enabled more women to access crucial medical care. These also included child care and reproductive healthcare services.

For example, at the Kalobeyei Refugee Settlement in Kakuma, northern Kenya, the UN Refugee Agency, said it continued to expand access to women seeking maternal healthcare services during the pandemic.

The UNHCR in partnership with the Kenya Red Cross Society-operated healthcare services at the Natukobenyo Health Clinic, provide services to the refugee population in Kakuma and Kalobeyei settlements in the area which borders South Sudan.

The need to heighten infection, prevention and control measures to stop the spread of the coronavirus especially amongst women seeking maternity services has also dominated debate amongst healthcare professionals in Africa.

Health complications

Infection control measures would help to reduce maternal health complications and co-infections, which might have arisen during the pandemic.

A survey conducted in medical facilities in Zimbabwe before surgeries related to childbirth showed 25 per cent of the patients had Covid-19 before surgery, according to Dr Venge.

There were cases reported after the surgeries had been done.

The survey, covering a sample size of 1,000 patients in Zimbabwean hospitals, also showed that at least 75 per cent of those tested later developed some forms of chest-relates complications.

This brings to the fore the importance of observing safety while providing maternal health care in the face of the pandemic.

As in the case of Zimbabwe, safety of the maternal healthcare services during the pandemic has been guaranteed by ensuring the continued supply of Personal Protective Equipment.

“Effective infection control prevention strategies were responsible for curbing 11 per cent  cases of maternal healthcare complications related to childbirth and newborn care,” Dr Venge told the webinar, which sought to help upgrade the quality of maternal healthcare during the Covid-19 pandemic period.

 

 

 

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