EHS-CO(VID (362) Reproductive health (20)

1 June, 2021

This paper from the LSHTM is especially interesting as it includes reports from frontline health workers in over 60 LMICs with 'local solutions to the direct and indirect challenges brought to maternal and newborn health services by COVID-19'. This is one of the objectives of the current WHO/HIFA project so there is potential for collaboration.

CITATION: Protecting hard-won gains for mothers and newborns in low-income and middle-income countries in the face of COVID-19: call for a service safety net

Wendy Jane Graham et al. BMJ Global Health 2020

Correspondence to Professor Wendy Jane Graham;


- The adverse impact of COVID-19 on maternal and newborn services in low-income and middle-income countries risks undermining improvements in health outcomes and care achieved over the last three decades.

- Alarming declines in the use of services and in the quality of care in health facilities are being reported from sources on the ground, captured rapidly and in real time using e-communication tools.

- Local solutions to the direct and indirect challenges brought to maternal and newborn health services by COVID-19 must be captured effectively and shared efficiently to support health workers and managers.

- Providing adequate funding to maintain essential services alongside urgent action plans for COVID-19 is essential to enable rapid adaptation and modifications to service delivery in response to different transmission scenarios and stages of the pandemic.


In this commentary, we use insights from those on the ground in low-income and middle-income countries (LMICs) to highlight both the impact of COVID-19 on facility births and the innovative local solutions being adopted to mitigate these effects.

What was clear long before COVID-19 is that some facilities are unsafe for the physical and mental well-being of women and newborns and that the most marginalised women often receive the poorest quality of care

Examples of reports received during a recent online survey and webinar organised by the authors. Collectively, these voices, hailing from over 60 LMICs, suggest two main trends: declining use of services and deteriorating quality, in some cases dramatically so.

1. Service use is falling, owing to

- Fear of using services

- Women cannot get to services or delay in accessing

2. Overall quality of care is deteriorating, owing to

- Under-staffing of existing services

- Rapidly changing guidelines with unclear or inconsistent communication

- COVID-19 aggravates existing challenges and weaknesses in provision of maternity and newborn care and brings new ones.

Neil Pakenham-Walsh, HIFA Coordinator,