Following from my previous message, here are some aspects of reduced demand and 'local solutions to the direct and indirect challenges brought to maternal and newborn health services by COVID-19'.
A. REDUCED DEMAND
1. Fear of using services
- Fear of women/babies becoming infected, and bringing illness back to homes, being treated badly, or costs if unable to work and pay for care.
- Fear of being quarantined away from family and support networks in case women test positive.
- Fear of aggravating domestic violence if use of services defies partner.
- Ambulances feared as sources of COVID-19 infection.
- Radio campaigns and messaging urging women to continue attending maternity care services.
- Use of visual aids and pictographs in public places and health facilities to ensure women with low literacy have access to correct information.
- Increased use of Whats App and other social media, with appropriate safeguards for reliability of information, to communicate with women and share information about health workers.
2. Women cannot get to services or delay in accessing
- Huge demands on few hospital transport/ambulances that exist, with ambulances used for COVID-19.
- Confusion over public health messaging about staying at home means women delay to seek care, and some facilities are seeing a marked increase in complicated cases on admission.
- Curfews, permit requirements from a local authority, bans on private vehicles, shutdowns of public transport.
- Childcare responsibilities (school closure) and care for elderly prevent women from seeking care for themselves or their newborns...
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; Wendy.Graham@lshtm.ac.uk