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‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic

BACKGROUND AND OBJECTIVE: The COVID-19 pandemic response overwhelmed health systems, disrupting other services, including maternal health services. The disruptive effects on the utilization of maternal health services in low-resource settings, including Nigeria have not been well documented. We asse...

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Autores principales: Iliyasu, Zubairu, Umar, Amina A., Gaya, Fatima S., Nass, Nafisa S., Abdullahi, Hadiza M., Kwaku, Aminatu A., Amole, Taiwo G., Tsiga-Ahmed, Fatimah I., Galadanci, Hadiza S., Salihu, Hamisu M., Aliyu, Muktar H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Global Health and Education Projects, Inc 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172809/
https://www.ncbi.nlm.nih.gov/pubmed/37182114
http://dx.doi.org/10.21106/ijma.632
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author Iliyasu, Zubairu
Umar, Amina A.
Gaya, Fatima S.
Nass, Nafisa S.
Abdullahi, Hadiza M.
Kwaku, Aminatu A.
Amole, Taiwo G.
Tsiga-Ahmed, Fatimah I.
Galadanci, Hadiza S.
Salihu, Hamisu M.
Aliyu, Muktar H.
author_facet Iliyasu, Zubairu
Umar, Amina A.
Gaya, Fatima S.
Nass, Nafisa S.
Abdullahi, Hadiza M.
Kwaku, Aminatu A.
Amole, Taiwo G.
Tsiga-Ahmed, Fatimah I.
Galadanci, Hadiza S.
Salihu, Hamisu M.
Aliyu, Muktar H.
author_sort Iliyasu, Zubairu
collection PubMed
description BACKGROUND AND OBJECTIVE: The COVID-19 pandemic response overwhelmed health systems, disrupting other services, including maternal health services. The disruptive effects on the utilization of maternal health services in low-resource settings, including Nigeria have not been well documented. We assessed maternal health service utilization, predictors, and childbirth experiences amidst COVID-19 restrictions in a rural community of Kumbotso, Kano State, in northern Nigeria. METHODS: Using an explanatory mixed methods design, 389 mothers were surveyed in January 2022 using validated interviewer-administered questionnaires, followed by in-depth interviews with a sub-sample (n=20). Data were analyzed using logistic regression models and the framework approach. RESULTS: Less than one-half (n=165, 42.4%) of women utilized maternal health services during the period of COVID-19 restrictions compared with nearly two-thirds (n=237, 65.8%) prior to the period (p<0.05). Non-utilization was mainly due to fear of contracting COVID-19 (n=122, 54.5%), clinic overcrowding (n=43, 19.2%), transportation challenges (n=34, 15.2%), and harassment by security personnel (n=24, 10.7%). The utilization of maternal health services was associated with participant’s post-secondary education (aOR=2.06, 95% CI:1.14- 11.40) (p=0.02), and employment type (civil service, aOR=4.60, 95% CI: 1.17-19.74) (p<0.001), business aOR=1.94, 95% CI:1.19- 4.12) (p=0.032) and trading aOR=1.62, 95% CI:1.19-2.94) (p=0.04)). Women with higher household monthly income (≥ N30,000, equivalent to 60 US Dollars) (aOR=1.53, 95% CI:1.13-2.65) (p=0.037), who adhered to COVID-19 preventive measures and utilized maternal health services before the COVID-19 pandemic were more likely to utilize those services during the COVID-19 restrictions. In contrast, mothers of higher parity (≥5 births) were less likely to use maternal health services during the lockdown (aOR=0.30, 95% CI:0.10-0.86) (p=0.03). Utilization of maternal services was also associated with partner education and employment type. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: The utilization of maternal health services declined during the COVID-19 restrictions. Utilization was hindered by fear of contracting COVID-19, transport challenges, and harassment by security personnel. Maternal and partner characteristics, adherence to COVID-19 preventive measures, and pre-COVID maternity service utilization influenced attendance. There is a need to build resilient health systems and contingent alternative service delivery models for future pandemics.
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spelling pubmed-101728092023-05-12 ‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic Iliyasu, Zubairu Umar, Amina A. Gaya, Fatima S. Nass, Nafisa S. Abdullahi, Hadiza M. Kwaku, Aminatu A. Amole, Taiwo G. Tsiga-Ahmed, Fatimah I. Galadanci, Hadiza S. Salihu, Hamisu M. Aliyu, Muktar H. Int J MCH AIDS Original Article | Maternal Health BACKGROUND AND OBJECTIVE: The COVID-19 pandemic response overwhelmed health systems, disrupting other services, including maternal health services. The disruptive effects on the utilization of maternal health services in low-resource settings, including Nigeria have not been well documented. We assessed maternal health service utilization, predictors, and childbirth experiences amidst COVID-19 restrictions in a rural community of Kumbotso, Kano State, in northern Nigeria. METHODS: Using an explanatory mixed methods design, 389 mothers were surveyed in January 2022 using validated interviewer-administered questionnaires, followed by in-depth interviews with a sub-sample (n=20). Data were analyzed using logistic regression models and the framework approach. RESULTS: Less than one-half (n=165, 42.4%) of women utilized maternal health services during the period of COVID-19 restrictions compared with nearly two-thirds (n=237, 65.8%) prior to the period (p<0.05). Non-utilization was mainly due to fear of contracting COVID-19 (n=122, 54.5%), clinic overcrowding (n=43, 19.2%), transportation challenges (n=34, 15.2%), and harassment by security personnel (n=24, 10.7%). The utilization of maternal health services was associated with participant’s post-secondary education (aOR=2.06, 95% CI:1.14- 11.40) (p=0.02), and employment type (civil service, aOR=4.60, 95% CI: 1.17-19.74) (p<0.001), business aOR=1.94, 95% CI:1.19- 4.12) (p=0.032) and trading aOR=1.62, 95% CI:1.19-2.94) (p=0.04)). Women with higher household monthly income (≥ N30,000, equivalent to 60 US Dollars) (aOR=1.53, 95% CI:1.13-2.65) (p=0.037), who adhered to COVID-19 preventive measures and utilized maternal health services before the COVID-19 pandemic were more likely to utilize those services during the COVID-19 restrictions. In contrast, mothers of higher parity (≥5 births) were less likely to use maternal health services during the lockdown (aOR=0.30, 95% CI:0.10-0.86) (p=0.03). Utilization of maternal services was also associated with partner education and employment type. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: The utilization of maternal health services declined during the COVID-19 restrictions. Utilization was hindered by fear of contracting COVID-19, transport challenges, and harassment by security personnel. Maternal and partner characteristics, adherence to COVID-19 preventive measures, and pre-COVID maternity service utilization influenced attendance. There is a need to build resilient health systems and contingent alternative service delivery models for future pandemics. Global Health and Education Projects, Inc 2023 2023-05-07 /pmc/articles/PMC10172809/ /pubmed/37182114 http://dx.doi.org/10.21106/ijma.632 Text en Copyright © 2023 Iliyasu et al. https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article | Maternal Health
Iliyasu, Zubairu
Umar, Amina A.
Gaya, Fatima S.
Nass, Nafisa S.
Abdullahi, Hadiza M.
Kwaku, Aminatu A.
Amole, Taiwo G.
Tsiga-Ahmed, Fatimah I.
Galadanci, Hadiza S.
Salihu, Hamisu M.
Aliyu, Muktar H.
‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic
title ‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic
title_full ‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic
title_fullStr ‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic
title_full_unstemmed ‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic
title_short ‘We delivered at home out of fear’: Maternity Care in Rural Nigeria During the COVID-19 Pandemic
title_sort ‘we delivered at home out of fear’: maternity care in rural nigeria during the covid-19 pandemic
topic Original Article | Maternal Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172809/
https://www.ncbi.nlm.nih.gov/pubmed/37182114
http://dx.doi.org/10.21106/ijma.632
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