Impact of the COVID-19 pandemic on access to and delivery of maternal and child healthcare services in low-and middle-income countries: a systematic review of the literature

Alina Kuandyk Sabitova; Miguel-Angel Ortega; Magashi Joseph Ntegwa; Antonio Sarria-Santamera

doi:10.3389/fpubh.2024.1346268

Impact of the COVID-19 pandemic on access to and delivery of maternal and child healthcare services in low-and middle-income countries: a systematic review of the literature

Front Public Health. 2024 Apr 8:12:1346268. doi: 10.3389/fpubh.2024.1346268. eCollection 2024.

Authors

Alina Kuandyk Sabitova¹, Miguel-Angel Ortega², Magashi Joseph Ntegwa³, Antonio Sarria-Santamera¹

Affiliations

¹ Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan.
² Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain.
³ Graduate School of Public Policy, Nazarbayev University, Astana, Kazakhstan.

Abstract

Background: The COVID-19 pandemic has had a multifaceted impact on maternal and child services and adversely influenced pregnancy outcomes. This systematic review aims to determine the impact of the COVID-19 pandemic on access to and delivery of maternal and child healthcare services in low- and middle-income countries.

Methods: The review was reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A primary search of electronic databases was performed using a combination of search terms related to the following areas of interest: "impact' AND 'COVID-19' AND 'maternal and child health services' AND 'low- and middle-income countries. A narrative synthesis approach was used to analyse and integrate the results.

Results: Overall, 45 unique studies conducted across 28 low- and middle-income countries met the inclusion criteria for the review. The findings suggest the number of family planning visits, antenatal and postnatal care visits, consultations for sick children, paediatric emergency visits and child immunisation levels decreased compared to the pre-pandemic levels in the majority of included studies. An analytical framework including four main categories was developed based on the concepts that emerged from included studies: the anxiety of not knowing (1), overwhelmed healthcare systems (2), challenges perceived by healthcare professionals (3) and difficulties perceived by service users (4).

Conclusion: The COVID-19 pandemic disrupted family planning services, antenatal and postnatal care coverage, and emergency and routine child services. Generalised conclusions are tentative due to the heterogeneity and inconsistent quality of the included studies. Future research is recommended to define the pandemic's impact on women and children worldwide and prepare healthcare systems for future resurgences of COVID-19 and potential challenges beyond.

Systematic review registration: PROSPERO (CRD42021285178).

Keywords: COVID-19; low- and middle-income countries; maternal and child healthcare services; paediatric; women.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Child
Developing Countries*
Female
Health Services Accessibility* / statistics & numerical data
Humans
Maternal-Child Health Services* / statistics & numerical data
Pregnancy
SARS-CoV-2

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was sponsored by Nazarbayev University (Grant No. NU 021220CRP0822). The funder had no input to the study design, analysis, interpretation of data, production of this manuscript nor decision to publish.