ArticleBMJ global health2022
'We are not going to shut down, because we cannot postpone pregnancy': a mixed-methods study of the provision of maternal healthcare in six referral maternity wards in four sub-Saharan African countries during the COVID-19 pandemic.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Factors influencing the uptake of antenatal care in Uganda: a mixed methods systematic review.BMC pregnancy and childbirth · 2024Pooled it
- Prevalence, indications, and complications of caesarean section in health facilities across Nigeria: a systematic review and meta-analysis.Reproductive health · 2023Pooled it
- Discharge time from healthcare facilities after birth in Tanzania : a secondary analysis of demographic and health surveys from 2015 to 16 and 2022.BMC health services research · 2026Article
- A longitudinal study examining determinants of essential health services during the COVID-19 pandemic in regional referral hospitals across Uganda.Scientific reports · 2025Observational
- Health providers' perspectives on effects of the COVID-19 pandemic and anti-epidemic measures on maternal health services in Nairobi, Kenya: a qualitative study.BMC pregnancy and childbirth · 2025Article
- COVID-19 and Contraceptive Use in Two African Countries: Examining Conflicting Pressures on Women.Population and development review · 2024Article
- Article
- Perspectives and experiences of healthcare providers on the response to the COVID-19 pandemic in three maternal and neonatal referral hospitals in Guinea in 2020: a qualitative study.BMC health services research · 2024Article
- Has the Gratuité policy reduced inequities in geographic access to antenatal care in Burkina Faso? Evidence from facility-based data from 2014 to 2022.Frontiers in global women's health · 2024Article
- Mixed influence of COVID-19 on primary maternal and child health services in sub-Saharan Africa: a scoping review.Frontiers in public health · 2024Article
- Perceptions of health care workers on maternal and child health services in Pakistan during COVID-19: A cross-sectional study.Dialogues in health · 2023Article
- Protecting small and sick newborn care in the COVID-19 pandemic: multi-stakeholder qualitative data from four African countries with NEST360.BMC pediatrics · 2023Article
- Observational
- Stress and coping in the face of COVID-19: a qualitative inquiry into early pandemic experiences and psychological well-being of health workers in Burkina Faso, Senegal and The Gambia.Health policy and planning · 2023Article
- Effectiveness of the Gratuité user fee exemption policy on utilization and outcomes of maternal, newborn and child health services in conflict-affected districts of Burkina Faso from 2013 to 2018: a pre-post analysis.Conflict and health · 2023Article
- Health and economic implications of the ongoing coronavirus disease (COVID-19) pandemic on women and children in Africa.Reproductive health · 2023Article
- Effect of the COVID-19 pandemic on maternal and neonatal health services in three referral hospitals in Guinea: an interrupted time-series analysis.Reproductive health · 2023Observational
- An integrative literature review on the impact of COVID-19 on maternal and child health in Africa.BMC pregnancy and childbirth · 2023Review
- Provision and utilization of maternal health services during the COVID-19 pandemic in 16 hospitals in sub-Saharan Africa.Frontiers in global women's health · 2023Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 10 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionReferral hospitals in sub-Saharan Africa are located in crowded urban areas, which were often epicentres of the COVID-19 pandemic. This paper prospectively assesses how maternal healthcare was provided in six referral hospitals in Guinea, Nigeria, Tanzania and Uganda during the first year of the COVID-19 pandemic.
methodsMixed-methods design using three data sources: (1) qualitative data from repeated rounds of semi-structured interviews conducted between July 2020 and February 2021 with 22 maternity skilled heath personnel (SHP) on perceptions of care provision; (2) quantitative monthly routine data on caesarean section and labour induction from March 2019 to February 2021; and (3) timeline data of COVID-19 epidemiology, national and hospital-level events. Qualitative and quantitative data were analysed separately, framed based on timeline analysis, and triangulated during reporting.
resultsWe identified three periods: first wave, slow period and second wave. The first wave was challenging for SHP given little knowledge about COVID-19, lack of infection prevention and control training, and difficulties reaching workplace. Challenges that persisted beyond the first wave were shortage of personal protective equipment and no rapid testing for women suspected with COVID-19. We noted no change in the proportion of caesarean sections during the pandemic, and a small increase in the proportion of labour inductions. All hospitals arranged isolation areas for women suspected/confirmed with COVID-19 and three hospitals provided care to women with suspected/confirmed COVID-19. Breastfeeding was not discouraged and newborns were not separated from mothers confirmed with COVID-19. Care provision was maintained through dedication of SHP, support from hospital management and remote communication between SHP.
conclusionRoutine maternal care provision was maintained in referral hospitals, despite first wave challenges. Referral hospitals and SHP contributed to guideline development for pregnant women suspected/confirmed with COVID-19. Maternity SHP, women and pregnancy must always be included in priority setting when responding to health system shocks, including outbreaks.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.