Observational studyBMJ open2022
Effects of the COVID-19 pandemic on maternal and perinatal health service utilisation and outcomes in Mozambique: an interrupted time series analysis.
Observational study in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- The impact of COVID-19 mitigation measures on neonatal health outcomes in sub-Saharan Africa: A systematic review and meta-analysis.Public health · 2025Pooled it
- Impact of COVID-19 on Maternal Health Service Uptake and Perinatal Outcomes in Sub-Saharan Africa: A Systematic Review.International journal of environmental research and public health · 2024Pooled it
- 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.Frontiers in public health · 2024Pooled it
- Mortality before and during the COVID-19 pandemic in Manhiça district, Southern Mozambique.Population health metrics · 2026Article
- The effects of COVID-19 on reproductive, maternal, neonatal, and child health service provision and utilisation: qualitative results from Burkina Faso and Mozambique.Journal of global health · 2026Article
- "She helped from the first minute to the last" - Experiences of respectful maternal and newborn care during the COVID-19 pandemic in Nampula Province, Mozambique.PLOS global public health · 2025Article
- Article
- Temporal trend in fetal mortality according to two death avoidability classifications.Revista da Escola de Enfermagem da U S P · 2024Article
- Perinatal care and breastfeeding education during the COVID-19 pandemic: Perspectives from Kenyan mothers and healthcare workers.Maternal & child nutrition · 2023Article
- The Silent Victims of the Pandemic: Children During the Coronavirus Disease 2019 Crisis.Turkish archives of pediatrics · 2023Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo measure the effects of the COVID-19 pandemic on maternal and perinatal health services and outcomes in Mozambique.
designThis is an observational study analysing routine service delivery data using interrupted time series analysis. We used 43 months of district-level panel data with April 2020 as the point of interruption, adjusting for seasonality and population growth to analyse service utilisation outcomes.
settingThe 222 public health facilities in Nampula Province, Mozambique, from January 2018 to July 2021. OUTCOME MEASURES: The change in the number of antenatal care (ANC) visits and facility deliveries, and the change in the rate of adverse birth outcomes at pandemic onset and over time compared with expected levels and trends, respectively.
resultsThere were no significant disruptions to ANC at pandemic onset. Following this, there was a significant monthly increase of 29.8 (18.2-41.4) first ANC visits and 11.3 (5.5-17.2) ANC visits within the first trimester per district above prepandemic trends. There was no significant change in the number of fourth ANC visits completed. At the onset of COVID-19, districts experienced a significant decrease of 71.1 (-110.5 to -31.7) facility deliveries, but the rate then increased significantly above prepandemic trends. There was no significant increase in any adverse birth outcomes during the pandemic. Conversely, districts observed a significant monthly decrease of 5.3 uterine rupture cases (-9.9 to -0.6) and 19.2 stillbirths (-33.83 to -4.58) per 100 000 facility deliveries below prepandemic trends. There was a significant drop of 23.5 cases of neonatal sepsis/100 000 facility deliveries per district at pandemic onset.
conclusionDespite pandemic interference, Nampula Province saw no disruptions to ANC, only temporary disruptions to facility deliveries and no increases in adverse birth outcomes. ANC visits surprisingly increased, and the rates of uterine rupture, stillbirth and neonatal sepsis decreased, suggesting that Nampula Province may offer insights about health system resilience.
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