Evidence map›Paper›PMID 36607314›Full record

ArticleGlobal health action2023

Indirect effects of COVID-19 on maternal and child health in South Africa.

Evelyn Thsehla, Adam Balusik, Micheal Kofi Boachie, Winfrida Tombe-Mdewa, Chodziwadziwa Kabudula, Jacques Du Toit, Kathleen Kahn, Francesc Xavier Gómez-Olivé, Stephen Tollman, Susan Goldstein and 1 more

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In one paragraph

Article in Global health action, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Evelyn ThsehlaSAMRC/WITS Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa.
Adam BalusikSAMRC/WITS Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa.
Micheal Kofi BoachieSAMRC/WITS Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa.
Winfrida Tombe-MdewaSAMRC/WITS Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa.
Chodziwadziwa KabudulaMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Jacques Du ToitMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Kathleen KahnMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Francesc Xavier Gómez-OlivéMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Stephen TollmanMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Susan GoldsteinSAMRC/WITS Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa.
Karen HofmanSAMRC/WITS Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa.

Funding

Medical Research Council MR/V028537/1
6 · The paper itself

Abstract

backgroundThe unfinished burden of poor maternal and child health contributes to the quadruple burden of disease in South Africa with the direct and indirect effects of the COVID-19 pandemic yet to be fully documented.

objectiveTo investigate the indirect effects of COVID-19 on maternal and child health in different geographical regions and relative wealth quintiles.

methodsWe estimated the effects of COVID-19 on maternal and child health from April 2020 to June 2021. We estimated this by calculating mean changes across facilities, relative wealth index (RWI) quintiles, geographical areas and provinces. To account for confounding by underlying seasonal or linear trends, we subsequently fitted a segmented fixed effect panel model.

resultsA total of 4956 public sector facilities were included in the analysis. Between April and September 2020, full immunisation and first dose of measles declined by 6.99% and 2.44%, respectively. In the follow-up months, measles first dose increased by 4.88% while full immunisation remained negative (-0.65%) especially in poorer quintiles. At facility level, the mean change in incidence and mortality due to pneumonia, diarrhoea and severe acute malnutrition was negative. Change in first antenatal visits, delivery by 15-19-year olds, delivery by C-section and maternal mortality was positive but not significant.

conclusionCOVID-19 disrupted utilisation of child health services. While reduction in child health services at the start of the pandemic was followed by an increase in subsequent months, the recovery was not uniform across different quintiles and geographical areas. This study highlights the disproportionate impact of the pandemic and the need for targeted interventions to improve utilisation of health services.

Indexed as

COVID-19Maternal Health ServicesMeaslesChildChild HealthFemaleHumansPandemicsPregnancyPrenatal CareSouth AfricadiarrhoeaImmunizationmortalitypneumoniapregnancysevere acute malnutrition

Identifiers

PMID36607314
PMCPMC9828580

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.