Provision of maternal health service in Indonesian primary care during the COVID-19 pandemic.

Background: Maternal health services in Indonesia faced significant challenges during the COVID-19 pandemic. The service had to manage the infection and ensure the continuity of maternity service for women. This research explored in depth the way maternal health service was provided in Indonesia during the COVID-19 pandemic and provided suggestions to improve the service in primary care. Methods: We conducted a practical qualitative study using semi-structured interviews and focus groups (FGs) between May and October 2021, with the focus area of study in Yogyakarta province. The participants were general practitioners (GPs), midwives, nurses, obstetricians, and women who had experience providing or accessing maternity care during the pandemic. The data were analysed using an inductive approach of thematic analysis. Results: A total of 23 participants participated in the FGs/interviews. Three overarching themes were identified: applied COVID safety measures, confusion and further expectations. COVID-19 safety measures, such as screening, hygiene and triage, were applied in the service. However, challenges and confusion occurred, particularly regarding the limited clinical resources, limited guidelines and escalation plan and patients' low literacy levels. Participants also expected the development of mobile apps to support care for women. Conclusion: Despite the classical challenges in primary care practice, Indonesia implemented strategies to provide maternity care and limit the spread of COVID-19 infection. Continuous improvements and further research are needed to provide practical recommendations and escalation plans to optimise the quality of maternity service in primary care.