ArticleBMJ open2024
Impact of the COVID-19 pandemic on maternal, neonatal and child health service utilisation, delivery and health outcomes in Gauteng province, South Africa: an interrupted time series (ITS) analysis.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Perspectives of senior health managers on COVID-19 response and challenges, lessons learned and opportunities against future outbreaks in Gauteng province, South Africa.BMC health services research · 2026Article
- The population-level impact of COVID-19 on maternal healthcare utilization: evidence from the 2022 Kenya Demographic and Health Survey.International health · 2026Article
- Health system stress: Assessing the impact of the COVID-19 pandemic on obstetric haemorrhage-related mortality in South Africa using confidential enquiry into maternal deaths data.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- Article
- Drivers of COVID-19 infections: Perspectives of managers in the Gauteng Department of Health, South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
- A comparative analysis of voluntary medical male circumcision before and during the COVID-19 pandemic in Gauteng province, South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
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4 authors.
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Abstract
backgroundGauteng was one of the provinces in South Africa most hit by COVID-19. However, there has been no assessment of the pandemic's impact on essential maternal, neonatal and child health (MNCH) services in Gauteng, for planning against future emergencies. This study sought to assess the impact of the COVID-19 pandemic on essential MNCH service utilisation, delivery and health outcomes in Gauteng province.
methodsWe employed a quasi-experimental interrupted time series (ITS) study design, using the District Health Information System (DHIS) data set to evaluate the impact of COVID-19 on eight key MNCH indicators between March 2019 to February 2021. Using Stata V.17.0 and 5% alpha, a segmented linear regression (ITS) model quantified the trends of the indicators before COVID-19 (March 2019 to February 2020) (β1), the immediate change in level due to the March 2020 lockdown (β2), the post-lockdown (March 2020 to February 2021) trend (β4) and the change in gradient from before to after the lockdown (β3).
resultsCOVID-19 lockdown exerted a significant decline in primary healthcare headcount<5 years (n) (β2= -60 106.9 (95% CI, -116 710.4; -3503.3), p=0.039); and postnatal care visits within 6 days (rate) (β2=-8.2 (95% CI, -12.4; -4.1), p=0.001). Antenatal care first visits before 20 weeks (rate) declined during COVID-19 (β3=-0.4 (95% CI, -0.7; -0.1), p=0.013) compared with the pre-COVID-19 period. COVID-19 adverse effects on service delivery (measles second dose coverage and fully immunised<1 year) and health outcomes (facility deaths 0-6 days, maternal mortality ratio and pneumonia case fatality<1 year) were insignificant. While some indicators post-lockdown attempted to recover, others deteriorated.
conclusionIn Gauteng province, the COVID-19 pandemic significantly disrupted essential MNCH service utilisation, particularly during the March 2020 lockdown. The mechanism of MNCH service disruption by COVID-19 was induced by both supply and demand services. It is imperative to strike a balance between maintaining routine healthcare services and managing an outbreak.
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