Rapid cross-sectional impact assessment of an earthquake on the continuity of antenatal care for pregnant women living with hepatitis B in Vanuatu.

Purpose: Natural disasters such as earthquakes, cyclones, and volcanic eruptions directly and indirectly impact health and wellbeing. This work aimed to understand how access to, and use of, peripartum health services were impacted following a large 7.3 magnitude earthquake in Vanuatu in the context of an ongoing field trial looking at the effectiveness of universal peripartum antiviral prophylaxis for pregnant women living with hepatitis B to prevent mother-to-child transmission. Methods: Participants were pregnant women enrolled in the intervention-arm of a field trial at sites in the earthquake-affected area. During routine monitoring calls, we asked additional questions about the impact of the earthquake on continued access to health services and continued use of daily hepatitis B antiviral prophylaxis with tenofovir disoproxil fumarate. Results: Seventeen participants of 26 women enrolled in the trial could be contacted and answered all questions from early-February to early-March 2025. Self-reported continued use of tenofovir disoproxil fumarate was high, with only two of 17 participants reporting interruptions to use in the weeks following the earthquake. Seven participants (41%) reported missing at least one routine antenatal or postnatal appointment in the three months following the earthquake. Conclusions: In natural disaster-prone settings, it is critical that field research take an adaptive approach that can adjust and respond to health emergencies. While natural disasters are inevitable, health systems must implement risk mitigation strategies to limit interruptions to routine health services to reduce negative short-, medium-, and long-term health impacts of natural disasters.