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Ekawati FM, Widyasari A, Lisa HRA, Ame CGP, Tuteja A. Core recommendations of effective preconception counselling services in low-and-middle-income countries - A scoping review. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 41:101005. [PMID: 38991482 DOI: 10.1016/j.srhc.2024.101005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 06/07/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Extensive guidelines and recommendations are available for preconception counselling service in high-income-countries. However limited comprehensive recommendations are available for preconception care and counselling in low-and-middle-income countries (LMICs), where most of maternal mortality occurs in the settings. AIM/OBJECTIVES This review aims to identify any design, model or set of recommendations for their potential adoption to develop preconception care and counselling service for LMICs context. METHODS A systematic literature search was conducted in five major databases to identify articles covering any designs, models or recommendations on preconception care, for or from LMICs settings published between 2013-2023. Articles on any single screening for preconception counselling, those evaluating the service without specific model or sets of recommendations were excluded. Articles satisfied the inclusion criteria were then appraised and were extracted and analysed using inductive approach of thematic analysis. FINDINGS A total of nine articles were eligible for complete review, mostly were review papers, editorials and commission articles with moderate manuscript quality. Three themes of recommendations emerged from the analysis: Platforms, Core Principles, and Women Empowerment. The Platform contains recommendations on the settings, while Core principles provide essential recommendation of screening and management, while the theme Women Empowerment highlights the importance of empowering women to prepare and decide on their pregnancy. IMPLICATIONS Actual model of preconception care in LMICs is deficient, results of this review will inform research on the development of appropriate preconception care in LMICs . We also propose for access equity and strategies to promote women empowerment as the key to succeed the preconception care in LMICs.
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Affiliation(s)
| | - Anis Widyasari
- Department of Obstetrics and Gynaecology, Universitas Gadjah Mada, Indonesia
| | | | | | - Amita Tuteja
- Department of General Practice, University of Melbourne, Australia
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Alie MS, Girma D, Negesse Y, Adugna A, Abebe GF. Impact of COVID-19 on individual mental health and maternal health services in Ethiopia: systematic review and meta-analysis. Front Public Health 2024; 12:1407269. [PMID: 38979045 PMCID: PMC11228260 DOI: 10.3389/fpubh.2024.1407269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 05/23/2024] [Indexed: 07/10/2024] Open
Abstract
Background The COVID-19 pandemic has caused a major outbreak in the 21st century and has led to significant mental health hazards worldwide. To address this issue, a systematic review has been conducted to analyze existing literature on the impact of COVID-19 on the psychological well-being of the general population, as well as the associated risk factors. Methods A comprehensive search was carried out on PubMed, Embase, Medline, Web of Science, and Scopus databases, covering all available literature up until February 20, 2024. This search was conducted in accordance with the PRISMA guidelines, ensuring a systematic approach. The selection of articles was based on predetermined eligibility criteria, ensuring the inclusion of appropriate and suitable research. In the final analysis, a total of 15 articles focusing on depression and anxiety, 11 articles on stress, and 7 articles on psychological problems were included. These articles specifically examined the outcome variables within the context of English language and specific areas. For the meta-analysis on maternal health services, 11 articles were included for family planning, 25 articles for postnatal care services, 16 articles for institutional delivery, and 14 articles for safe abortion services. These articles were carefully selected for the final pooled analysis. Result According to a recent systematic review, anxiety, depression, stress, and psychological distress have been prevalent in Ethiopia during the COVID-19 pandemic, with rates of 40, 41, 23, and 41%, respectively. The review also identified various sociodemographic factors that have impacted the country's response to the pandemic, including female gender, age, marital status, incarceration, low income, and lack of social support. Furthermore, the review found that maternal health services have experienced significant reductions during the pandemic. Conclusion The COVID-19 pandemic has led to a significant increase in psychological distress, which in some cases, is severe enough to require clinical treatment. It is crucial to prioritize efforts to address the negative impact of COVID-19 on mental health as a global public health priority. Additionally, it is important to pay attention to maternal health services during COVID-19 mitigation programs.
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Affiliation(s)
- Melsew Setegn Alie
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Desalegn Girma
- Department of Midwifery, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Yilkal Negesse
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Gojjam, Ethiopia
| | - Amanuel Adugna
- Department of Midwifery, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Gossa Fetene Abebe
- Department of Midwifery, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
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Horn C, Bam NE, Matsipane MJ. Exploring disaster preparedness in an obstetric unit in a district hospital in the Western Cape Province. BMC Health Serv Res 2024; 24:654. [PMID: 38773494 PMCID: PMC11110375 DOI: 10.1186/s12913-024-11104-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/13/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Research on disaster preparedness in public hospitals is limited, and specialised units such as obstetric departments need to be even more prepared when rendering health care to vulnerable populations. Disasters can be natural, such as floods due to human interventions, sinkholes due to mining, or pandemic occurrences, such as the recent COVID-19 pandemic. Research on disaster preparedness is limited, and even more so in specialised units such as obstetrics and evacuating a ward of maternal and neonatal patients present unique challenges. Being prepared for any disaster is the only assurance of effective patient healthcare during a disaster. This study explored and described nurses' knowledge and attitudes regarding preparedness for a disaster in an obstetric unit in a public institution. The study aimed to make recommendations to improve disaster preparedness in an obstetric ward based on the nurses' knowledge and attitudes. METHODS This study utilised an exploratory, descriptive qualitative design within a contextual approach. The data were acquired through individual interviews that were done using a semi-structured interview schedule. An observational walkabout was performed with the unit manager to validate interviewee responses. The study employed purposive sampling with a sample size of 17 nurses (N = 32, n = 17) and a response rate of 53%. The interviews were transcribed verbatim, and later, the data underwent analysis using theme analysis and a co-coder. RESULTS The results indicate that the participants demonstrate an awareness of disaster terminology but need more assertiveness in executing the institutional disaster policy. The results illustrate that more frequent training, disaster rehearsals, and simulations should be implemented to improve disaster readiness. Strategies are recommended to enhance preparedness for a disaster in the obstetric unit. CONCLUSION The study findings recommend more education and training opportunities that should be regularly instilled as a practice within the obstetric ward. More disaster drills and simulation exercises should be performed to ensure confidence in disaster preparedness. Obstetric staff of all levels should be involved with policymaking and disaster plan development.
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Affiliation(s)
- Carla Horn
- NuMIQ Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom Campus, Potchefstroom, South Africa.
| | - Nokwanda Edith Bam
- NuMIQ Focus Area, Faculty of Health Sciences, North-West University, Mahikeng Campus, Mahikeng, South Africa
| | - Molekodi Jacob Matsipane
- NuMIQ Focus Area, Faculty of Health Sciences, North-West University, Mahikeng Campus, Mahikeng, South Africa
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Zayoud D, Haddad C, Khachman D, Ajrouche R, Lahoud N. Estimating COVID-19 vaccine acceptance in pregnant and lactating women: a cross-sectional study in Lebanon. Arch Public Health 2024; 82:38. [PMID: 38500217 PMCID: PMC10949662 DOI: 10.1186/s13690-024-01267-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/08/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic highlights vaccination's critical role in reducing morbidity and mortality, depending on public attitude. This study aims to identify the estimates of COVID-19 vaccine acceptance in pregnant and lactating women, as well as associated potential factors. METHODS A cross-sectional study was conducted between August and September 2021, through an online survey and with a paper survey distributed in gynecology and pediatric clinics. Pregnant and breastfeeding women aged 18 years and above were recruited. The attitude scale was created specifically for evaluating attitudes towards the COVID-19 vaccine. RESULTS In total, 207 women participated, with 132 breastfeeding, 74 pregnant and 1 experiencing both conditions. Of these, one hundred and twenty women (58%) considered themselves at risk for COVID-19 infection. In addition, 51.7% (n = 107) of women expressed the intent to receive the vaccine once available. A multivariable linear regression was conducted taking the COVID-19 vaccination attitude scale as a dependent variable. The results revealed an R-squared value of 0.558, indicating that approximately 55.8% of the variance in the attitude scale was accounted for by the included predictors. The results showed that preventive measures (ß=2.25, 95% Confidence Interval (CI) [1.02; 3.48], p < 0.001), preference for vaccines made in Europe and America (ß=1.23; 95% CI [0.69-1.77], p < 0.001), protect yourself for getting sick (ß=4.22, 95% Confidence Interval (CI) [2.83; 5.61], p < 0.001) and belief in the importance of vaccination for themselves and their baby (ß=3.49; 95% CI [2.01; 4.98], p < 0.001) were associated with a positive attitude towards vaccination. Conversely, experiencing a previous bad reaction to a vaccine (ß= -1.35; 95% CI [0.85-1.85], p < 0.001) and concerns regarding COVID-19 vaccine safety (ß= -4.09; 95% CI [-5.98; -2.21], p < 0.001) were associated with a negative attitude towards vaccination. CONCLUSION Our findings reveal that COVID-19 vaccine acceptability among pregnant and breastfeeding women, amidst the pandemic was insufficient to meet community immunity. The identified reasons for vaccine reluctance, notably concerns about safety for both personal health and the health of their pregnancy or newborns, along with insufficient information about the vaccine, underscore the pressing need to address these factors to improve immunization rates.
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Affiliation(s)
- Dana Zayoud
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Chadia Haddad
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon.
- Faculty of Public Health, Lebanese University, Fanar, Lebanon.
- School of Medicine, Lebanese American University, Byblos, Lebanon.
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
| | - Dalia Khachman
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Roula Ajrouche
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- Department of Health Sciences, University of Sciences and Arts in Lebanon, Beirut, Lebanon
| | - Nathalie Lahoud
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
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Jain G, Prajapati RKP, Bisen V. Assessing the Impact of the COVID-19 Pandemic on Maternal and Child Health Services: A Comprehensive Analysis of Government Initiatives in Northern India. Cureus 2024; 16:e56313. [PMID: 38629024 PMCID: PMC11020602 DOI: 10.7759/cureus.56313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The coronavirus disease (COVID-19) pandemic has significantly impacted healthcare services globally, with particular challenges observed in maternal and child health (MCH) care. This study aimed to assess the impact of the pandemic on MCH services in northern India, focusing on key government programs. METHODS Data were collected from four major MCH programs in India: Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK), Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), and the Universal Immunization Program (UIP). The study compared MCH service utilization and outcomes during the pandemic period (March-September 2020) with the same period in 2019. RESULTS Preliminary findings indicated a significant reduction in the utilization of MCH services during the pandemic, with a decrease observed in institutional deliveries, antenatal care visits, and immunization coverage. For instance, institutional deliveries declined by 30% compared with the previous year, with a similar decrease observed in antenatal care visits. Immunization coverage also decreased by approximately 25%, indicating a substantial decline in preventive care services. Challenges in accessing essential treatments for sick infants have also been reported, with a 40% decrease in the utilization of free treatment services under the JSSK program. CONCLUSION The COVID-19 pandemic has substantially impacted MCH services in northern India, highlighting the vulnerability of these essential health programs during public health emergencies. Addressing the challenges identified in this study is crucial to ensuring the continuity and resilience of MCH services in similar settings.
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Affiliation(s)
- Garima Jain
- Department of Management Sciences, Institute of Co-operative and Corporate Management, Research and Training, Lucknow, IND
| | - Ram Komal Prasad Prajapati
- Department of Management Sciences, Institute of Co-operative and Corporate Management, Research and Training, Lucknow, IND
| | - Vikram Bisen
- Department of Management Sciences, Basudev Institute of Management and Technology, Lucknow, IND
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Bergantini LS, Ichisato SMT, Salci MA, Birolim MM, dos Santos MLA, Höring CF, Rossa R, Facchini LA. Factors associated with hospitalizations and deaths of pregnant women from Paraná due to COVID-19: a cross-sectional study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27:e240005. [PMID: 38324869 PMCID: PMC10846414 DOI: 10.1590/1980-549720240005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVE To analyze the factors associated with hospitalization in the ward and intensive care unit (ICU), and with death from COVID-19 in pregnant women with confirmed cases. METHODS Observational, cross-sectional study, carried out with data from pregnant women with a confirmed case of COVID-19 from the Influenza Epidemiological Surveillance Information System and the Paraná's state COVID-19 notification system. The association between the independent and dependent variables (hospitalization in the ward and ICU, and death) was investigated using the Poisson regression model with robust variance. RESULTS 4,719 pregnant women comprised the study population. 9.6 and 5.1% were hospitalized in wards and ICU, respectively. 1.9% died. There was an association between advanced maternal age and hospitalization in wards (PR=1.36; 95%CI 1.10-1.62) and ICU (PR=2.25; 95%CI 1.78-2.71), and death (PR=3.22; 95%CI 2.30-4.15). An association was found between the third trimester and hospitalization in wards (PR=5.06; 95%CI 2.82-7.30) and ICU (PR=6.03; 95%CI 3.67-8.39) and death (PR=13.56; 95%CI 2.90-24.23). The second trimester was associated with ICU admission (PR=2.67; 95%CI 1.36-3.99). Pregnant women with cardiovascular disease had a higher frequency of hospitalization in wards (PR=2.24; 95%CI 1.43-3.05) and ICU (PR=2.66; 95%CI 1.46-3.87). Obesity was associated with ICU admission (PR=3.79; 95%CI 2.71-4.86) and death (PR=5.62; 95%CI 2.41-8.83). CONCLUSIONS Advanced maternal age, the end of the gestational period and comorbidities were associated with severe COVID-19.
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Affiliation(s)
- Larissa Silva Bergantini
- Universidade Estadual de Maringá, Postgraduate Program in Physiological Sciences – Maringá (PR), Brazil
| | | | - Maria Aparecida Salci
- Universidade Estadual de Maringá, Postgraduate Program in Nursing – Maringá (PR), Brazil
| | - Marcela Maria Birolim
- Centro Universitário Guairacá, Postgraduate Program in Health Promotion – Guarapuava (PR), Brazil
| | | | | | - Roberta Rossa
- Universidade Estadual de Maringá, Postgraduate Program in Nursing – Maringá (PR), Brazil
| | - Luiz Augusto Facchini
- Universidade Federal de Pelotas, Department of Social Medicine – Pelotas (RS), Brazil
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Galle A, Kavira G, Semaan A, Malonga Kaj F, Benova L, Ntambue A. Utilisation of services along the continuum of maternal healthcare during the COVID-19 pandemic in Lubumbashi, DRC: findings from a cross-sectional household survey of women. BMJ Open 2023; 13:e069409. [PMID: 37369398 PMCID: PMC10410797 DOI: 10.1136/bmjopen-2022-069409] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVES The continuum of maternal care along antenatal (ANC), intrapartum and postnatal care (PNC) is fundamental for protecting women's and newborns' health. The COVID-19 pandemic interrupted the provision and use of these essential services globally. This study examines maternal healthcare utilisation along the continuum during the COVID-19 pandemic in the Democratic Republic of the Congo (DRC). DESIGN This is a cross-sectional study using data collected on a survey of 599 households in Lubumbashi, DRC, using stratified random sampling. PARTICIPANTS We included 604 women (15-49 years) who were pregnant between March 2020 and May 2021. OUTCOME MEASURES A structured interview involved questions on sociodemographic characteristics, attitudes regarding COVID-19 and maternal service use and cost. Complete continuum of care was defined as receiving ANC 4+ consultations, skilled birth attendance and at least one PNC check for both mother and newborn. Data were analysed in SPSS using descriptive statistics and multivariable logistic regression. RESULTS One-third (36%) of women who gave birth during the COVID-19 pandemic completed the continuum of maternal healthcare. Factors significantly associated with completing the continuum included higher education (aOR=2.6; p<0.001) and positive attitude towards the COVID-19 vaccination (aOR=1.9; p=0.04). Reasons for not seeking maternal care included lack of money and avoiding COVID-19 vaccination. CONCLUSION During the COVID-19 pandemic, maternal healthcare seeking behaviours were shaped by vaccine hesitancy and care unaffordability in Lubumbashi. Addressing the high cost of maternal healthcare and vaccine hesitancy appear essential to improve access to maternal healthcare.
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Affiliation(s)
- Anna Galle
- Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Gladys Kavira
- Department of Epidemiology and Maternal and Child Health, Université de Lubumbashi, École de Santé Publique, Unité d'Epidémiologie et de Santé de la Mère, du Nouveau-né et de l'enfant, Lubumbashi, Congo (the Democratic Republic of the)
| | - Aline Semaan
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Françoise Malonga Kaj
- Department of Epidemiology and Maternal and Child Health, Université de Lubumbashi, École de Santé Publique, Unité d'Epidémiologie et de Santé de la Mère, du Nouveau-né et de l'enfant, Lubumbashi, Congo (the Democratic Republic of the)
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Abel Ntambue
- Department of Epidemiology and Maternal and Child Health, Université de Lubumbashi, École de Santé Publique, Unité d'Epidémiologie et de Santé de la Mère, du Nouveau-né et de l'enfant, Lubumbashi, Congo (the Democratic Republic of the)
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Moise IK, Ivanova N, Wilson C, Wilson S, Halwindi H, Spika VM. Lessons from digital technology-enabled health interventions implemented during the coronavirus pandemic to improve maternal and birth outcomes: a global scoping review. BMC Pregnancy Childbirth 2023; 23:195. [PMID: 36941565 PMCID: PMC10026210 DOI: 10.1186/s12884-023-05454-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/17/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Timely access to essential obstetric and gynecologic healthcare is an effective method for improving maternal and neonatal outcomes; however, the COVID-19 pandemic impacted pregnancy care globally. In this global scoping review, we select and investigate peer-reviewed empirical studies related to mHealth and telehealth implemented during the pandemic to support pregnancy care and to improve birth outcomes. METHODS We searched MEDLINE and PubMed, Scopus, CINAHL and Web of Science for this Review because they include peer-reviewed literature in the disciplines of behavioral sciences, medicine, clinical sciences, health-care systems, and psychology. Because our investigative searches reviewed that there is considerable 'grey literature' in this area; we did not restrict our review to any study design, methods, or place of publication. In this Review, peer-reviewed preprints were comparable to published peer-reviewed articles, with relevant articles screened accordingly. RESULTS The search identified 1851 peer reviewed articles, and after removal of duplicates, using inclusion and exclusion criteria, only 22 studies were eligible for inclusion in the review published from January 2020 to May 2022. mHealth interventions accounted for 72.7% (16 of 22 studies) and only 27.3% (6 of 22 studies) were telehealth studies. There were only 3 example studies that integrated digital technologies into healthcare systems and only 3 studies that developed and evaluated the feasibility of mobile apps. Experimental studies accounted 68.8% of mHealth studies and only 33.3% studies of telehealth studies. Key functionalities of the pregnancy apps and telehealth platforms focused on mental and physical wellness, health promotion, patient tracking, health education, and parenting support. Implemented interventions ranged from breastfeeding and selfcare to behavioral health. Facilitators of uptake included perceived benefits, user satisfaction and convenience. Mobile apps and short messaging services were the primary technologies employed in the implemented mHealth interventions. CONCLUSION Although our Review emphasizes a lack of studies on mHealth interventions and data from pregnant women during the COVID-19 crisis, the review shows that implementation of digital health interventions during emergencies are inevitable given their potential for supporting pregnancy care. There is also a need for more randomized clinical trials and longitudinal studies to better understand the effectiveness and feasibility of implementing such interventions during disease outbreaks and emergencies.
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Affiliation(s)
- Imelda K Moise
- Department of Geography & Sustainable Development, College of Arts and Sciences, University of Miami, 1300 Campo Sano Ave, Coral Gables, FL, 33124, USA.
| | - Nicole Ivanova
- Global Health Studies Program, College of Arts and Sciences, University of Miami, 1252 Memorial Drive, Coral Gables, FL, 33146, USA
| | - Cyril Wilson
- Department of Geography & Anthropology, University of Wisconsin-Eau Claire, Eau Claire, WI, 54702-4004, USA
| | - Sigmond Wilson
- Department of History & Political Science, Rogers State University, 1701 W. Will Rogers Blvd, Claremore, OK, 74017, USA
| | - Hikabasa Halwindi
- Department of Community and Family Medicine, School of Public Health, University of Zambia, P.O Box 50110, Lusaka, Zambia
| | - Vera M Spika
- University of Miami, 1300 Memorial Drive, Coral Gables, FL, 33124, USA
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Benoit B, Aston M, Price S, Iduye D, Sim SM, Ollivier R, Joy P, Nassaji NA. Mothers’ Access to Social and Health Care Systems Support during Their Infants’ First Year during the COVID-19 Pandemic: A Qualitative Feminist Poststructural Study. NURSING REPORTS 2023; 13:412-423. [PMID: 36976690 PMCID: PMC10057522 DOI: 10.3390/nursrep13010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023] Open
Abstract
Social support and health services are crucial for mothers and families during their infants’ first year. The aim of this study was to explore the effect of self-isolation imposed by the COVID-19 pandemic on mothers’ access to social and health care systems support during their infants’ first year. We utilized a qualitative design using feminist poststructuralism and discourse analysis. Self-identifying mothers (n = 68) of infants aged 0 to 12 months during the COVID-19 pandemic in Nova Scotia, Canada completed an online qualitative survey. We identified three themes: (1) COVID-19 and the Social Construction of Isolation, (2) Feeling Forgotten and Dumped: Perpetuating the Invisibility of Mothering, and (3) Navigating and Negotiating Conflicting Information. Participants emphasized a need for support and the associated lack of support resulting from mandatory isolation during the COVID-19 pandemic. They did not see remote communication as equivalent to in-person connection. Participants described the need to navigate alone without adequate access to in-person postpartum and infant services. Participants identified conflicting information related to COVID-19 as a challenge. Social interactions and interactions with health care providers are crucial to the health and experiences of mothers and their infants during the first year after birth and must be sustained during times of isolation.
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Affiliation(s)
- Britney Benoit
- Rankin School of Nursing, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada
- Correspondence: ; Tel.: +1-(902)-867-1396
| | - Megan Aston
- School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Sheri Price
- School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Damilola Iduye
- School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - S Meaghan Sim
- Research, Innovation & Discovery, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Rachel Ollivier
- School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Phillip Joy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
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Recommendations for improving maternal health services in Indonesian primary care under the COVID-19 pandemic: Results of a systematic review and appraisal of international guidelines. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 35:100811. [PMID: 36669234 PMCID: PMC9834121 DOI: 10.1016/j.srhc.2023.100811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/25/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND A large volume of evidence and reviews about COVID-19 recommendations have been published; however, only a few provide recommendations on maternal health services ready for their adoption in Indonesia. This review aims to identify a set of potential recommendations for improving maternal care in the Indonesian primary care setting under the COVID-19 pandemic. METHODS A literature search to identify articles that cover a set of recommendations, or maternal guideline under the SARS-COV-1 outbreak or COVID-19 pandemic that were published from 2020 to 1 November 2022 was applied in six academic databases. The search used various keywords and phrases of 'maternal', 'model' and 'coronavirus', and excluded reviews and those evaluating interventions or medicine prescription. The eligible guidelines were appraised using AGREE II instrument, coded, and thematically analysed for their potential adoption to Indonesian settings. FINDINGS Fourteen guidelines were fully reviewed, and most of them had high AGREE II scores. Two main themes emerged from the analysis: clinical and supporting arrangements for maternal health services. Potential challenges for the implementation of these recommendations in Indonesia were also discussed. CONCLUSION AND IMPLICATION FOR PRACTICE Potential recommendations for improving maternal health for women in Indonesia under the COVID-19 pandemic both on the clinical and supporting services arrangements have been identified. Available clinical resources, different context of providers' practice authority and patients' literacy may challenge their implementation in practice. Further research is needed to seek consensus on the recommendation adoption in practice and to desirably redesign maternal health service in Indonesia.
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Mekonnen BD, Yirdaw BW. Impact of COVID-19 pandemic on utilization of essential maternal healthcare services in Ethiopia: A systematic review and meta-analysis. PLoS One 2023; 18:e0281260. [PMID: 36749776 PMCID: PMC9904479 DOI: 10.1371/journal.pone.0281260] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 01/19/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has a significant challenge for countries to maintain the provision of essential maternity services. Many women could experience difficulties in accessing maternal healthcare due to transport problems, anxiety, and fear of infection. A reduction in the utilization of maternity services has been suggested as a possible cause of worsened maternal health outcomes. Thus, this study aimed to determine the impact of the COVID-19 pandemic on the utilization of maternal healthcare services in Ethiopia. METHODS Searching of articles was conducted from PubMed, Science Direct, Cochrane Library, Web of Science, Scopus, and Google scholar. The quality of studies was evaluated using the Newcastle-Ottawa scale. Inspection of the Funnel plot and Egger's test were used to evaluate the evidence of publication bias. Heterogeneity was evaluated using Cochran's Q statistic and quantified by I2. A random-effects model was used to determine pooled estimates using STATA 14. RESULTS After reviewing 41,188 articles, 21 studies were included in this systematic review and meta-analysis. The pooled reduction was 26.62% (95% CI: 13.86, 39.37) for family planning, 19.30% (95% CI: 15.85, 22.76) for antenatal care, 12.82% (95% CI: 7.29, 18.34) for institutional delivery, 17.82% (95% CI: 8.32, 27.32) for postnatal care, and 19.39% (95% CI: 11.29, 27.49) for abortion care. This study also demonstrated that maternal perception of poor quality of care and fear of infection, lack of transport, cultural events, diversion of resources, lack of essential drugs, and lack of personal protective equipment and sanitizer were identified as the main challenges faced during the pandemic. CONCLUSION This study revealed that the utilization of maternal healthcare services in Ethiopia significantly decreased during the COVID-19 pandemic. Government measures, health facility-related barriers, and maternal-related factors were identified as challenges faced during the pandemic. Thus, service providers, policy-makers, and other relevant stakeholders should prioritize maternity care as an essential core healthcare service. Besides, increasing awareness of women through mass media, and making maternity services more accessible and equitable would likely increase the utilization of maternal healthcare services. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021293681.
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12
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Reis ZSN, Pires MC, Ramos LEF, Sales TLS, Pereira PD, Martins KPMP, Garbini AF, dos Reis Gomes AG, Pessoa BP, Matos CC, Cimini CCR, Rempel C, Ponce D, Aranha FFMG, Anschau F, Crestani GP, Grizende GMS, Bastos GAN, dos Santos Goedert GM, Menezes LSM, Carneiro M, Tolfo MF, Corrêa MAM, Maciel de Amorim M, Guimarães Júnior MH, Durães PAA, da Silva Rosa PM, de Lima Martelli PJ, Santos Charão de Almeida R, Martins RC, Alvarenga SP, Boersma E, Pessoa de Aguiar RAL, Marcolino MS. Mechanical ventilation and death in pregnant patients admitted for COVID-19: a prognostic analysis from the Brazilian COVID-19 registry score. BMC Pregnancy Childbirth 2023; 23:18. [PMID: 36627576 PMCID: PMC9830611 DOI: 10.1186/s12884-022-05310-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/14/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The assessment of clinical prognosis of pregnant COVID-19 patients at hospital presentation is challenging, due to physiological adaptations during pregnancy. Our aim was to assess the performance of the ABC2-SPH score to predict in-hospital mortality and mechanical ventilation support in pregnant patients with COVID-19, to assess the frequency of adverse pregnancy outcomes, and characteristics of pregnant women who died. METHODS This multicenter cohort included consecutive pregnant patients with COVID-19 admitted to the participating hospitals, from April/2020 to March/2022. Primary outcomes were in-hospital mortality and the composite outcome of mechanical ventilation support and in-hospital mortality. Secondary endpoints were pregnancy outcomes. The overall discrimination of the model was presented as the area under the receiver operating characteristic curve (AUROC). Overall performance was assessed using the Brier score. RESULTS From 350 pregnant patients (median age 30 [interquartile range (25.2, 35.0)] years-old]), 11.1% had hypertensive disorders, 19.7% required mechanical ventilation support and 6.0% died. The AUROC for in-hospital mortality and for the composite outcome were 0.809 (95% IC: 0.641-0.944) and 0.704 (95% IC: 0.617-0.792), respectively, with good overall performance (Brier = 0.0384 and 0.1610, respectively). Calibration was good for the prediction of in-hospital mortality, but poor for the composite outcome. Women who died had a median age 4 years-old higher, higher frequency of hypertensive disorders (38.1% vs. 9.4%, p < 0.001) and obesity (28.6% vs. 10.6%, p = 0.025) than those who were discharged alive, and their newborns had lower birth weight (2000 vs. 2813, p = 0.001) and five-minute Apgar score (3.0 vs. 8.0, p < 0.001). CONCLUSIONS The ABC2-SPH score had good overall performance for in-hospital mortality and the composite outcome mechanical ventilation and in-hospital mortality. Calibration was good for the prediction of in-hospital mortality, but it was poor for the composite outcome. Therefore, the score may be useful to predict in-hospital mortality in pregnant patients with COVID-19, in addition to clinical judgment. Newborns from women who died had lower birth weight and Apgar score than those who were discharged alive.
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Affiliation(s)
- Zilma Silveira Nogueira Reis
- grid.8430.f0000 0001 2181 4888Department of Gynecology and Obstetrics, University Hospital. Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil
| | - Magda Carvalho Pires
- grid.8430.f0000 0001 2181 4888Department of Statistics, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil
| | - Lucas Emanuel Ferreira Ramos
- grid.8430.f0000 0001 2181 4888Department of Statistics, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil
| | - Thaís Lorenna Souza Sales
- grid.428481.30000 0001 1516 3599Universidade Federal de São João del-Rei, R. Sebastião Gonçalves Coelho, 400, Chanadour, Divinópolis, MG 35501-296 Brazil
| | - Polianna Delfino Pereira
- grid.8430.f0000 0001 2181 4888Department of Internal Medicine, Medical School, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil ,Institute for Health Technology Assessment (IATS/CNPq), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil
| | - Karina Paula Medeiros Prado Martins
- grid.8430.f0000 0001 2181 4888University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil
| | - Andresa Fontoura Garbini
- grid.414914.dHospital Nossa Senhora da Conceição and Hospital Cristo Redentor, Av. Francisco Trein, 326, Porto Alegre, Brazil
| | | | - Bruno Porto Pessoa
- Hospital Júlia Kubitschek, R. Dr. Cristiano Rezende, Belo Horizonte, 2745 Brazil
| | - Carolina Cunha Matos
- grid.419130.e0000 0004 0413 0953Faculdade de Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias, 275, Belo Horizonte, Brazil
| | - Christiane Corrêa Rodrigues Cimini
- Hospital Santa Rosália, R. Dr. Onófre, 575, Teófilo Otoni, Brazil ,grid.411287.90000 0004 0643 9823Mucuri Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri, R. Cruzeiro, 01, Teófilo Otoni, Brazil
| | - Claudete Rempel
- Hospital Bruno Born, Av. Benjamin Constant, 881, Lajeado, Brazil
| | - Daniela Ponce
- grid.410543.70000 0001 2188 478XBotucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho” and Hospital das Clínicas da Faculdade de Medicina de Botucatu, Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Botucatu, Brazil
| | | | - Fernando Anschau
- grid.414914.dHospital Nossa Senhora da Conceição and Hospital Cristo Redentor, Av. Francisco Trein, 326, Porto Alegre, Brazil
| | - Gabriela Petry Crestani
- grid.414871.f0000 0004 0491 7596Hospital Mãe de Deus, R. José de Alencar, 286, Porto Alegre, Brazil
| | - Genna Maira Santos Grizende
- grid.477816.b0000 0004 4692 337XHospital Santa Casa de Misericórdia de Belo Horizonte, Av. Francisco Sales, 1111, Belo Horizonte, Brazil
| | - Gisele Alsina Nader Bastos
- grid.414856.a0000 0004 0398 2134Hospital Moinhos de Vento, R. Ramiro Barcelos, 910, Porto Alegre, Brazil
| | | | | | - Marcelo Carneiro
- Hospital Santa Cruz, R. Fernando Abott, 174, Santa Cruz do Sul, Brazil
| | - Marcia Ffner Tolfo
- Faculdade Integrada de Santa Maria, R. José do Patrocínio, 26, Santa Maria, Brazil
| | - Maria Augusta Matos Corrêa
- grid.411287.90000 0004 0643 9823Mucuri Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri, R. Cruzeiro, 01, Teófilo Otoni, Brazil
| | - Mariani Maciel de Amorim
- grid.411513.30000 0001 2111 8057Universidade Luterana do Brasil, Av. Farroupilha, 8001, Canoas, Brazil
| | | | - Pamela Andrea Alves Durães
- grid.412520.00000 0001 2155 6671Pontifícia Universidade Católica de Minas Gerais, R. do Rosário, 1081, Betim, Brazil
| | - Patryk Marques da Silva Rosa
- grid.411452.70000 0000 9898 6728Centro Universitário de Belo Horizonte, Av. Professor Werneck, 1685, Belo Horizonte, Brazil
| | - Petrônio José de Lima Martelli
- grid.411227.30000 0001 0670 7996Centro de Ciências Médicas, Universidade Federal de Pernambuco, Hospital das Clínicas da Universidade Federal de Pernambuco, Av. Prof. Moraes Rego, 1235, Recife, Brazil
| | | | | | - Samuel Penchel Alvarenga
- grid.428481.30000 0001 1516 3599Universidade Federal de São João del-Rei, R. Sebastião Gonçalves Coelho, 400, Chanadour, Divinópolis, MG 35501-296 Brazil
| | - Eric Boersma
- grid.5645.2000000040459992XDepartment of Cardiology, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Regina Amélia Lopes Pessoa de Aguiar
- grid.8430.f0000 0001 2181 4888Department of Gynecology and Obstetrics, University Hospital. Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil
| | - Milena Soriano Marcolino
- grid.8430.f0000 0001 2181 4888Department of Internal Medicine, Medical School, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil ,Institute for Health Technology Assessment (IATS/CNPq), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil ,grid.8430.f0000 0001 2181 4888University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil ,grid.8430.f0000 0001 2181 4888Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena 190, Belo Horizonte, Brazil
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Disruptions in Accessing Women's Health Care Services: Evidence Using COVID-19 Health Services Disruption Survey. Matern Child Health J 2023; 27:395-406. [PMID: 36609799 PMCID: PMC9823248 DOI: 10.1007/s10995-022-03585-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 09/22/2022] [Accepted: 12/23/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The world is experiencing the Coronavirus pandemic and the aftermath consequences leading to lockdown and travel restrictions. The pandemic has brought a far-reaching impact on various sectors, including the economic, and health sectors. Therefore, this study analyses the possible impact of the COVID-19 pandemic on the disruption - in accessing family planning measures i.e. contraception facilities; and in seeking help from women organizations for health services. METHODS This study has used the COVID-19 health services disruption survey-2020 and data was obtained from the Institute of Health Metrics and Evaluation. This survey was conducted in 76 countries using the smartphone-based premise data collection platform. Respondents were individual members of the general population ages 15-49 years who were identified as women. Data were collected from 12,354 respondents. Our data analysis has been done on both aggregate samples as well as region-wise samples (i.e. Africa, Asia, Europe, and Latin America & the Caribbean) to assess the change in levels of service delivery in both pre-COVID and post-COVID periods. RESULTS Descriptive statistics results shows that two particular reasons - unable to access due to lockdown restrictions (5.4%), and fear of being infected with COVID-19 (9.7%) were reported as mostly impacting the access to contraception facilities due to lockdown restriction. Further, the logit regression using socio-economic and demographic variables suggests that geographical location (rural), and poor financial status turned out negative and significant, showing higher odds of facing difficulty than the reference category for the aggregate sample. The region-wise analysis suggests that Europe and Asia are the regions with the highest percentage of respondents reporting unavailability of services during COVID-19. CONCLUSION The study concludes that pandemic-related emergencies affect the health care system, especially women-related health care services. The implication of our study indicates the requirement of a supply chain strategy for managing health care demand during emerging situations. So, the disruptions and bottlenecks in health care facilities should be addressed by various governments through appropriate policies and interventions.
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Palo SK, Dubey S, Negi S, Sahay MR, Patel K, Swain S, Mishra BK, Bhuyan D, Kanungo S, Som M, Merta BR, Bhattacharya D, Kshatri JS, Pati S. Effective interventions to ensure MCH (Maternal and Child Health) services during pandemic related health emergencies (Zika, Ebola, and COVID-19): A systematic review. PLoS One 2022; 17:e0268106. [PMID: 35536838 PMCID: PMC9089853 DOI: 10.1371/journal.pone.0268106] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 04/22/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Ensuring accessible and quality health care for women and children is an existing challenge, which is further exacerbated during pandemics. There is a knowledge gap about the effect of pandemics on maternal, newborn, and child well-being. This systematic review was conducted to study maternal and child health (MCH) services utilization during pandemics (Zika, Ebola, and COVID-19) and the effectiveness of various interventions undertaken for ensuring utilization of MCH services. METHODOLOGY A systematic and comprehensive search was conducted in MEDLINE/PubMed, Cochrane CENTRAL, Embase, Epistemonikos, ScienceDirect, and Google Scholar. Of 5643 citations, 60 potential studies were finally included for analysis. The included studies were appraised using JBI Critical appraisal tools. Study selection and data extraction were done independently and in duplicate. Findings are presented narratively based on the RMNCHA framework by World Health Organization (WHO). RESULTS Maternal and child health services such as antenatal care (ANC) visits, institutional deliveries, immunization uptake, were greatly affected during a pandemic situation. Innovative approaches in form of health care services through virtual consultation, patient triaging, developing dedicated COVID maternity centers and maternity schools were implemented in different places for ensuring continuity of MCH care during pandemics. None of the studies reported the effectiveness of these interventions during pandemic-related health emergencies. CONCLUSION The findings suggest that during pandemics, MCH care utilization often gets affected. Many innovative interventions were adopted to ensure MCH services. However, they lack evidence about their effectiveness. It is critically important to implement evidence-based appropriate interventions for better MCH care utilization.
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Affiliation(s)
| | - Shubhankar Dubey
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Sapna Negi
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Kripalini Patel
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Swagatika Swain
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Dinesh Bhuyan
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Srikanta Kanungo
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Meena Som
- United Nations Children’s Fund (UNICEF), Odisha, India
| | | | | | | | - Sanghamitra Pati
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
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15
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Martin MM, Knobel R, Nandi V, Pereira JG, Trapani Junior A, Andreucci CB. Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:398-408. [PMID: 35176779 PMCID: PMC9948289 DOI: 10.1055/s-0041-1741450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The present study aimed to evaluate the antenatal care adequacy for women who gave birth at the University Hospital of Santa Catarina in Florianopolis (Brazil) during the COVID-19 pandemic, and to evaluate the association of adequacy with sociodemographic, clinical, and access characteristics. METHODS Data were collected between October and December 2020, including 254 patients who delivered in the University Hospital from Federal University of Santa Catarina and answered our questionnaires. Additional data were obtained from patients' antenatal booklets. Antenatal care was classified as adequate, intermediate, or inadequate according to the number of appointments, gestational age at the beginning of follow-up, and tests results. We carried out a descriptive statistical analysis and a bivariate/with odds ratio analysis on maternal sociodemographic, clinical and health access variables that were compared with antenatal adequacy. RESULTS Antenatal care was considered adequate in 35.8% of cases, intermediate in 46.8%, and inadequate in 17.4%. The following maternal variables were associated with inadequate prenatal care (intermediate or inadequate prenatal care): having black or brown skin colour, having two or more children, being of foreign nationality, not being fluent in Portuguese, and using illicit drugs during pregnancy; the clinical variables were more than 6 weeks between appointments, and not attending high-risk antenatal care; as for access, the variables were difficulties in attending or scheduling appointments, and attending virtual appointments only. CONCLUSION In a sample of pregnant women from a teaching hospital in Florianópolis during the COVID-19 pandemic, antenatal care was considered adequate in 35.8%, intermediate in 46.8%, and inadequate in 17.4% of cases.
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Affiliation(s)
- Margot Marie Martin
- Divisão de Saúde da Mulher, Hospital Universitário Polydoro Ernani de São Thiago, Florianópolis, SC, Brazil
| | - Roxana Knobel
- Departamento de ginecologia e obstetrícia, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Vitor Nandi
- Divisão de Saúde da Mulher, Hospital Universitário Polydoro Ernani de São Thiago, Florianópolis, SC, Brazil
| | - Jessica Goedert Pereira
- Departamento de ginecologia e obstetrícia, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Alberto Trapani Junior
- Divisão de Saúde da Mulher, Hospital Universitário Polydoro Ernani de São Thiago, Florianópolis, SC, Brazil.,Departamento de ginecologia e obstetrícia, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.,Programa de residência médica em ginecologia e obstetrícia, Hospital Regional Homero de Miranda Gomes, São José, SC, Brazil
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Houlden S, Veletsianos G, Hodson J, Reid D, Thompson CP. COVID-19 health misinformation: using design-based research to develop a theoretical framework for intervention. HEALTH EDUCATION 2022. [DOI: 10.1108/he-05-2021-0073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeBecause health misinformation pertaining to COVID-19 is a serious threat to public health, the purpose of this study is to develop a framework to guide an online intervention into some of the drivers of health misinformation online. This framework can be iterated upon through the use of design-based research to continue to develop further interventions as needed.Design/methodology/approachUsing design-based research methods, in this paper, the authors develop a theoretical framework for addressing COVID-19 misinformation. Using a heuristic analysis of research on vaccine misinformation and hesitancy, the authors propose a framework for education interventions that use the narrative effect of transportation as a means to increase knowledge of the drivers of misinformation online.FindingsThis heuristic analysis determined that a key element of narrative transportation includes orientation towards particular audiences. Research indicates that mothers are the most significant household decision-makers with respect to vaccines and family health in general; the authors suggest narrative interventions should be tailored specifically to meet their interests and tastes, and that this may be different for mothers of different backgrounds and cultural communities.Originality/valueWhile there is a significant body of literature on vaccine hesitancy and vaccine misinformation, more research is needed that helps people understand the ways in which misinformation works upon social media users. The framework developed in this research guided the development of an education intervention meant to facilitate this understanding.
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Burger M, Einspieler C, Unger M, Niehaus D. Prioritising maternal mental health and infant neurodevelopment research in Africa – A call for action amidst the backdrop of the COVID‑19 pandemic. S Afr J Psychiatr 2022; 28:1716. [PMID: 35169511 PMCID: PMC8832021 DOI: 10.4102/sajpsychiatry.v28i0.1716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/07/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Marlette Burger
- Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Christa Einspieler
- Research Unit (IDN) Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Marianne Unger
- Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Dana Niehaus
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Wang EW, Parchem JG, Atmar RL, Clark EH. SARS-CoV-2 Vaccination During Pregnancy: A Complex Decision. Open Forum Infect Dis 2021; 8:ofab180. [PMID: 34056031 PMCID: PMC8083262 DOI: 10.1093/ofid/ofab180] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/08/2021] [Indexed: 12/13/2022] Open
Abstract
As the first severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines passed UK and US regulatory milestones in late 2020 and early 2021, multiple professional societies offered recommendations to assist pregnant and breastfeeding people as they choose whether to undergo vaccination. Despite such guidance, the lack of data describing vaccine safety, immunogenicity, and efficacy in pregnant and breastfeeding people has made this decision challenging for many. However, even considering the paucity of data, the known risks of coronavirus disease 2019 during pregnancy likely outweigh the not yet fully elucidated risks of SARS-CoV-2 vaccines, which have reassuring safety and efficacy profiles among nonpregnant people.
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Affiliation(s)
- Elizabeth Wenqian Wang
- Department of Infectious Diseases, University of Maryland St. Joseph Medical Center, Towson, Maryland, USA
| | - Jacqueline G Parchem
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Robert L Atmar
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Eva H Clark
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- Center for Innovations in Quality, Safety, and Effectiveness (IQuESt), Section of Health Services Research, Department of Medicine, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas, USA
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Ceulemans M, Foulon V, Panchaud A, Winterfeld U, Pomar L, Lambelet V, Cleary B, O’Shaughnessy F, Passier A, Richardson JL, Allegaert K, Nordeng H. Vaccine Willingness and Impact of the COVID-19 Pandemic on Women's Perinatal Experiences and Practices-A Multinational, Cross-Sectional Study Covering the First Wave of the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073367. [PMID: 33805097 PMCID: PMC8038007 DOI: 10.3390/ijerph18073367] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/11/2021] [Accepted: 03/22/2021] [Indexed: 12/13/2022]
Abstract
The COVID-19 pandemic may be of particular concern for pregnant and breastfeeding women. We aimed to explore their beliefs about the coronavirus and COVID-19 vaccine willingness and to assess the impact of the pandemic on perinatal experiences and practices. A multinational, cross-sectional, web-based study was performed in six European countries between April and July 2020. The anonymous survey was promoted via social media. In total, 16,063 women participated (including 6661 pregnant and 9402 breastfeeding women). Most responses were collected from Belgium (44%), Norway (18%) and the Netherlands (16%), followed by Switzerland (11%), Ireland (10%) and the UK (3%). Despite differences between countries, COVID-19 vaccine hesitancy was identified among 40–50% of the respondents at the end of the first wave of the pandemic and was higher among pregnant women. Education level and employment status were associated with vaccine hesitancy. The first wave had an adverse impact on pregnancy experiences and disrupted access to health services and breastfeeding support for many women. In the future, access to health care and support should be maintained at all times. Evidence-based and tailored information on COVID-19 vaccines should also be provided to pregnant and breastfeeding women to avoid unfounded concerns about the vaccines and to support shared decision making in this population.
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Affiliation(s)
- Michael Ceulemans
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (V.F.); (K.A.)
- Teratology Information Service, Pharmacovigilance Centre Lareb, 5237 MH ‘s Hertogenbosch, The Netherlands;
- Correspondence: ; Tel.: +32-1637-7227
| | - Veerle Foulon
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (V.F.); (K.A.)
| | - Alice Panchaud
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
| | - Ursula Winterfeld
- Swiss Teratogen Information Service, Service de Pharmacologie Clinique, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;
| | - Léo Pomar
- Materno-Fetal and Obstetrics Research Unit, Lausanne University Hospital, 1011 Lausanne, Switzerland; (L.P.); (V.L.)
| | - Valentine Lambelet
- Materno-Fetal and Obstetrics Research Unit, Lausanne University Hospital, 1011 Lausanne, Switzerland; (L.P.); (V.L.)
| | - Brian Cleary
- Rotunda Hospital, D01 P5W9 Dublin, Ireland; (B.C.); (F.O.)
- School of Pharmacy, Royal College of Surgeons Ireland, D02 VN51 Dublin, Ireland
| | - Fergal O’Shaughnessy
- Rotunda Hospital, D01 P5W9 Dublin, Ireland; (B.C.); (F.O.)
- School of Pharmacy, Royal College of Surgeons Ireland, D02 VN51 Dublin, Ireland
| | - Anneke Passier
- Teratology Information Service, Pharmacovigilance Centre Lareb, 5237 MH ‘s Hertogenbosch, The Netherlands;
| | - Jonathan Luke Richardson
- UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 4AB, UK;
| | - Karel Allegaert
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (V.F.); (K.A.)
- Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
- Department of Clinical Pharmacy, Erasmus MC Sophia Children’s Hospital, 3000 CA Rotterdam, The Netherlands
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway;
- Department of Child Health and Development, Norwegian Institute of Public Health, 0213 Oslo, Norway
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