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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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