Effects of the COVID-19 pandemic on antenatal care utilisation in Kenya: a cross-sectional study. Issue 4 (13th April 2022)

• Record Type: Journal Article
• Authors: Landrian, Amanda; Mboya, John; Golub, Ginger; Moucheraud, Corrina; Kepha, Stella; Sudhinaraset, May
• Is Part Of: BMJ open. Volume 12:Issue 4(2022)
• Publication Date: 2022-04-13
• Subjects: COVID-19 -- obstetrics -- public health; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-060185
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: The aim of this study was to assess the effects of COVID-19 on antenatal care (ANC) utilisation in Kenya, including women's reports of COVID-related barriers to ANC and correlates at the individual and household levels. Design: Cross-sectional study. Setting: Six public and private health facilities and associated catchment areas in Nairobi and Kiambu Counties in Kenya. Participants: Data were collected from 1729 women, including 1189 women who delivered in healthcare facilities before the COVID-19 pandemic (from September 2019–January 2020) and 540 women who delivered during the pandemic (from July through November 2020). Women who delivered during COVID-19 were sampled from the same catchment areas as the original sample of women who delivered before to compare ANC utilisation. Primary and secondary outcome measures: Timing of ANC initiation, number of ANC visits and adequate ANC utilisation were primary outcome measures. Among only women who delivered during COVID-19 only, we explored women's reports of the pandemic having affected their ability to access or attend ANC as a secondary outcome of interest. Results: Women who delivered during COVID-19 had significantly higher odds of delayed ANC initiation (ie, beginning ANC during the second vs first trimester) than women who delivered before (aOR 1.72, 95% CI 1.24 to 2.37), although no significant differences were detected in the odds of attending 4–7 or ≥8 ANC visits versus <4 ANC visits, respectively (aOR 1.12, 95% CI 0.86 to 1.44 and aOR 1.46, 95% CI 0.74 to 2.86). Nearly half (n=255/540; 47%) of women who delivered during COVID-19 reported that the pandemic affected their ability to access ANC. Conclusions: Strategies are needed to mitigate disruptions to ANC among pregnant women during pandemics and other public health, environmental, or political emergencies.