Effect of the COVID-19 pandemic on maternal and neonatal health services in three referral hospitals in Guinea: an interrupted time-series analysis

Tamba Mina Millimouno, Nafissatou Dioubaté, Harissatou Niane, Mamadou Cellou Diallo, Cécé Maomou, Telly Sy, Ibrahima Sory Diallo, Aline Semaan, Thérèse Delvaux, Lenka Benova, Alexandre Delamou

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Abstract

INTRODUCTION: In sub-Saharan Africa, there is limited evidence on the COVID-19 health-related effect from front-line health provision settings. Therefore, this study aimed to analyse the effect of the COVID-19 pandemic on routine maternal and neonatal health services in three referral hospitals.

MATERIALS AND METHODS: We conducted an observational study using aggregate monthly maternal and neonatal health services routine data for two years (March 2019-February 2021) in three referral hospitals including two maternities: Hôpital National Ignace Deen (HNID) in Conakry and Hôpital Regional de Mamou (HRM) in Mamou and one neonatology ward: Institut de Nutrition et de Santé de l'Enfant (INSE) in Conakry. We compared indicators of health service utilisation, provision and health outcomes before and during the COVID-19 pandemic periods. An interrupted time-series analysis (ITSA) was performed to assess the relationship between changes in maternal and neonatal health indicators and COVID-19 through cross-correlation.

RESULTS: During COVID-19, the mean monthly number (MMN) of deliveries decreased significantly in HNID (p = 0.039) and slightly increased in HRM. In the two maternities, the change in the MMN of deliveries were significantly associated with COVID-19. The ITSA confirmed the association between the increase in the MMN of deliveries and COVID-19 in HRM (bootstrapped F-value = 1.46, 95%CI [0.036-8.047], p < 0.01). We observed an increasing trend in obstetric complications in HNID, while the trend declined in HRM. The MMN of maternal deaths increased significantly (p = 0.011) in HNID, while it slightly increased in HRM. In INSE, the MMN of neonatal admissions significantly declined (p < 0.001) and this decline was associated with COVID-19. The MMN of neonatal deaths significantly decreased (p = 0.009) in INSE and this decrease was related to COVID-19.

CONCLUSION: The pandemic negatively affected the maternal and neonatal care provision, health service utilisation and health outcomes in two referral hospitals located in Conakry, the COVID-19 most-affected region.

Original languageEnglish
Article number50
JournalReproductive Health
Volume20
Issue number1
Number of pages13
ISSN1742-4755
DOIs
Publication statusPublished - 2023

Keywords

  • Pregnancy
  • Infant, Newborn
  • Female
  • Humans
  • Guinea
  • Pandemics
  • Infant Health
  • COVID-19/epidemiology
  • Hospitals
  • Health Services
  • Referral and Consultation
  • Maternal Health Services

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