Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

Aline Semaan, Constance Audet, Elise Huysmans, Bosede Afolabi, Bouchra Assarag, Aduragbemi Banke-Thomas, Hannah Blencowe, Séverine Caluwaerts, Oona Maeve Renee Campbell, Francesca L Cavallaro, Leonardo Chavane, Louise Tina Day, Alexandre Delamou, Therese Delvaux, Wendy Jane Graham, Giorgia Gon, Peter Kascak, Mitsuaki Matsui, Sarah Moxon, Annettee NakimuliAndrea Pembe, Emma Radovich, Thomas van den Akker, Lenka Benova

Research output: Contribution to journalA1: Web of Science-articlepeer-review

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INTRODUCTION: The COVID-19 pandemic has substantially impacted maternity care provision worldwide. Studies based on modelling estimated large indirect effects of the pandemic on services and health outcomes. The objective of this study was to prospectively document experiences of frontline maternal and newborn healthcare providers.

METHODS: We conducted a global, cross-sectional study of maternal and newborn health professionals via an online survey disseminated through professional networks and social media in 12 languages. Information was collected between 24 March and 10 April 2020 on respondents' background, preparedness for and response to COVID-19 and their experience during the pandemic. An optional module sought information on adaptations to 17 care processes. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregating by low-income and middle-income countries (LMICs) and high-income countries (HICs).

RESULTS: We analysed responses from 714 maternal and newborn health professionals. Only one-third received training on COVID-19 from their health facility and nearly all searched for information themselves. Half of respondents in LMICs received updated guidelines for care provision compared with 82% in HICs. Overall, 47% of participants in LMICs and 69% in HICs felt mostly or completely knowledgeable in how to care for COVID-19 maternity patients. Facility-level responses to COVID-19 (signage, screening, testing and isolation rooms) were more common in HICs than LMICs. Globally, 90% of respondents reported somewhat or substantially higher levels of stress. There was a widespread perception of reduced use of routine maternity care services, and of modification in care processes, some of which were not evidence-based practices.

CONCLUSIONS: Substantial knowledge gaps exist in guidance on management of maternity cases with or without COVID-19. Formal information-sharing channels for providers must be established and mental health support provided. Surveys of maternity care providers can help track the situation, capture innovations and support rapid development of effective responses.

Original languageEnglish
Article numbere002967
JournalBMJ Global Health
Issue number6
Number of pages11
Publication statusPublished - 2020


  • Betacoronavirus
  • Child Health Services/statistics & numerical data
  • Coronavirus Infections
  • Cross-Sectional Studies
  • Female
  • Health Personnel/statistics & numerical data
  • Humans
  • Infant, Newborn
  • Maternal Health Services/statistics & numerical data
  • Occupational Stress
  • Pandemics
  • Pneumonia, Viral
  • Poverty
  • Surveys and Questionnaires


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