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Maintaining Continuity of Care for Expectant Mothers in Kenya During the COVID-19 Pandemic: A Study of MomCare.
Sanctis, Teresa De; Etiebet, Mary-Ann; Janssens, Wendy; van der Graaf, Mark H; van Montfort, Colette; Waiyaiya, Emma; Spieker, Nicole.
  • Sanctis T; PharmAccess Foundation, Amsterdam, The Netherlands.
  • Etiebet MA; Merck & Co., Inc., Kenilworth, NJ, USA.
  • Janssens W; Amsterdam Institute for Global Health and Development; Department of Economics; School of Business and Economics, Vrije Universiteit, Amsterdam, The Netherlands.
  • van der Graaf MH; PharmAccess Foundation, Amsterdam, The Netherlands.
  • van Montfort C; PharmAccess Foundation, Amsterdam, The Netherlands.
  • Waiyaiya E; PharmAccess Foundation, Nairobi, Kenya.
  • Spieker N; PharmAccess Foundation, Amsterdam, The Netherlands. n.spieker@pharmaccess.org.
Glob Health Sci Pract ; 10(4)2022 08 30.
Article in English | MEDLINE | ID: covidwho-2025434
ABSTRACT
In Kenya, early coronavirus disease (COVID-19) modeling studies predicted that disruptions in antenatal care and hospital services could increase indirect maternal and neonatal deaths and stillbirths. As the Kenyan government enforced lockdowns and a curfew, many mothers-to-be were unable to safely reach hospital facilities, especially at night. Fear of contracting COVID-19, increasing costs of accessing care, stigma, and falling incomes forced many expectant mothers to give birth at home. MomCare, which primarily serves communities in remote areas and urban slums, links mothers-to-be with payers and health care providers, following a standardized pregnancy program based on World Health Organization guidelines at a predetermined cost and quality. Expectant mothers gain access to care through a mobile wallet on their feature phone (voice, text, and basic internet), and providers are paid after appropriate care is given. Within the first 3 weeks of the pandemic in Kenya, the following services were added to the MomCare bundle emergency ambulance services during curfew hours, extended bed allowances to encourage early care, phone calls to check on mothers approaching their delivery dates and to promote the generation of a birth plan, SMS messages to inform mothers of open facilities and COVID-19 protocols, and training for clinic staff in managing COVID-19 patients and infection prevention. We compare data collected through the MomCare platform during the 6 months before the first confirmed COVID-19 case in Kenya (September 2019-February 2020) with data collected during the 6 months that followed. This study shows that care-seeking behaviors (enrollment, antenatal/postnatal care, skilled deliveries) increased for mothers-to-be enrolled in MomCare during the COVID-19 lockdowns, while quality of care and outcomes were maintained. Public health practitioners can promote interactive, patient-driven technology like MomCare to augment traditional responses, quickly linking payments with patients and providers in times of crisis.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Prognostic study Limits: Female / Humans / Infant, Newborn / Pregnancy Country/Region as subject: Africa Language: English Year: 2022 Document Type: Article Affiliation country: GHSP-D-21-00665

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Prognostic study Limits: Female / Humans / Infant, Newborn / Pregnancy Country/Region as subject: Africa Language: English Year: 2022 Document Type: Article Affiliation country: GHSP-D-21-00665