The Effects of COVID-19 and of the policy response on access and utilization of maternal and child health services in Tanzania

ABSTRACT

Background: Tanzania as other parts of the world experienced several waves of Corona Virus Disease (COVID-19). However, little is known on the extent to which the disease has affected access and delivery of maternal and child health services. The study aims to explore and measure the effects of COVID-19 and of the related response measures on access and utilization of maternal and child health services in Tanzania. Method(s) This cross-sectional study was conducted in Mjini Magharibi and Chake Chake in Zanzibar and Ilala districts in the mainland, representing urban as well as rural areas in Tanzania. It employed a mixed methods study design using both quantitative and qualitative data collection techniques where we conducted 34 in-depth interviews with key informants and influential community persons, 60 semi-structured interviews with household members, complemented with 11 focus group discussions with community leaders, members, and health care providers. Result(s) Study participants from both settings reported to have observed the effects of COVID-19 on maternal and child health attributed to measures that were taken to contain the pandemic. COVID-19 prevention and treatment services were given more priorities which jeopardized other services. Scarcity of medical commodities were widely reported, including vaccines, equipment, and other medical supplies due to ban of international travels. There was rescheduling of medical appointments;shorter time for delivering mothers to stay in the health facility;rescheduling of reproductive and child health clinic from monthly to quarterly appointments and reduced time for health education and child growth monitoring. Fear of getting infected with corona virus was reported by mothers and care providers. Our informants linked such effects to a lower uptake of antenatal and postnatal, postnatal, family planning and immunisation services and institutional deliveries. Conclusion(s) The effect of directing efforts to COVID-19 and its measures taken to restructuring the health system led to reduction in Reproductive and Child Health (RCH) services delivery. Hence, preparedness plan for balancing maternal and child health (MCH) service provision need to be worked out ready for implementation to maintain standards and quality of service provided to mothers and children in future pandemics in order to meet defined international and national goals.