Effect of COVID-19 Pandemic on Utilization of Paediatric Health Services at the Federal Medical Centre, Asaba, Nigeria.

BACKGROUND AND OBJECTIVES: Corona virus disease was declared a global pandemic in March 2020 and it precipitated unprecedented and devastating crisis on non-COVID hospital visits in almost all the countries within the globe, with a downward slide in the number of paediatric consultations and emergency admissions. Thus, we assessed the utilization of services offered in the department of Paediatrics and the observed mortality rates in comparison to similar non-pandemic period. METHODS: This study was carried out in the department of Pediatrics, Federal Medical Center Asaba. All the admissions at the children's ward and emergency, then visits at clinics and the immunization center were reviewed using a consecutive sampling method from April 2019 to September 2019 (pre COVID-19) and April 2020 to September 2020 (during COVID-19 pandemic). RESULTS: The total number of vaccines given in the immunization clinic was higher during the pre-COVID-19 period, so also the number of clinic visits. There was a decline in admission by 68.2% from the pre-COVID period to the pandemic period and this decline was across all age groups and gender. Also, a 60.8% increase in mortality was observed during the COVID-19 period and mortality pattern showed no gender difference across both study periods. CONCLUSION: There was a decline in the utilization of health services at the Department of Paediatrics, Federal Medical Center Asaba, during the COVID-19 pandemic, with a rise in mortality, despite the fact that all the units of the department were fully operational within the period of pandemic.

CONTEXTE ET OBJECTIFS: La maladie à virus Corona a été déclarée pandémie mondiale en mars 2020 et a précipité une crise sans précédent et dévastatrice sur les visites hospitalières non COVID dans presque tous les pays du globe, avec une baisse du nombre de consultations pédiatriques et d'admissions d'urgence. Nous avons donc évalué l'utilisation des services offerts dans le département de pédiatrie et les taux de mortalité observés par rapport à une période non pandémique similaire. MÉTHODES: Cette étude a été réalisée dans le département de pédiatrie du Centre médical fédéral d'Asaba. Toutes les admissions au service pédiatrique et aux urgences, puis les visites dans les cliniques et au centre de vaccination ont été examinées selon une méthode d'échantillonnage consécutif d'avril 2019 à septembre 2019 (avant COVID-19) et d'avril 2020 à septembre 2020 (pendant la pandémie de COVID-19). RÉSULTATS: Le nombre total de vaccins administrés dans le centre de vaccination était plus élevé pendant la période pré-COVID-19, de même que le nombre de visites au centre. Le nombre d'admissions a diminué de 68,2 % entre la période pré-COVID et la période pandémique, et cette baisse a concerné tous les groupes d'âge et tous les sexes. Par ailleurs, une augmentation de 60,8 % de la mortalité a été observée au cours de la période COVID-19 et le schéma de mortalité n'a montré aucune différence entre les sexes au cours des deux périodes d'étude. CONCLUSION: Il y a eu une baisse de l'utilisation des services de santé au département de pédiatrie du Federal Medical Center Asaba pendant la pandémie de COVID-19, avec une augmentation de la mortalité, malgré le fait que toutes les unités du département étaient pleinement opérationnelles pendant la période de la pandémie. Mots-clés: Pandémie, Covid-19, Enfants, Mortalité, Clinique, Admission, Services de santé, Effet, Utilisation.

Breastfeeding Practices and Growth

Background: Breastfeeding is vital for the growth and development of infants and young children. Early initiation within the half hour of birth fosters optimal breastfeeding practice; promotes growth and development.Objective: To evaluate breastfeeding practices and the growth of infants. Method: This was a crosssectional survey at three immunisation clinics in Asaba metropolis of Delta state. Using a structured questionnaire; we assessed breastfeeding practice of attendees and the growth of babies and documented information on the socio demographic characteristics; breastfeeding practices; previous weights of infants' and their Anthropometric measurements.Results: There were 97 mother infant/ pairs. 49 males; 48 females; giving a male to female ratio of 1:1. 20.6% were neonates; 74.2% were less than 6 months while 25.8% were older. About 50% of the mothers initiated breastfeeding within an hour of delivery; 25% of mothers gave pre-lacteal feeds. 49.5% of babies were optimally breastfed; of these; 68.7% mothers had initiated breastfeeding within an hour of birth (p=0.001). Underweight and stunting was only seen among babies of mothers who did not practice optimal breastfeeding. It was observed that babies' weights were not documented routinely in the road to health chart of the immunization cards after the measurements were taken. This was a missed opportunity for counselling and health promotion.Conclusion: Early initiation of breastfeeding increases the probability of optimal breastfeeding practice and prevents infant malnutrition. Even though growth was assessed; the information was not utilized for feed back to the mothers at the well-baby clinics; growth monitoring and promotion was not supported at the well-baby clinics in the health centres