This article is a Preprint
Preprints are preliminary research reports that have not been certified by peer review. They should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Preprints posted online allow authors to receive rapid feedback and the entire scientific community can appraise the work for themselves and respond appropriately. Those comments are posted alongside the preprints for anyone to read them and serve as a post publication assessment.
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
Preprint
in English
| medRxiv
| ID: ppmedrxiv-20093393
Journal article
A scientific journal published article is available and is probably based on this preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
See journal article
A scientific journal published article is available and is probably based on this preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
See journal article
ABSTRACT
ObjectiveTo prospectively document experiences of frontline maternal and newborn healthcare providers during the COVID-19 pandemic. DesignCross-sectional study via an online survey disseminated through professional networks and social media in 12 languages. We analysed responses using descriptive statistics and qualitative thematic analysis disaggregating by low- and middle-income countries (LMICs) and high-income countries (HICs). Setting81 countries, between March 24 and April 10, 2020. Participants714 maternal and newborn healthcare providers. Main outcome measuresPreparedness for and response to COVID-19, experiences of health workers providing care to women and newborns, and adaptations to 17 outpatient and inpatient care processes during the pandemic. ResultsOnly one third of respondents 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, only 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. ConclusionsSubstantial 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. Key MessagesO_LSTWhat is already knownC_LSTO_LIIn addition to lack of healthcare worker protection, staffing shortages, heightened risk of nosocomial transmission and decreased healthcare use described in previous infectious disease outbreaks, maternal and newborn care during the COVID-19 pandemic has also been affected by large-scale lockdowns/curfews. C_LIO_LIThe two studies assessing the indirect effects of COVID-19 on maternal and child health have used models to estimate mortality impacts. C_LIO_LIExperiences of frontline health professionals providing maternal and newborn care during the COVID-19 pandemic have not been empirically documented to date. C_LI O_LSTWhat this study addsC_LSTO_LIRespondents in high-income countries more commonly reported available/updated guidelines, access to COVID-19 testing, and dedicated isolation rooms for confirmed/suspected COVID-19 maternity patients. C_LIO_LILevels of stress increased among health professionals globally, including due to changed working hours, difficulties in reaching health facilities, and staff shortages. C_LIO_LIHealthcare providers were worried about the impact of rapidly changing care practices on health outcomes:
reduced access to antenatal care, fewer outpatient visits, shorter length-of-stay in facilities after birth, banning birth companions, separating newborns from COVID-19 positive mothers, and postponing routine immunisations. C_LIO_LICOVID-19 illustrates the susceptibility of maternity care services to emergencies, including by reversing hard-won gains in healthcare utilisation and use of evidence-based practices. These rapid findings can inform countries of the main issues emerging and help develop effective responses. C_LI
cc_by
Full text:
Available
Collection:
Preprints
Database:
medRxiv
Type of study:
Observational study
/
Prognostic study
/
Qualitative research
Language:
English
Year:
2020
Document type:
Preprint