Impact of COVID-19 on essential service provision for reproductive, maternal, neonatal, and child health in the Southeast Asia region: a systematic review.

Background

There is increasing evidence that the COVID-19 pandemic has impacted adversely on the provision of essential health services globally. The Southeast Asia region (SEAR) has experienced extremely high rates of COVID-19 infection, with potential adverse impacts on provision of reproductive, maternal, neonatal, and child health (RMNCH) services.

Methods

We conducted a systematic literature review of quantitative evidence to characterise the impact of COVID-19 on the provision of essential RMNCH services across the SEAR. Studies published between December 2019 and May 2022 were included in the study. The quality of studies was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist.

Findings

We reviewed 1924 studies and analysed data from 20 peer-reviewed studies and three reports documenting quantitative pre-post estimates of RMNCH service disruption because of the COVID-19 pandemic. Eleven studies were of low methodological quality, in addition to seven and five studies of moderate and high methodological qualities respectively. Six countries in the region were represented in the included studies: India (11 studies), Bangladesh (4), Nepal (3), Sri Lanka (1), Bhutan (1) and Myanmar (1). These countries demonstrated a wide reduction in antenatal care services (-1.6% to -69.6%), facility-based deliveries (-2.3% to -52.4%), child immunisation provision (-13.5% to -87.7%), emergency obstetric care (+4.0% to -76.6%), and family planning services (-4.2% to -100%).

Interpretation

There have been large COVID-19 pandemic related disruptions for a wide range of RMNCH essential health service indicators in several SEAR countries. Notably, we found a higher level of service disruption than the WHO PULSE survey estimates. If left unaddressed, such disruptions may set back hard-fought gains in RMNCH outcomes across the region. The absence of studies in five SEAR countries is a priority evidence gap that needs addressing to better inform policies for service protection.

Funding

WHO Sri Lanka Country Office.

Informations de copyright

© 2024 The Author(s).

Déclaration de conflit d'intérêts

This work was supported by the WHO Sri Lanka Country office (payment made to institution). TG is supported by a University Postgraduate Award from the University of New South Wales. DP is supported by a NHMRC Principal Research Fellowship. TS was supported by the Queen Elizabeth II Diamond Jubilee Scholarship and was awarded T. Russell Wilkins Memorial Scholarship and Global Experience Award by McMaster University. DN was supported by the India Alliance Fellowship (IA/CPHI/16/1/502,653, salary support) and received consulting fees from Department of Data and Analytics-WHO (included guest editorship of a special issue on COVID-19 and inequality). LD received £500 on three separate occasions for delivering lectures to Kings college London (2022, 2021) and Imperial college London (2022), and is an expert member of the health economics advisory group to the UK Infected Blood Inquiry (2020–2022) [no payment was received]. Authors declare no other conflicts of interest.