Maternal and newborn care during the COVID-19 pandemic in Kenya: re-contextualising the community midwifery model
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(2020) 18:75
REVIEW
Open Access
Maternal and newborn care during the COVID-19 pandemic in Kenya: recontextualising the community midwifery model Rachel Wangari Kimani1* , Rose Maina1, Constance Shumba1,2 and Sheila Shaibu1
Abstract Peripartum deaths remain significantly high in low- and middle-income countries, including Kenya. The COVID-19 pandemic has disrupted essential services, which could lead to an increase in maternal and neonatal mortality and morbidity. Furthermore, the lockdowns, curfews, and increased risk for contracting COVID-19 may affect how women access health facilities. SARS-CoV-2 is a novel coronavirus that requires a community-centred response, not just hospital-based interventions. In this prolonged health crisis, pregnant women deserve a safe and humanised birth that prioritises the physical and emotional safety of the mother and the baby. There is an urgent need for innovative strategies to prevent the deterioration of maternal and child outcomes in an already strained health system. We propose strengthening community-based midwifery to avoid unnecessary movements, decrease the burden on hospitals, and minimise the risk of COVID-19 infection among women and their newborns. Keywords: COVID-19, Community health, Midwifery, Kenya, LMIC, Africa, Pandemic, Maternal, Neonatal, Community Interventions, Coronavirus, Pregnant women
Background The COVID-19 pandemic caused significant disruption of essential health services in sub-Saharan Africa. As COVID-19 continues to spread in Africa, health resources have been diverted to focus on general population needs rather than the specific needs of vulnerable groups, such as pregnant women and their children. These modifications in resource allocation may cause an increase in maternal and newborn deaths [1]. Given the high burden of maternal and neonatal mortality in sub-Saharan Africa, there is an urgent need for innovative strategies to prevent the deterioration of maternal and child outcomes in already strained health systems. * Correspondence: [email protected] 1 School of Nursing and Midwifery, Aga Khan University, PO Box 39340, Nairobi 00623, Kenya Full list of author information is available at the end of the article
Limited information is available about the pathophysiological effect of SARS-CoV-2 on pregnant women. However, emerging evidence indicates that pregnant women are not at a higher risk for severe COVID-19 illness than other population groups [2, 3]. To date, most reports of COVID-19 cases in pregnancy were either asymptomatic or self-limiting pneumonia [4]. Nevertheless, immunological and physiological adaptations during pregnancy could make women more vulnerable to SARS-CoV-2 infection than the general populace [5]. Furthermore, there have been reports of severe illness among pregnant women with comorbidities, such as diabetes [6]. In addition, previous human coronaviruses (e.g. pandemic influenza and SARS) were associated with increased maternal and neonatal deaths [7, 8]. Although pregnancy is ordinarily considered a normal p
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