The Changing Aspects of Motherhood in Face of the COVID-19 Pandemic in Low- and Middle-Income Countries
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COMMENTARY
The Changing Aspects of Motherhood in Face of the COVID‑19 Pandemic in Low‑ and Middle‑Income Countries Jennifer Prince Kingsley1 · Paul Kingsley Vijay2 · Jacob Kumaresan3 · Nalini Sathiakumar1 Accepted: 6 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To advocate perspectives to strengthen existing healthcare systems to prioritize maternal health services amidst and beyond the COVID-19 pandemic in low- and middle income countries. Description COVID-19 directly affects pregnant women causing more severe disease and adverse pregnancy outcomes. The indirect effects due to the monumental COVID-19 response are much worse, increasing maternal and neonatal mortality. Assessment Amidst COVID-19, governments must balance effective COVID-19 response measures while continuing delivery of essential health services. Using the World Health Organization’s operational guidelines as a base, countries must conduct contextualized analyses to tailor their operations. Evidence based information on different services and comparative cost-benefits will help decisions on trade-offs. Situational analyses identifying extent and reasons for service disruptions and estimates of impacts using modelling techniques will guide prioritization of services. Ensuring adequate supplies, maintaining core interventions, expanding non-physician workforce and deploying telehealth are some adaptive measures to optimize care. Beyond the COVID-19 pandemic, governments must reinvest in maternal and child health by building more resilient maternal health services supported by political commitmentand multisectoral engagement, and with assistance from international partners. Conclusions Multi-sectoral investments providing high-quality care that ensures continuity and available to all segments of the population are needed. A robust primary healthcare system linked to specialist care and accessible to all segments of the population including marginalized subgroups is of paramount importance. Systematic approaches to digital health care solutions to bridge gaps in service is imperative. Future pandemic preparedness programs must include action plans for resilient maternal health services. Keyword Maternal and child health · Covid 19 · Pandemic · Pregnant women · Preparedness
Significance Statement What is Already Know on this Subject? * Jennifer Prince Kingsley [email protected] Paul Kingsley Vijay [email protected] Jacob Kumaresan [email protected] Nalini Sathiakumar [email protected] 1
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, USA
2
Clinic Qualitas, Johor Bahru, Malaysia
3
Former WHO Executive Director, New York, USA
The direct effects of COVID-19 on pregnant women include more severe disease and increased risk of adverse pregnancy outcomes such as preterm births. The indirect effects from barriers to health services are more severe exacerbating maternal/neonatal morbidity and mortality particularly in low- and middle-income countries
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