Peer-reviewed article
Impact of the COVID-19 pandemic on access to and delivery of maternal and child healthcare services in low-and middle-income countries: a systematic review of the literature.
Kuandyk Sabitova A, Ortega MA, Ntegwa MJ, Sarria-Santamera A ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review examined how the COVID-19 pandemic affected maternal and child healthcare services in 28 low- and middle-income countries, analysing 45 studies. The findings show that family planning visits, antenatal and postnatal care, child health consultations, emergency visits, and immunisation rates all decreased during the pandemic compared to before. The review identifies four main barriers: uncertainty and anxiety, healthcare system overwhelm, challenges faced by healthcare workers, and difficulties experienced by families seeking care. The authors note that conclusions are tentative due to variation in study quality and call for more research to understand the pandemic's full impact on women and children.
Key points
- Family planning visits, antenatal and postnatal care visits decreased in the majority of studies
- Consultations for sick children, paediatric emergency visits and child immunisation levels decreased compared to pre-pandemic levels
- Four main barriers identified: anxiety of not knowing, overwhelmed healthcare systems, challenges for healthcare professionals, and difficulties for service users
- COVID-19 pandemic disrupted family planning services, antenatal and postnatal care coverage, and routine child services
- Heterogeneity and inconsistent quality of included studies limits the ability to draw generalised conclusions
Limitations
The review acknowledges heterogeneity and inconsistent quality across the included studies, which limits the ability to draw firm generalised conclusions. The document does not provide detailed information about specific contexts, implementation factors, or recovery trajectories in different settings.
Abstract
Background The COVID-19 pandemic has had a multifaceted impact on maternal and child services and adversely influenced pregnancy outcomes. This systematic review aims to determine the impact of the COVID-19 pandemic on access to and delivery of maternal and child healthcare services in low- and middle-income countries. Methods The review was reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A primary search of electronic databases was performed using a combination of search terms related to the following areas of interest: "impact' AND 'COVID-19' AND 'maternal and child health services' AND 'low- and middle-income countries. A narrative synthesis approach was used to analyse and integrate the results. Results Overall, 45 unique studies conducted across 28 low- and middle-income countries met the inclusion criteria for the review. The findings suggest the number of family planning visits, antenatal and postnatal care visits, consultations for sick children, paediatric emergency visits and child immunisation levels decreased compared to the pre-pandemic levels in the majority of included studies. An analytical framework including four main categories was developed based on the concepts that emerged from included studies: the anxiety of not knowing (1), overwhelmed healthcare systems (2), challenges perceived by healthcare professionals (3) and difficulties perceived by service users (4). Conclusion The COVID-19 pandemic disrupted family planning services, antenatal and postnatal care coverage, and emergency and routine child services. Generalised conclusions are tentative due to the heterogeneity and inconsistent quality of the included studies. Future research is recommended to define the pandemic's impact on women and children worldwide and prepare healthcare systems for future resurgences of COVID-19 and potential challenges beyond. Systematic review registration PROSPERO (CRD42021285178).