Peer-reviewed article
The COVID-19 pandemic and disruptions to maternal and child health services in public primary care Malaysia: a retrospective time-series analysis.
Mohd Ujang IR, Hamidi N, Ab Hamid J, Awang S, Zulkifli NW et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how COVID-19 lockdowns affected the use of maternal and child health services in Malaysia's public primary care clinics between 2019 and 2021. Using data from over 1,100 clinics, researchers tracked eight service areas including antenatal care, postnatal care, child health checks, and immunisation. Most maternal and child health services declined significantly during lockdowns, with child health services dropping by 19% and antenatal care by 8%, though services partially recovered between lockdowns. Importantly, infant immunisation services remained stable throughout the entire period.
Key points
- Child health services showed the largest decline at -19.23% during the first lockdown period
- Antenatal care utilisation dropped by -8.10% when the pandemic began
- Immunisation services for infants remained unaffected throughout the entire study period
- Most affected services showed partial recovery after the first lockdown was lifted
- A second lockdown caused temporary reductions ranging from -11.29% to -25.92% in most services, but no sustained decline
Limitations
The study examined utilisation data only and cannot explain why services were disrupted or what barriers families faced in accessing care. It does not assess health outcomes for children and mothers who missed services during these periods.
Abstract
Introduction The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide. Maintaining essential health services, including maternal and child health (MCH), while addressing the pandemic is an enormous task. This study aimed to assess the impact of the COVID-19 pandemic on the utilisation of MCH services in Malaysian public primary care. Methods A retrospective analysis was conducted using national administrative data from 1124 public primary care clinics. Eight indicators were selected to measure service utilisation covering antenatal, postnatal, women's health, child health, and immunisation services. Interrupted time-series analysis was used to evaluate changes in levels and trends of indicators during four different periods: pre-pandemic (January 2019-February 2020), during pandemic and first lockdown (March-May 2020), after the first lockdown was lifted (June-December 2020) and after the second lockdown was implemented (January-June 2021). Results Most indicators showed no significant trend in monthly utilisation prior to the pandemic. The onset of the pandemic and first lockdown implementation were associated with significant decreasing trends in child health (-19.23%), women's health (-10.12%), antenatal care (-8.10%), contraception (-6.50%), postnatal care (-4.85%) and postnatal care 1-week (-3.52%) indicators. These indicators showed varying degrees of recovery after the first lockdown was lifted. The implementation of the second lockdown caused transient reduction ranging from -11.29% to -25.92% in women's health, contraception, child and two postnatal indicators, but no sustained reducing trend was seen afterwards. Two immunisation indicators appeared unaffected throughout the study period. Conclusion The COVID-19 pandemic significantly impacted MCH services utilisation in Malaysia. While most MCH services were negatively affected by the lockdown implementation with varying degrees of recovery, infant immunisation showed resilience throughout. This highlights the need for a targeted preparedness plan to ensure the resilience of MCH services in future crises.