Peer-reviewed article
Disruption and recovery of maternal and child health services following COVID-19 emergency measures in Zimbabwe
Tadiwanashe Mutemeri, Neuville Katandika, James January, Nyaradzai Katena, Juliet Gamuchirai Nyamasve et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study looked at how COVID-19 lockdown measures affected maternal and child health services in Zimbabwe's ten provinces. It used monthly routine health data from 2016 to 2024 and compared service levels before, during and after lockdown. Completing four or more antenatal visits and newborn postnatal care within three days fell during lockdown. First antenatal visits and institutional deliveries rose after lockdown. Neonatal deaths were higher after lockdown. The authors conclude that childhood immunisation and institutional deliveries held up comparatively well, and that better emergency preparedness and recovery planning are needed.
Key points
- Completion of at least four antenatal visits fell during lockdown (aRR 0.68, 95% CI 0.61–0.76).
- Newborn postnatal care within three days fell during lockdown (aRR 0.81, 95% CI 0.76–0.87).
- First antenatal visits were stable during lockdown (aRR 0.99) and increased afterwards (aRR 1.23, 95% CI 1.05–1.43).
- Institutional deliveries increased during recovery (aRR 1.25, 95% CI 1.11–1.40), and neonatal deaths increased post-lockdown (aRR 1.38, 95% CI 1.17–1.62).
- Disruption and recovery differed between provinces.
Limitations
This is a secondary analysis of routine facility data, so it shows changes over time but cannot explain why they happened. The abstract gives no figures for immunisation and does not say whether the rise in neonatal deaths was caused by the lockdown.
Abstract
COVID-19 emergency measures disrupted access to essential health services in many low- and middle-income countries. In Zimbabwe, maternal and child health (MCH) services are central to primary healthcare, yet evidence on the magnitude of disruption and recovery remains limited. This study assessed changes in selected MCH service indicators before, during, and after COVID-19 lockdown measures across Zimbabwe’s ten provinces. We conducted a secondary analysis of monthly provincial DHIS2 data from January 2016 to December 2024. Segmented interrupted time-series regression with generalized estimating equations with a Poisson distribution and log link to estimate immediate lockdown and post-lockdown recovery effects for first antenatal care (ANC) visits, completion of at least four ANC visits, institutional deliveries, newborn postnatal care within three days, primary immunisation course completion, and neonatal deaths. Models adjusted for province, calendar month, and within-province correlation. Completion of at least four ANC visits declined during lockdown (aRR 0.68, 95% CI 0.61–0.76), as did newborn postnatal care within three days (aRR 0.81, 95% CI 0.76–0.87). First ANC visits remained stable during lockdown (aRR 0.99, 95% CI 0.84–1.16) but increased post-lockdown (aRR 1.23, 95% CI 1.05–1.43). Institutional deliveries also increased during recovery (aRR 1.25, 95% CI 1.11–1.40), while neonatal deaths increased post-lockdown (aRR 1.38, 95% CI 1.17–1.62). Provincial patterns indicated heterogeneous disruption and recovery. COVID-19 lockdown measures disrupted selected routine MCH services, particularly continued antenatal and early postnatal care, whereas institutional deliveries and childhood immunisation were comparatively resilient. Strengthening emergency preparedness and recovery planning is essential to maintaining continuity of MCH services during future public health emergencies.