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Published in: Conflict and Health 1/2022

Open Access 01-12-2022 | Nutrition | Research

A mixed methods study to assess the impact of COVID-19 on maternal, newborn, child health and nutrition in fragile and conflict-affected settings

Authors: Mariana Rodo, Lucy Singh, Neal Russell, Neha S. Singh

Published in: Conflict and Health | Issue 1/2022

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Abstract

Background

The impacts of COVID-19 are unprecedented globally. The pandemic is reversing decades of progress in maternal, newborn, child health and nutrition (MNCHN), especially fragile and conflict-affected settings (FCAS) whose populations were already facing challenges in accessing basic health and nutrition services. This study aimed to investigate the collateral impact of COVID-19 on funding, services and MNCHN outcomes in FCAS, as well as adaptations used in the field to continue activities.

Methods

A scoping review of peer-reviewed and grey literature published between 1st March 2020–31st January 2021 was conducted. We analysed 103 publications using a narrative synthesis approach. 39 remote semi-structured key informant interviews with humanitarian actors and donor staff within 12 FCAS were conducted between October 2020 and February 2021. Thematic analysis was undertaken independently by two researchers on interview transcripts and supporting documents provided by key informants, and triangulated with literature review findings.

Results

Funding for MNCHN has been reduced or suspended with increase in cost of continuing the same activities, and diversion of MNCHN funding to COVID-19 activities. Disruption in supply and demand of interventions was reported across different settings which, despite data evidence still being missing, points towards likely increased maternal and child morbidity and mortality. Some positive adaptations including use of technology and decentralisation of services have been reported, however overall adaptation strategies have been insufficient to equitably meet additional challenges posed by the pandemic, and have not been evaluated for their effectiveness.

Conclusions

COVID-19 is further exacerbating negative women’s and children’s health outcomes in FCAS. Increased funding is urgently required to re-establish MNCHN activities which have been deprioritised or halted. Improved planning to sustain routine health services and enable surge planning for emergencies with focus on the community/service users throughout adaptations is vital for improved MNCHN outcomes in FCAS.
Appendix
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Literature
2.
go back to reference United Nations Population Fund (UNFPA). Maternal mortality in humanitarian crises and in fragile settings. 2015. United Nations Population Fund (UNFPA). Maternal mortality in humanitarian crises and in fragile settings. 2015.
3.
go back to reference Percival V, Richards E, MacLean T, Theobald S. Health systems and gender in post-conflict contexts: building back better? Confl Health. 2014;8(1):1–14.CrossRef Percival V, Richards E, MacLean T, Theobald S. Health systems and gender in post-conflict contexts: building back better? Confl Health. 2014;8(1):1–14.CrossRef
4.
go back to reference Meagher K, Singh NS, Patel P. The role of gender inclusive leadership during the COVID-19 pandemic to support vulnerable populations in conflict settings. BMJ Glob Heal. 2020;5(9):e003760.CrossRef Meagher K, Singh NS, Patel P. The role of gender inclusive leadership during the COVID-19 pandemic to support vulnerable populations in conflict settings. BMJ Glob Heal. 2020;5(9):e003760.CrossRef
7.
go back to reference Lau LS, Samari G, Moresky RT, Casey SE, Kachur SP, Roberts LF, et al. COVID-19 in humanitarian settings and lessons learned from past epidemics. Nat Med. 2020;26(5):647–8.PubMedCrossRef Lau LS, Samari G, Moresky RT, Casey SE, Kachur SP, Roberts LF, et al. COVID-19 in humanitarian settings and lessons learned from past epidemics. Nat Med. 2020;26(5):647–8.PubMedCrossRef
8.
go back to reference Sochas L, Channon AA, Nam S. Counting indirect crisis-related deaths in the context of a low-resilience health system: the case of maternal and neonatal health during the Ebola epidemic in Sierra Leone. Health Policy Plan. 2017;32:iii32–9.PubMedCrossRef Sochas L, Channon AA, Nam S. Counting indirect crisis-related deaths in the context of a low-resilience health system: the case of maternal and neonatal health during the Ebola epidemic in Sierra Leone. Health Policy Plan. 2017;32:iii32–9.PubMedCrossRef
9.
go back to reference Phillips DE, Bhutta ZA, Binagwaho A, Boerma T, Freeman MC, Hirschhorn LR, et al. Learning from exemplars in global health: a road map for mitigating indirect effects of COVID-19 on maternal and child health On behalf of the Exemplars in Global Health Partnership Commentary Learning from Exemplars in Global Health: a road map for mitig. BMJ Glob Health. 2020;5:3430.CrossRef Phillips DE, Bhutta ZA, Binagwaho A, Boerma T, Freeman MC, Hirschhorn LR, et al. Learning from exemplars in global health: a road map for mitigating indirect effects of COVID-19 on maternal and child health On behalf of the Exemplars in Global Health Partnership Commentary Learning from Exemplars in Global Health: a road map for mitig. BMJ Glob Health. 2020;5:3430.CrossRef
10.
go back to reference Takemoto MLS, McKay G, Amorim M, Gbomosa CN, Tengbeh AF, Wenham C. How can countries create outbreak response policies that are sensitive to maternal health? BMJ. 2021;373:1–4. Takemoto MLS, McKay G, Amorim M, Gbomosa CN, Tengbeh AF, Wenham C. How can countries create outbreak response policies that are sensitive to maternal health? BMJ. 2021;373:1–4.
11.
go back to reference Di Toro F, Gjoka M, Di Lorenzo G, De Santo D, De Seta F, Maso G, et al. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clin Microbiol Infect. 2021;27(1):36–46.PubMedCrossRef Di Toro F, Gjoka M, Di Lorenzo G, De Santo D, De Seta F, Maso G, et al. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clin Microbiol Infect. 2021;27(1):36–46.PubMedCrossRef
12.
go back to reference Wei SQ, Bilodeau-Bertrand M, Liu S, Auger N. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. CMAJ. 2021;193(16):E540–8.PubMedPubMedCentralCrossRef Wei SQ, Bilodeau-Bertrand M, Liu S, Auger N. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. CMAJ. 2021;193(16):E540–8.PubMedPubMedCentralCrossRef
13.
go back to reference Kotlar B, Gerson E, Petrillo S, Langer A, Tiemeier H. The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review, vol. 18, Reproductive Health. BioMed Central Ltd; 2021. p. 10. Kotlar B, Gerson E, Petrillo S, Langer A, Tiemeier H. The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review, vol. 18, Reproductive Health. BioMed Central Ltd; 2021. p. 10.
14.
go back to reference Picchioni F, Goulao LF, Roberfroid D. The impact of COVID-19 on diet quality, food security and nutrition in low and middle income countries: a systematic review of the evidence. Clin Nutr. 2021. Picchioni F, Goulao LF, Roberfroid D. The impact of COVID-19 on diet quality, food security and nutrition in low and middle income countries: a systematic review of the evidence. Clin Nutr. 2021.
15.
go back to reference Benova L, Huysmans E, Portela A. Rapid scoping review of measures taken to maintain the provision and the use of essential services for MNCAAH (maternal, newborn, child, adolescent and older person’s health).protocols.io; 2020. Benova L, Huysmans E, Portela A. Rapid scoping review of measures taken to maintain the provision and the use of essential services for MNCAAH (maternal, newborn, child, adolescent and older person’s health).protocols.io; 2020.
16.
go back to reference UNICEF. Tracking the situation of children during COVID-19. Dashboard. 2020. UNICEF. Tracking the situation of children during COVID-19. Dashboard. 2020.
17.
go back to reference The World Bank. FY21 List of Fragile and Conflict-affected Situations. FCS List. 2020. The World Bank. FY21 List of Fragile and Conflict-affected Situations. FCS List. 2020.
18.
go back to reference COVID-19 Humanitarian Team. COVID-19 Humanitarian Platform. 2020. COVID-19 Humanitarian Team. COVID-19 Humanitarian Platform. 2020.
19.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
20.
go back to reference Semaan A, Audet C, Huysmans E, Afolabi B, Assarag B, Banke-Thomas A, et al. Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic. BMJ Glob Heal. 2020;5(6):e002967.CrossRef Semaan A, Audet C, Huysmans E, Afolabi B, Assarag B, Banke-Thomas A, et al. Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic. BMJ Glob Heal. 2020;5(6):e002967.CrossRef
21.
go back to reference Coker M, Folayan MO, Michelow IC, Oladokun RE, Torbunde N, Sam-Agudu NA. Things must not fall apart: the ripple effects of the COVID-19 pandemic on children in sub-Saharan Africa. Pediatr Res. 2020;89:1–9. Coker M, Folayan MO, Michelow IC, Oladokun RE, Torbunde N, Sam-Agudu NA. Things must not fall apart: the ripple effects of the COVID-19 pandemic on children in sub-Saharan Africa. Pediatr Res. 2020;89:1–9.
22.
go back to reference Ogundele IO, Alakaloko FM, Nwokoro CC, Ameh EA. Early impact of COVID-19 pandemic on paediatric surgical practice in Nigeria: a national survey of paediatric surgeons. BMJ Paediatr Open. 2020;4(1):732.CrossRef Ogundele IO, Alakaloko FM, Nwokoro CC, Ameh EA. Early impact of COVID-19 pandemic on paediatric surgical practice in Nigeria: a national survey of paediatric surgeons. BMJ Paediatr Open. 2020;4(1):732.CrossRef
23.
go back to reference Minckas N, Medvedev MM, Adejuyigbe EA, Brotherton H, Chellani H, Estifanos AS, et al. Preterm care during the COVID-19 pandemic: a comparative risk analysis of neonatal deaths averted by kangaroo mother care versus mortality due to SARS-CoV-2 infection. EClinicalMedicine. 2021;33:100733.PubMedPubMedCentralCrossRef Minckas N, Medvedev MM, Adejuyigbe EA, Brotherton H, Chellani H, Estifanos AS, et al. Preterm care during the COVID-19 pandemic: a comparative risk analysis of neonatal deaths averted by kangaroo mother care versus mortality due to SARS-CoV-2 infection. EClinicalMedicine. 2021;33:100733.PubMedPubMedCentralCrossRef
24.
go back to reference Enyama D, Chelo D, Noukeu Njinkui D, Mayouego Kouam J, Fokam Djike Puepi Y, Mekone Nkwele I, et al. Impact of the COVID-19 pandemic on pediatricians’ clinical activity in Cameroon. Arch Pediatr. 2020;27:423–7.PubMedPubMedCentralCrossRef Enyama D, Chelo D, Noukeu Njinkui D, Mayouego Kouam J, Fokam Djike Puepi Y, Mekone Nkwele I, et al. Impact of the COVID-19 pandemic on pediatricians’ clinical activity in Cameroon. Arch Pediatr. 2020;27:423–7.PubMedPubMedCentralCrossRef
25.
go back to reference Banke-Thomas A, Makwe CC, Balogun M, Afolabi BB, Alex-Nwangwu TA, Ameh CA. Utilization cost of maternity services for childbirth among pregnant women with coronavirus disease 2019 in Nigeria’s epicenter. Int J Gynaecol Obs. 2020;152:242–8.CrossRef Banke-Thomas A, Makwe CC, Balogun M, Afolabi BB, Alex-Nwangwu TA, Ameh CA. Utilization cost of maternity services for childbirth among pregnant women with coronavirus disease 2019 in Nigeria’s epicenter. Int J Gynaecol Obs. 2020;152:242–8.CrossRef
26.
go back to reference Roberton T, Carter ED, Chou VB, Stegmuller AR, Jackson BD, Tam Y, et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Heal. 2020;8(7):e901–8.CrossRef Roberton T, Carter ED, Chou VB, Stegmuller AR, Jackson BD, Tam Y, et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Heal. 2020;8(7):e901–8.CrossRef
27.
go back to reference Sherrard-Smith E, Hogan AB, Hamlet A, Watson OJ, Whittaker C, Winskill P, et al. The potential public health consequences of COVID-19 on malaria in Africa. Nat Med. 2020;26(9):1411–6.PubMedCrossRef Sherrard-Smith E, Hogan AB, Hamlet A, Watson OJ, Whittaker C, Winskill P, et al. The potential public health consequences of COVID-19 on malaria in Africa. Nat Med. 2020;26(9):1411–6.PubMedCrossRef
28.
go back to reference Bizri AR, Khachfe HH, Fares MY, Musharrafieh U. COVID-19 pandemic: an insult over injury for Lebanon. J Community Health. 2020;46:487–93.PubMedCentralCrossRef Bizri AR, Khachfe HH, Fares MY, Musharrafieh U. COVID-19 pandemic: an insult over injury for Lebanon. J Community Health. 2020;46:487–93.PubMedCentralCrossRef
29.
go back to reference Lusambili AM, Martini M, Abdirahman F, Asante A, Ochieng S, Guni JN, et al. “We have a lot of home deliveries” A qualitative study on the impact of COVID-19 on access to and utilization of reproductive, maternal, newborn and child health care among refugee women in urban Eastleigh, Kenya. J Migr Heal. 2020;1:1–2. Lusambili AM, Martini M, Abdirahman F, Asante A, Ochieng S, Guni JN, et al. “We have a lot of home deliveries” A qualitative study on the impact of COVID-19 on access to and utilization of reproductive, maternal, newborn and child health care among refugee women in urban Eastleigh, Kenya. J Migr Heal. 2020;1:1–2.
30.
go back to reference Ijarotimi OA, Ubom AE, Olofinbiyi BA, Kuye-Kuku T, Orji EO, Ikimalo JI. COVID-19 and obstetric practice: a critical review of the Nigerian situation. Vol. 151, International Journal of Gynecology and Obstetrics. Wiley; 2020. p. 17–22. Ijarotimi OA, Ubom AE, Olofinbiyi BA, Kuye-Kuku T, Orji EO, Ikimalo JI. COVID-19 and obstetric practice: a critical review of the Nigerian situation. Vol. 151, International Journal of Gynecology and Obstetrics. Wiley; 2020. p. 17–22.
31.
go back to reference Zar HJ, Dawa J, Fischer GB, Castro-Rodriguez JA. Challenges of COVID-19 in children in low- and middle-income countries. Paediatr Respir Rev. 2020;35:70–4.PubMedPubMedCentral Zar HJ, Dawa J, Fischer GB, Castro-Rodriguez JA. Challenges of COVID-19 in children in low- and middle-income countries. Paediatr Respir Rev. 2020;35:70–4.PubMedPubMedCentral
32.
go back to reference Dinleyici EC, Borrow R, Safadi MAP, van Damme P, Munoz FM. Vaccines and routine immunization strategies during the COVID-19 pandemic. Hum Vaccin Immunother. 2020;17:400–7.PubMedPubMedCentralCrossRef Dinleyici EC, Borrow R, Safadi MAP, van Damme P, Munoz FM. Vaccines and routine immunization strategies during the COVID-19 pandemic. Hum Vaccin Immunother. 2020;17:400–7.PubMedPubMedCentralCrossRef
33.
go back to reference Masresha BG, Luce R Jr, Shibeshi ME, Ntsama B, N’Diaye A, Chakauya J, et al. The performance of routine immunization in selected African countries during the first six months of the COVID-19 pandemic. Pan Afr Med J. 2020;37(Suppl 1):12.PubMedPubMedCentral Masresha BG, Luce R Jr, Shibeshi ME, Ntsama B, N’Diaye A, Chakauya J, et al. The performance of routine immunization in selected African countries during the first six months of the COVID-19 pandemic. Pan Afr Med J. 2020;37(Suppl 1):12.PubMedPubMedCentral
34.
go back to reference Moyo J, Madziyire G. Use of telemedicine in obstetrics and gynaecology in Zimbabwe during a lockdown period. Pan Afr Med J. 2020;35(Supplement 2):1–4. Moyo J, Madziyire G. Use of telemedicine in obstetrics and gynaecology in Zimbabwe during a lockdown period. Pan Afr Med J. 2020;35(Supplement 2):1–4.
35.
go back to reference Abbas K, Procter SR, van Zandvoort K, Clark A, Funk S, Mengistu T, et al. Routine childhood immunisation during the COVID-19 pandemic in Africa: a benefit–risk analysis of health benefits versus excess risk of SARS-CoV-2 infection. Lancet Glob Health. 2020;8(10):e1264–72.PubMedPubMedCentralCrossRef Abbas K, Procter SR, van Zandvoort K, Clark A, Funk S, Mengistu T, et al. Routine childhood immunisation during the COVID-19 pandemic in Africa: a benefit–risk analysis of health benefits versus excess risk of SARS-CoV-2 infection. Lancet Glob Health. 2020;8(10):e1264–72.PubMedPubMedCentralCrossRef
36.
go back to reference Mahmassani D, Tamim H, Makki M, Hitti E. The impact of COVID-19 lockdown measures on ED visits in Lebanon. Am J Emerg Med. 2020;46:634–9. Mahmassani D, Tamim H, Makki M, Hitti E. The impact of COVID-19 lockdown measures on ED visits in Lebanon. Am J Emerg Med. 2020;46:634–9.
37.
go back to reference Abdulah DM, Abdulla BMO, Liamputtong P. Psychological response of children to home confinement during COVID-19: a qualitative arts-based research. Int J Soc Psychiatry. 2020;67:761–9.PubMedCrossRef Abdulah DM, Abdulla BMO, Liamputtong P. Psychological response of children to home confinement during COVID-19: a qualitative arts-based research. Int J Soc Psychiatry. 2020;67:761–9.PubMedCrossRef
38.
go back to reference Akseer N, Kandru G, Keats EC, Bhutta ZA. COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition. Am J Clin Nutr. 2020;112(2):251–6.PubMedPubMedCentralCrossRef Akseer N, Kandru G, Keats EC, Bhutta ZA. COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition. Am J Clin Nutr. 2020;112(2):251–6.PubMedPubMedCentralCrossRef
39.
go back to reference Ahmed SAKS, Ajisola M, Azeem K, Bakibinga P, Chen Y-F, Choudhury NN, et al. Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan: results of pre-COVID and COVID-19 lockdown stakeholder engagements. BMJ Glob Heal. 2020;5(8):e003042.CrossRef Ahmed SAKS, Ajisola M, Azeem K, Bakibinga P, Chen Y-F, Choudhury NN, et al. Impact of the societal response to COVID-19 on access to healthcare for non-COVID-19 health issues in slum communities of Bangladesh, Kenya, Nigeria and Pakistan: results of pre-COVID and COVID-19 lockdown stakeholder engagements. BMJ Glob Heal. 2020;5(8):e003042.CrossRef
40.
go back to reference Govender K, Cowden RG, Nyamaruze P, Armstrong RM, Hatane L. Beyond the disease: contextualized implications of the COVID-19 pandemic for children and young people living in Eastern and Southern Africa. Front Public Heal. 2020;8:504.CrossRef Govender K, Cowden RG, Nyamaruze P, Armstrong RM, Hatane L. Beyond the disease: contextualized implications of the COVID-19 pandemic for children and young people living in Eastern and Southern Africa. Front Public Heal. 2020;8:504.CrossRef
41.
go back to reference Dmello BS, Housseine N. Impact of COVID-19 on maternal and child health. 2020. Dmello BS, Housseine N. Impact of COVID-19 on maternal and child health. 2020.
42.
go back to reference Walker D, Chandir S. COVID-19’s lost generation of unvaccinated children. 2021. Walker D, Chandir S. COVID-19’s lost generation of unvaccinated children. 2021.
44.
go back to reference Mustafa F, Green RJ. The implications of COVID-19 for the children of Africa. S Afr Med J. 2020;110(6):1–1.CrossRef Mustafa F, Green RJ. The implications of COVID-19 for the children of Africa. S Afr Med J. 2020;110(6):1–1.CrossRef
45.
go back to reference Fore HH, Dongyu Q, Beasley DM, Ghebreyesus TA. Child malnutrition and COVID-19: the time to act is now. The Lancet. 2020;396:517–8.CrossRef Fore HH, Dongyu Q, Beasley DM, Ghebreyesus TA. Child malnutrition and COVID-19: the time to act is now. The Lancet. 2020;396:517–8.CrossRef
46.
go back to reference Mellis C. Sustaining routine childhood immunisations during COVID-19 in Africa. J Paediatr Child Health. 2020;57:457. Mellis C. Sustaining routine childhood immunisations during COVID-19 in Africa. J Paediatr Child Health. 2020;57:457.
47.
go back to reference Fore HH. A wake-up call: COVID-19 and its impact on children’s health and wellbeing. Lancet Global Health. 2020;8:e861–2.PubMedCrossRef Fore HH. A wake-up call: COVID-19 and its impact on children’s health and wellbeing. Lancet Global Health. 2020;8:e861–2.PubMedCrossRef
48.
go back to reference Nghochuzie NN, Olwal CO, Udoakang AJ, Amenga-Etego LN-K, Amambua-Ngwa A. Pausing the fight against malaria to combat the COVID-19 pandemic in Africa: is the future of malaria bleak? Front Microbiol. 2020;11:1476.PubMedPubMedCentralCrossRef Nghochuzie NN, Olwal CO, Udoakang AJ, Amenga-Etego LN-K, Amambua-Ngwa A. Pausing the fight against malaria to combat the COVID-19 pandemic in Africa: is the future of malaria bleak? Front Microbiol. 2020;11:1476.PubMedPubMedCentralCrossRef
49.
go back to reference The Lancet Global Health. Food insecurity will be the sting in the tail of COVID-19. Lancet Global Health. 2020;8:e737. The Lancet Global Health. Food insecurity will be the sting in the tail of COVID-19. Lancet Global Health. 2020;8:e737.
50.
go back to reference Aborode AT, Ogunsola SO, Adeyemo AO. A crisis within a crisis: Covid-19 and hunger in African children. Am J Trop Med Hyg. 2021;104:30.PubMedCrossRef Aborode AT, Ogunsola SO, Adeyemo AO. A crisis within a crisis: Covid-19 and hunger in African children. Am J Trop Med Hyg. 2021;104:30.PubMedCrossRef
51.
go back to reference Adamu AA, Jalo RI, Habonimana D, Wiysonge CS. COVID-19 and routine childhood immunization in Africa: leveraging systems thinking and implementation science to improve immunization system performance. Int J Infect Dis. 2020;98:161–5.PubMedPubMedCentralCrossRef Adamu AA, Jalo RI, Habonimana D, Wiysonge CS. COVID-19 and routine childhood immunization in Africa: leveraging systems thinking and implementation science to improve immunization system performance. Int J Infect Dis. 2020;98:161–5.PubMedPubMedCentralCrossRef
52.
go back to reference Busch-Hallen J, Walters D, Rowe S, Chowdhury A, Arabi M. Impact of COVID-19 on maternal and child health. Lancet Global Health. 2020;8:e1257.PubMedCrossRef Busch-Hallen J, Walters D, Rowe S, Chowdhury A, Arabi M. Impact of COVID-19 on maternal and child health. Lancet Global Health. 2020;8:e1257.PubMedCrossRef
53.
54.
go back to reference Murewanhema G, Makurumidze R. Essential health services delivery in Zimbabwe during the COVID-19 pandemic: perspectives and recommendations. Pan Afr Med J. 2020;35(Suppl 2):143.PubMedPubMedCentral Murewanhema G, Makurumidze R. Essential health services delivery in Zimbabwe during the COVID-19 pandemic: perspectives and recommendations. Pan Afr Med J. 2020;35(Suppl 2):143.PubMedPubMedCentral
55.
go back to reference Khamala Wangamati C, Sundby J. The ramifications of COVID-19 on maternal health in Kenya. Sex Reprod Health Matters. 2020;28(1):1804716.CrossRef Khamala Wangamati C, Sundby J. The ramifications of COVID-19 on maternal health in Kenya. Sex Reprod Health Matters. 2020;28(1):1804716.CrossRef
56.
go back to reference Graham WJ, Afolabi B, Benova L, Campbell OMR, Filippi V, Nakimuli A, et al. Protecting hard-won gains for mothers and newborns in low-income and middle-income countries in the face of COVID-19: call for a service safety net. BMJ Glob Health. 2020;5(6):2754.CrossRef Graham WJ, Afolabi B, Benova L, Campbell OMR, Filippi V, Nakimuli A, et al. Protecting hard-won gains for mothers and newborns in low-income and middle-income countries in the face of COVID-19: call for a service safety net. BMJ Glob Health. 2020;5(6):2754.CrossRef
57.
go back to reference Menendez C, Gonzalez R, Donnay F, Leke RGF. Avoiding indirect effects of COVID-19 on maternal and child health. Lancet Global Health. 2020;8:e863–4.PubMedCrossRef Menendez C, Gonzalez R, Donnay F, Leke RGF. Avoiding indirect effects of COVID-19 on maternal and child health. Lancet Global Health. 2020;8:e863–4.PubMedCrossRef
58.
go back to reference Hobday K, Prata N, Hulme J, Homer CS. Preventing post-partum haemorrhage at home during COVID-19: what are we waiting for? Lancet Glob Heal. 2021;9(3):e245–6.CrossRef Hobday K, Prata N, Hulme J, Homer CS. Preventing post-partum haemorrhage at home during COVID-19: what are we waiting for? Lancet Glob Heal. 2021;9(3):e245–6.CrossRef
60.
go back to reference Headey D, Heidkamp R, Osendarp S, Ruel M, Scott N, Black R, et al. Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality. The Lancet. 2020;396:519–21.CrossRef Headey D, Heidkamp R, Osendarp S, Ruel M, Scott N, Black R, et al. Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality. The Lancet. 2020;396:519–21.CrossRef
61.
go back to reference McClure EM, Kinney MV, Leisher SH, Nam SL, Quigley P, Storey C, et al. Impact of COVID-19 on maternal and child health. Lancet Global Health. 2020;8:e1258.PubMedCrossRef McClure EM, Kinney MV, Leisher SH, Nam SL, Quigley P, Storey C, et al. Impact of COVID-19 on maternal and child health. Lancet Global Health. 2020;8:e1258.PubMedCrossRef
62.
go back to reference Ogunkola IO, Adebisi YA, Imo UF, Odey GO, Esu E, Lucero-Prisno DE. Impact of COVID-19 pandemic on antenatal healthcare services in Sub-Saharan Africa. Public Heal Pract. 2021;2:100076.CrossRef Ogunkola IO, Adebisi YA, Imo UF, Odey GO, Esu E, Lucero-Prisno DE. Impact of COVID-19 pandemic on antenatal healthcare services in Sub-Saharan Africa. Public Heal Pract. 2021;2:100076.CrossRef
63.
go back to reference Riley T, Sully E, Ahmed Z, Biddlecom A. Estimates of the potential impact of the COVID-19 pandemic on sexual and reproductive health in low-and middle-income countries. Int Perspect Sex Reprod Health. 2020;46:73–6.PubMedCrossRef Riley T, Sully E, Ahmed Z, Biddlecom A. Estimates of the potential impact of the COVID-19 pandemic on sexual and reproductive health in low-and middle-income countries. Int Perspect Sex Reprod Health. 2020;46:73–6.PubMedCrossRef
64.
go back to reference Ahmadi A, Essar MY, Lin X, Adebisi YA, Lucero-Prisno DE. Polio in Afghanistan: the current situation amid COVID-19. Am J Trop Med Hyg. 2020;103(4):1367–9.PubMedPubMedCentralCrossRef Ahmadi A, Essar MY, Lin X, Adebisi YA, Lucero-Prisno DE. Polio in Afghanistan: the current situation amid COVID-19. Am J Trop Med Hyg. 2020;103(4):1367–9.PubMedPubMedCentralCrossRef
65.
go back to reference Ogundele OA, Omotoso AA, Fagbemi AT. COVID-19 outbreak: a potential threat to routine vaccination programme activities in Nigeria. Hum Vaccines Immunother. 2020;17:661–3.CrossRef Ogundele OA, Omotoso AA, Fagbemi AT. COVID-19 outbreak: a potential threat to routine vaccination programme activities in Nigeria. Hum Vaccines Immunother. 2020;17:661–3.CrossRef
66.
go back to reference Adesunkanmi AO, Ubom AE, Olasehinde O, Fasubaa OB, Ijarotimi OA, Adesunkanmi ARK, et al. Impact of COVID-19 on the cost of surgical and obstetric care: experience from a Nigerian teaching hospital and a review of the Nigerian situation. Pan Afr Med J. 2020;37(Suppl 1):15.PubMedPubMedCentral Adesunkanmi AO, Ubom AE, Olasehinde O, Fasubaa OB, Ijarotimi OA, Adesunkanmi ARK, et al. Impact of COVID-19 on the cost of surgical and obstetric care: experience from a Nigerian teaching hospital and a review of the Nigerian situation. Pan Afr Med J. 2020;37(Suppl 1):15.PubMedPubMedCentral
67.
go back to reference Francis NN, Pegg S. Socially distanced school-based nutrition program under COVID 19 in the rural Niger Delta. Extr Ind Soc. 2020;7(2):576–9.PubMedPubMedCentral Francis NN, Pegg S. Socially distanced school-based nutrition program under COVID 19 in the rural Niger Delta. Extr Ind Soc. 2020;7(2):576–9.PubMedPubMedCentral
68.
go back to reference Elhadi M, Msherghi A, Elgzairi M, Alsuyihili A, Elkhafeefi F, Bouhuwaish A, et al. Assessment of the preparedness of obstetrics and gynecology healthcare systems during the COVID-19 pandemic in Libya. Int J Gynaecol Obstet. 2020;150:406–24.PubMedPubMedCentralCrossRef Elhadi M, Msherghi A, Elgzairi M, Alsuyihili A, Elkhafeefi F, Bouhuwaish A, et al. Assessment of the preparedness of obstetrics and gynecology healthcare systems during the COVID-19 pandemic in Libya. Int J Gynaecol Obstet. 2020;150:406–24.PubMedPubMedCentralCrossRef
69.
go back to reference Roberts L. Pandemic brings mass vaccinations to a halt. Science (80-). 2020;368:116–7.CrossRef Roberts L. Pandemic brings mass vaccinations to a halt. Science (80-). 2020;368:116–7.CrossRef
70.
go back to reference Cardwell R, Ghazalian PL. COVID-19 and international food assistance: policy proposals to keep food flowing. Spec Sect Pandemics Sustain. 2020;135:105059. Cardwell R, Ghazalian PL. COVID-19 and international food assistance: policy proposals to keep food flowing. Spec Sect Pandemics Sustain. 2020;135:105059.
71.
go back to reference Chimhuya S, Neal SR, Chimhini G, Gannon H, Cortina-Borja M, Crehan C, et al. Indirect impacts of the COVID-19 pandemic at two tertiary neonatal units in Zimbabwe and Malawi: an interrupted time series analysis. medRxiv. 2021. Chimhuya S, Neal SR, Chimhini G, Gannon H, Cortina-Borja M, Crehan C, et al. Indirect impacts of the COVID-19 pandemic at two tertiary neonatal units in Zimbabwe and Malawi: an interrupted time series analysis. medRxiv. 2021.
72.
go back to reference Hrynick T, Ripoll S, Carter S. Review: broader health impacts of vertical responses to COVID-19 in lon- and middle- income countries (LMICs). Brighton; 2020. Hrynick T, Ripoll S, Carter S. Review: broader health impacts of vertical responses to COVID-19 in lon- and middle- income countries (LMICs). Brighton; 2020.
73.
go back to reference ICRC. Somalia: decline in primary health care visits and childhood vaccinations during COVID-19. 2020. ICRC. Somalia: decline in primary health care visits and childhood vaccinations during COVID-19. 2020.
74.
go back to reference Save the Children. 60 Million Children across eight of the biggest humanitarian crises need help to survive this year, Warns Save the Children. 2021. Save the Children. 60 Million Children across eight of the biggest humanitarian crises need help to survive this year, Warns Save the Children. 2021.
75.
go back to reference Rahimov BB, Singh K, Bazar C. Integrating screening for acute malnutrition into the vitamin A supplementation campaign in the Rohingya camps during the pandemic. Field Exch Emerg Nutr Netw ENN. 2020;63:61–3. Rahimov BB, Singh K, Bazar C. Integrating screening for acute malnutrition into the vitamin A supplementation campaign in the Rohingya camps during the pandemic. Field Exch Emerg Nutr Netw ENN. 2020;63:61–3.
76.
go back to reference Martinez M, Akbar E, Wadood Z, Shukla H, et al. Progress toward poliomyelitis eradication—Afghanistan, January 2019–July 2020. 2020. Martinez M, Akbar E, Wadood Z, Shukla H, et al. Progress toward poliomyelitis eradication—Afghanistan, January 2019–July 2020. 2020.
77.
go back to reference iMMAP/DFS COVID-19. Situational Analysis. Update#4 - Syria. 2020. iMMAP/DFS COVID-19. Situational Analysis. Update#4 - Syria. 2020.
78.
go back to reference IRC. Continuing care during COVID-19: adopting life-saving approaches to treat acute malnutrition. 2020. IRC. Continuing care during COVID-19: adopting life-saving approaches to treat acute malnutrition. 2020.
79.
go back to reference UNICEF. UNICEF Bangladesh Country Office. COVID-19 Response Monthly Report 17. 2020. UNICEF. UNICEF Bangladesh Country Office. COVID-19 Response Monthly Report 17. 2020.
80.
go back to reference Roberts L. Why measles deaths are surging—and coronavirus could make it worse. Nature. 2020;580:446–7.PubMedCrossRef Roberts L. Why measles deaths are surging—and coronavirus could make it worse. Nature. 2020;580:446–7.PubMedCrossRef
81.
go back to reference Dube BT, Chelang M, Mustaphi P, Harlass S, Bourdaire J, Singh K, et al. Adaptations to CMAM programming in Cox’a Bazar in the context of the COVID-19 pandemic. Field Exch Emerg Nutr Netw ENN. 2020;63:57–60. Dube BT, Chelang M, Mustaphi P, Harlass S, Bourdaire J, Singh K, et al. Adaptations to CMAM programming in Cox’a Bazar in the context of the COVID-19 pandemic. Field Exch Emerg Nutr Netw ENN. 2020;63:57–60.
82.
go back to reference International Development Committee. Covid-19 in developing countries: secondary impacts. 2020. International Development Committee. Covid-19 in developing countries: secondary impacts. 2020.
83.
go back to reference Chatterjee A. The potential impact of health care disruption on child mortality in the Middle East and North Africa due to COVID-19. 2020. Chatterjee A. The potential impact of health care disruption on child mortality in the Middle East and North Africa due to COVID-19. 2020.
84.
go back to reference OCHA. Recent Developments in Northwest Syria. Situation Report No. 21. 2020. OCHA. Recent Developments in Northwest Syria. Situation Report No. 21. 2020.
85.
go back to reference Physicians Across Continents. Community surveillance Report May 20—Syria. 2020. Physicians Across Continents. Community surveillance Report May 20—Syria. 2020.
86.
go back to reference UNFPA. SRH Programme in NWS 2020 during the COVID-19 pandemic. 2021. UNFPA. SRH Programme in NWS 2020 during the COVID-19 pandemic. 2021.
87.
go back to reference Reuters. Child malnutrition at record highs in parts of Yemen: U.N. survey. Reuters. 2020. Reuters. Child malnutrition at record highs in parts of Yemen: U.N. survey. Reuters. 2020.
88.
go back to reference International Committee of the Red Cross. Nigeria: surge in malnutrition cases raises fear of looming disaster. International Committee of the Red Cross. 2020. International Committee of the Red Cross. Nigeria: surge in malnutrition cases raises fear of looming disaster. International Committee of the Red Cross. 2020.
89.
go back to reference Save the Children. YEMEN: tens of thousands of severely malnourished children are left without treatment since March. 2020. Save the Children. YEMEN: tens of thousands of severely malnourished children are left without treatment since March. 2020.
90.
go back to reference UNICEF UK. Malnutrition surges among young children in Yemen as conditions worsen. UNICEF UK. 2020. UNICEF UK. Malnutrition surges among young children in Yemen as conditions worsen. UNICEF UK. 2020.
91.
go back to reference Inter-Sector Coordination Group (ISCG) Gender Hub. In the shadows of the pandemic gendered impact of covid19 on rohingya and host communities. 2020. Inter-Sector Coordination Group (ISCG) Gender Hub. In the shadows of the pandemic gendered impact of covid19 on rohingya and host communities. 2020.
92.
go back to reference UNICEF. Analysis of Continuity of Critical Health and Nutrition Services—Zimbabwe. 2020. UNICEF. Analysis of Continuity of Critical Health and Nutrition Services—Zimbabwe. 2020.
93.
go back to reference UNICEF. Trends and implications of Covid in the health sector—Somalia. 2020. UNICEF. Trends and implications of Covid in the health sector—Somalia. 2020.
94.
go back to reference MSF. Responding to COVID-19. Global Accountability Report 2. June to August 2020. 2020. MSF. Responding to COVID-19. Global Accountability Report 2. June to August 2020. 2020.
95.
go back to reference Nwafor JI, Okedo-Alex IN, Ikeotuonye AC. Prevalence and predictors of depression, anxiety and stress symptoms among pregnant women during COVID-19-related lockdown in Abakaliki, Nigeria. 2020. Nwafor JI, Okedo-Alex IN, Ikeotuonye AC. Prevalence and predictors of depression, anxiety and stress symptoms among pregnant women during COVID-19-related lockdown in Abakaliki, Nigeria. 2020.
96.
go back to reference World Health Organization. The potential impact of health service disruptions on the burden of malaria: a modelling analysis for countries in Sub-Saharan Africa. Gene; 2020. World Health Organization. The potential impact of health service disruptions on the burden of malaria: a modelling analysis for countries in Sub-Saharan Africa. Gene; 2020.
97.
go back to reference Global Financing Facility. Preserve Essential Health Services during the COVID-19 Pandemic—Yemen. 2020. Global Financing Facility. Preserve Essential Health Services during the COVID-19 Pandemic—Yemen. 2020.
98.
go back to reference Global Financing Facility. Preserve essential health services during the COVID-19 Pandemic - South Sudan. 2020. Global Financing Facility. Preserve essential health services during the COVID-19 Pandemic - South Sudan. 2020.
99.
go back to reference Global Financing Facility. Preserver les Services de Sante Essentiels Pendant la Pandemie de COVID-19—Niger. 2020. Global Financing Facility. Preserver les Services de Sante Essentiels Pendant la Pandemie de COVID-19—Niger. 2020.
100.
go back to reference Stein D, Ward K, Cantelmo C. Estimating the Potential Impact of COVID-19 on Mothers and Newborns in Low- and Middle-Income Countries. Health Policy Plus. 2020. Stein D, Ward K, Cantelmo C. Estimating the Potential Impact of COVID-19 on Mothers and Newborns in Low- and Middle-Income Countries. Health Policy Plus. 2020.
101.
go back to reference Global Financing Facility. Preserve essential health services during the COVID-19 pandemic—Somalia. 2020. Global Financing Facility. Preserve essential health services during the COVID-19 pandemic—Somalia. 2020.
102.
go back to reference Global Financing Facility. Preserver les Services de Sante Essentiels Pendant la Pandemie de COVID-19—Republique Centrafricane. 2020. Global Financing Facility. Preserver les Services de Sante Essentiels Pendant la Pandemie de COVID-19—Republique Centrafricane. 2020.
103.
go back to reference UN Country Office Syria. COVID-19 Socio-Economic Impact Assessment. 2020. UN Country Office Syria. COVID-19 Socio-Economic Impact Assessment. 2020.
104.
go back to reference Global Financing Facility. preserve essential health services during the COVID-19 Pandemic—Nigeria. 2020. Global Financing Facility. preserve essential health services during the COVID-19 Pandemic—Nigeria. 2020.
105.
go back to reference Edwards J. Protect a Generation. The impact of COVID-19 on children’s lives. 2020. Edwards J. Protect a Generation. The impact of COVID-19 on children’s lives. 2020.
106.
go back to reference CARE. Girl-driven change. Meeting the needs of adolescent girls during COVID-19 and beyond. 2020. CARE. Girl-driven change. Meeting the needs of adolescent girls during COVID-19 and beyond. 2020.
107.
go back to reference Khorsandi P. World Food Programme warns of worsening famine in Yemen. World Food Program. 2021. Khorsandi P. World Food Programme warns of worsening famine in Yemen. World Food Program. 2021.
108.
go back to reference Richards K, Abdi M, Stephenson H, Northcote C, Mathieson K. Nutrition critical: why we must act now to tackle child malnutrition. London; 2020. Richards K, Abdi M, Stephenson H, Northcote C, Mathieson K. Nutrition critical: why we must act now to tackle child malnutrition. London; 2020.
109.
go back to reference McKernan B. Yemen: in a country stalked by disease, Covid barely registers. The Guardian. 2020. McKernan B. Yemen: in a country stalked by disease, Covid barely registers. The Guardian. 2020.
110.
go back to reference Al Hosse M, Edwards M. Inside the childhood hunger ‘emergency’ in Syria’a Idlib. The New Humanitarian. 2020. Al Hosse M, Edwards M. Inside the childhood hunger ‘emergency’ in Syria’a Idlib. The New Humanitarian. 2020.
111.
go back to reference Penn-Kekana L. COVID-19 and MNCH: beyond the models, what are we hearing from countries? 2020. Penn-Kekana L. COVID-19 and MNCH: beyond the models, what are we hearing from countries? 2020.
112.
go back to reference Global Financing facility. Preserver les Services de Sante Essentiels Pendant la Pandemie de COVID-19 - Republique Democratique du Congo. 2020. Global Financing facility. Preserver les Services de Sante Essentiels Pendant la Pandemie de COVID-19 - Republique Democratique du Congo. 2020.
113.
go back to reference Ramoni R. How COVID-19 is affecting antenatal care. Daily Trust. 2020. Ramoni R. How COVID-19 is affecting antenatal care. Daily Trust. 2020.
114.
go back to reference World Vision. A double-edged sword. Protection risks facing Venezuelan children during the COVID-19 Pandemic. 2020. World Vision. A double-edged sword. Protection risks facing Venezuelan children during the COVID-19 Pandemic. 2020.
115.
go back to reference Laouan FZ. Rapid Gender Analysis COVID-19. West Africa-April 2020. 2020. Laouan FZ. Rapid Gender Analysis COVID-19. West Africa-April 2020. 2020.
116.
go back to reference Save the Children. Impact of Covid19 Outbreak on women and children: save the Children Somalia Multi Sector Study. 2020. Save the Children. Impact of Covid19 Outbreak on women and children: save the Children Somalia Multi Sector Study. 2020.
117.
go back to reference Janvrin A, McKay G. READY: global readiness for major disease outbreak response. Maternal, Newborn, and reproductive health and COVID-19: adaptations, successes, challenges, and next steps. An expert consultation. 2020. Janvrin A, McKay G. READY: global readiness for major disease outbreak response. Maternal, Newborn, and reproductive health and COVID-19: adaptations, successes, challenges, and next steps. An expert consultation. 2020.
118.
go back to reference Social Sciences Analytics Cell (CASS). The impacts of the COVID-19 outbreak response on women and girls in the Democratic Republic of the Congo. 2020. Social Sciences Analytics Cell (CASS). The impacts of the COVID-19 outbreak response on women and girls in the Democratic Republic of the Congo. 2020.
119.
go back to reference West K. Collateral impacts of COVID-19 on non-COVID health—an update. 2020. West K. Collateral impacts of COVID-19 on non-COVID health—an update. 2020.
120.
go back to reference Ameh CA, Banke-Thomas AA, Balogun M, Makwe CC, Afolabi B. Reproductive maternal and Newborn Health providers assessment of facility preparedness and its Determinants during the COVID-19 pandemic in Lagos, Nigeria. 2020. Ameh CA, Banke-Thomas AA, Balogun M, Makwe CC, Afolabi B. Reproductive maternal and Newborn Health providers assessment of facility preparedness and its Determinants during the COVID-19 pandemic in Lagos, Nigeria. 2020.
121.
go back to reference The Global Fund. Mitigating the impact of COVID-19 on countries affected by HIV, tuberculosis and malaria. Geneva; 2020. The Global Fund. Mitigating the impact of COVID-19 on countries affected by HIV, tuberculosis and malaria. Geneva; 2020.
122.
go back to reference Martinez M, Akbar IE, Wadood MZ, Shukla H, Jorba J, Ehrhardt D. Progress toward poliomyelitis eradication—Afghanistan, January 2019–July 2020. MMWR Morb Mortal Wkly Rep. 2020;69(40):1464–8.PubMedPubMedCentralCrossRef Martinez M, Akbar IE, Wadood MZ, Shukla H, Jorba J, Ehrhardt D. Progress toward poliomyelitis eradication—Afghanistan, January 2019–July 2020. MMWR Morb Mortal Wkly Rep. 2020;69(40):1464–8.PubMedPubMedCentralCrossRef
124.
go back to reference Jones SA, Gopalakrishnan S, Ameh CA, White S, Van Den Broek NR. ‘Women and babies are dying but not of Ebola’: the effect of the Ebola virus epidemic on the availability, uptake and outcomes of maternal and newborn health services in Sierra Leone. BMJ Glob Health. 2016;1(3):e000065.PubMedPubMedCentralCrossRef Jones SA, Gopalakrishnan S, Ameh CA, White S, Van Den Broek NR. ‘Women and babies are dying but not of Ebola’: the effect of the Ebola virus epidemic on the availability, uptake and outcomes of maternal and newborn health services in Sierra Leone. BMJ Glob Health. 2016;1(3):e000065.PubMedPubMedCentralCrossRef
126.
go back to reference Martineau T, Woodward A, Sheahan K, Sondorp E. Health systems research in fragile and conflict affected states: a qualitative study of associated challenges. Health Res Policy Syst. 2017;15(1):1–12. Martineau T, Woodward A, Sheahan K, Sondorp E. Health systems research in fragile and conflict affected states: a qualitative study of associated challenges. Health Res Policy Syst. 2017;15(1):1–12.
127.
go back to reference Singh NS, Lokot M, Undie C-C, Onyango MA, Morgan R, Harmer A, et al. Research in forced displacement: guidance for a feminist and decolonial approach. Lancet. 2021;397:560–2.PubMedCrossRef Singh NS, Lokot M, Undie C-C, Onyango MA, Morgan R, Harmer A, et al. Research in forced displacement: guidance for a feminist and decolonial approach. Lancet. 2021;397:560–2.PubMedCrossRef
Metadata
Title
A mixed methods study to assess the impact of COVID-19 on maternal, newborn, child health and nutrition in fragile and conflict-affected settings
Authors
Mariana Rodo
Lucy Singh
Neal Russell
Neha S. Singh
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Conflict and Health / Issue 1/2022
Electronic ISSN: 1752-1505
DOI
https://doi.org/10.1186/s13031-022-00465-x

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