TY - JOUR
T1 - Impact of COVID-19 on the utilisation of maternal health services in Bangladesh
T2 - A division-level analysis
AU - Hossain, Aniqa Tasnim
AU - Akter, Ema
AU - Manna, Ridwana Maher
AU - Ara, Tasnu
AU - Hossain, Md Alamgir
AU - Tanvir, K. M.
AU - Rahman, Md Hafizur
AU - Sayeed, Abu
AU - Siddique, Abu Bakkar
AU - Ahamed, Bibek
AU - Haider, M. Sabbir
AU - Jabeen, Sabrina
AU - Ameen, Shafiqul
AU - Shomik, Mohammad Sohel
AU - Ahmed, Anisuddin
AU - Huicho, Luis
AU - Matijasevich, Alicia
AU - Maiga, Abdoulaye
AU - Rahman, Ahmed Ehsanur
AU - Akseer, Nadia
AU - El Arifeen, Shams
AU - Amouzou, Agbessi
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024
Y1 - 2024
N2 - Background The coronavirus disease 2019 (COVID-19) pandemic had substantially disrupted maternal health care provision and utilisation in Bangladesh. However, the extent of geographical disparities in service utilisation and how the health system withstood these challenges have not been studied. This study explores the divisional disparities in trends and disruptions in maternal health service utilisation caused by the COVID-19 pandemic. Methods Data was extracted from the District Health Information Software of Bangladesh from January 2017 to December 2021. We assessed the trend of first antenatal care visit, institutional delivery and number of caesarean sections over these years. We explored both the yearly and monthly trends to see the variations in the number of utilisations. Segmented regression with Poisson distribution was used to assess changes in service utilisation during the COVID-19 period. We reported incidence rate ratio (IRR) of service utilisation with a 95% confidence interval (CI) in different divisions during COVID-19 (2020–2021) compared to the reference period (2017–2019). Results Initially, a notable decline in maternal health care utilisation was observed in 2020 compared to the pre-pandemic period of 2017–2019. Divisional disparities were observed in this trend. Overall, compared to the pre-pandemic period, we observed around 30% decline in all three selected indicators of maternal health care. The lowest value was observed in Chattogram in 2020 (IRR = 0.66; 95% CI = 0.55–0.79) and Rajshahi in 2021 (IRR = 0.71; 95% CI = 0.60–0.82). For institutional delivery, Barishal division had the lowest IRR (0.64; 95% CI=0.60–0.68) in 2020 and, in 2021 Rajshahi had the lowest IRR (0.71; 95% CI = 0.60–0.82). For caesarean section, the lowest value was observed in Barishal division (IRR = 0.48; 95% CI = 0.44–0.53) in 2020 and in Mymensingh (IRR=0.37; 95% CI=0.32–0.43) in 2021. By 2021, the three maternal health care utilisation indicators demonstrated recovery.
AB - Background The coronavirus disease 2019 (COVID-19) pandemic had substantially disrupted maternal health care provision and utilisation in Bangladesh. However, the extent of geographical disparities in service utilisation and how the health system withstood these challenges have not been studied. This study explores the divisional disparities in trends and disruptions in maternal health service utilisation caused by the COVID-19 pandemic. Methods Data was extracted from the District Health Information Software of Bangladesh from January 2017 to December 2021. We assessed the trend of first antenatal care visit, institutional delivery and number of caesarean sections over these years. We explored both the yearly and monthly trends to see the variations in the number of utilisations. Segmented regression with Poisson distribution was used to assess changes in service utilisation during the COVID-19 period. We reported incidence rate ratio (IRR) of service utilisation with a 95% confidence interval (CI) in different divisions during COVID-19 (2020–2021) compared to the reference period (2017–2019). Results Initially, a notable decline in maternal health care utilisation was observed in 2020 compared to the pre-pandemic period of 2017–2019. Divisional disparities were observed in this trend. Overall, compared to the pre-pandemic period, we observed around 30% decline in all three selected indicators of maternal health care. The lowest value was observed in Chattogram in 2020 (IRR = 0.66; 95% CI = 0.55–0.79) and Rajshahi in 2021 (IRR = 0.71; 95% CI = 0.60–0.82). For institutional delivery, Barishal division had the lowest IRR (0.64; 95% CI=0.60–0.68) in 2020 and, in 2021 Rajshahi had the lowest IRR (0.71; 95% CI = 0.60–0.82). For caesarean section, the lowest value was observed in Barishal division (IRR = 0.48; 95% CI = 0.44–0.53) in 2020 and in Mymensingh (IRR=0.37; 95% CI=0.32–0.43) in 2021. By 2021, the three maternal health care utilisation indicators demonstrated recovery.
UR - http://www.scopus.com/inward/record.url?scp=85210464438&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85210464438&partnerID=8YFLogxK
U2 - 10.7189/JOGH.14.05040
DO - 10.7189/JOGH.14.05040
M3 - Article
C2 - 39575613
AN - SCOPUS:85210464438
SN - 2047-2978
VL - 14
JO - Journal of global health
JF - Journal of global health
M1 - 05040
ER -