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Cited by 9Global Maternal and Child HealthCOVID-19 Impact on ReproductionCOVID-19 and healthcare impacts

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Impact of COVID-19 on the utilisation of maternal health services in Bangladesh: A division-level analysis

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Hossain, Aniqa Tasnim, Akter, Ema, Manna, Ridwana Maher, Ara, Tasnu, Hossain, Md. Alamgir, Tanvir, KM, Rahman, Md Hafizur, Sayeed, Abu, Siddique, Abu Bakkar, Ahamed, Bibek, Haider, M Sabbir, Jabeen, Sabrina, Ameen, Shafiqul, Shomik, Mohammad Sohel, Ahmed, Anisuddin, Huicho, Luis, Matijasevich, Alicia, Maiga, Abdoulaye, Rahman, Ahmed Ehsanur, Akseer, Nadia, El Arifeen, Shams, Amouzou, Agbessi·2024·Journal of Global Health
DOI 10.7189/jogh.14.05040PMC PMC11583111
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Abstract

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. Conclusions: The effect of the pandemic, including lockdown, on the selected maternal service utilisation was observed in Bangladesh though there were substantial geographic disparities. These disruptions slightly recovered after the initial shock. These results will support the government in preparing the national and regional health systems for future epidemics in Bangladesh.

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Metadata

Authors
Hossain, A. T., Akter, E., Manna, R. M., Ara, T., Hossain, M. A., Tanvir, K., Rahman, M. H., Sayeed, A., Siddique, A. B., Ahamed, B., Haider, M. S., Jabeen, S., Ameen, S., Shomik, M. S., Ahmed, A., Huicho, L., Matijasevich, A., Maiga, A., Rahman, A. E., Akseer, N., El Arifeen, S., & Amouzou, A.
Affiliations
  • International Centre for Diarrhoeal Disease Research (BD)
  • University of Dhaka (BD)
  • Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
  • Institute of Epidemiology, Disease Control and Research (BD)
  • Universidad Peruana Cayetano Heredia (PE)
  • Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
  • Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  • Johns Hopkins University (US)
ORCID
Venue
Journal of Global Health
Publisher
International Society of Global Health
Published
2024-11-22
Volume
14
Pages
05040-05040
ISSN
  • 2047-2978 (ISSN-L)
  • 2047-2986
DOI
10.7189/jogh.14.05040
PMC
PMC11583111
OpenAlex
W4404615318
Cited by
9
References
0
Citations by year
2026: 3 · 2025: 6
FWCI
6.09
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Global Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • Bill and Melinda Gates Foundation (INV-001299)
  • UNICEF
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Obstetrics and Gynecology › COVID-19 Impact on Reproduction
  • Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
Keywords
COVID-19 pandemic, maternal health service utilization, prenatal care, institutional delivery, cesarean section, health system disruption, Bangladesh, Chittagong, Rajshahi, Barishal, Mymensingh, district-level health data
MeSH terms
Data Analysis, COVID-19, SARS-CoV-2, Adult, Bangladesh, Cesarean Section, Female, Humans, Maternal Health Services, Patient Acceptance of Health Care, Pregnancy, Prenatal Care, Quarantine, Regression Analysis, Confidence Intervals, Poisson Distribution, Parturition, Healthcare Disparities

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