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  1. Article ; Online: Can machine learning models predict maternal and newborn healthcare providers' perception of safety during the COVID-19 pandemic? A cross-sectional study of a global online survey.

    Hammoud, Bassel / Semaan, Aline / Elhajj, Imad / Benova, Lenka

    Human resources for health

    2022  Volume 20, Issue 1, Page(s) 63

    Abstract: Background: Maternal and newborn healthcare providers are essential professional groups vulnerable to physical and psychological risks associated with the COVID-19 pandemic. This study uses machine learning algorithms to create a predictive tool for ... ...

    Abstract Background: Maternal and newborn healthcare providers are essential professional groups vulnerable to physical and psychological risks associated with the COVID-19 pandemic. This study uses machine learning algorithms to create a predictive tool for maternal and newborn healthcare providers' perception of being safe in the workplace globally during the pandemic.
    Methods: We used data collected between 24 March and 5 July 2020 through a global online survey of maternal and newborn healthcare providers. The questionnaire was available in 12 languages. To predict healthcare providers' perception of safety in the workplace, we used features collected in the questionnaire, in addition to publicly available national economic and COVID-19-related factors. We built, trained and tested five machine learning models: Support Vector Machine (SVM), Random Forest (RF), XGBoost, CatBoost and Artificial Neural Network (ANN) for classification and regression. We extracted from RF models the relative contribution of features in output prediction.
    Results: Models included data from 941 maternal and newborn healthcare providers from 89 countries. ML models performed well in classification and regression tasks, whereby RF had 82% cross-validated accuracy for classification, and CatBoost with 0.46 cross-validated root mean square error for regression. In both classification and regression, the most important features contributing to output prediction were classified as three themes: (1) information accessibility, clarity and quality; (2) availability of support and means of protection; and (3) COVID-19 epidemiology.
    Conclusion: This study identified salient features contributing to maternal and newborn healthcare providers perception of safety in the workplace. The developed tool can be used by health systems globally to allow real-time learning from data collected during a health system shock. By responding in real-time to the needs of healthcare providers, health systems could prevent potential negative consequences on the quality of care offered to women and newborns.
    MeSH term(s) COVID-19/epidemiology ; Cross-Sectional Studies ; Female ; Health Personnel ; Humans ; Infant, Newborn ; Machine Learning ; Pandemics ; Perception ; Surveys and Questionnaires
    Language English
    Publishing date 2022-08-19
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2126923-3
    ISSN 1478-4491 ; 1478-4491
    ISSN (online) 1478-4491
    ISSN 1478-4491
    DOI 10.1186/s12960-022-00758-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Telehealth use in antenatal care? Not without women's voices.

    Galle, Anna / Semaan, Aline / Asefa, Anteneh / Benova, Lenka

    Lancet (London, England)

    2021  Volume 398, Issue 10309, Page(s) 1405–1406

    MeSH term(s) Female ; Humans ; Pregnancy ; Prenatal Care ; Telemedicine ; Voice
    Language English
    Publishing date 2021-10-12
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(21)01956-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Utilisation of services along the continuum of maternal healthcare during the COVID-19 pandemic in Lubumbashi, DRC: findings from a cross-sectional household survey of women.

    Galle, Anna / Kavira, Gladys / Semaan, Aline / Malonga Kaj, Françoise / Benova, Lenka / Ntambue, Abel

    BMJ open

    2023  Volume 13, Issue 6, Page(s) e069409

    Abstract: Objectives: The continuum of maternal care along antenatal (ANC), intrapartum and postnatal care (PNC) is fundamental for protecting women's and newborns' health. The COVID-19 pandemic interrupted the provision and use of these essential services ... ...

    Abstract Objectives: The continuum of maternal care along antenatal (ANC), intrapartum and postnatal care (PNC) is fundamental for protecting women's and newborns' health. The COVID-19 pandemic interrupted the provision and use of these essential services globally. This study examines maternal healthcare utilisation along the continuum during the COVID-19 pandemic in the Democratic Republic of the Congo (DRC).
    Design: This is a cross-sectional study using data collected on a survey of 599 households in Lubumbashi, DRC, using stratified random sampling.
    Participants: We included 604 women (15-49 years) who were pregnant between March 2020 and May 2021.
    Outcome measures: A structured interview involved questions on sociodemographic characteristics, attitudes regarding COVID-19 and maternal service use and cost. Complete continuum of care was defined as receiving ANC 4+ consultations, skilled birth attendance and at least one PNC check for both mother and newborn. Data were analysed in SPSS using descriptive statistics and multivariable logistic regression.
    Results: One-third (36%) of women who gave birth during the COVID-19 pandemic completed the continuum of maternal healthcare. Factors significantly associated with completing the continuum included higher education (aOR=2.6; p<0.001) and positive attitude towards the COVID-19 vaccination (aOR=1.9; p=0.04). Reasons for not seeking maternal care included lack of money and avoiding COVID-19 vaccination.
    Conclusion: During the COVID-19 pandemic, maternal healthcare seeking behaviours were shaped by vaccine hesitancy and care unaffordability in Lubumbashi. Addressing the high cost of maternal healthcare and vaccine hesitancy appear essential to improve access to maternal healthcare.
    MeSH term(s) Female ; Pregnancy ; Infant, Newborn ; Humans ; Cross-Sectional Studies ; Democratic Republic of the Congo/epidemiology ; COVID-19 Vaccines ; Pandemics ; COVID-19/epidemiology ; Maternal Health Services ; Delivery of Health Care ; Patient Acceptance of Health Care ; Prenatal Care
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2023-06-26
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2022-069409
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Stress and safety of maternal and newborn healthcare workers early in the COVID-19 pandemic: a repeat cross-sectional analysis from a global online survey from March 2020 to March 2021.

    Ezema, Ashley / Caputo, Matthew / Semaan, Aline / Benova, Lenka / Liang, Shu-Ting / Hirschhorn, Lisa R

    BMJ open

    2023  Volume 13, Issue 8, Page(s) e072155

    Abstract: Objectives: This study aims to characterise the physical and psychological well-being of maternal and newborn healthcare workers (MNHCWs) during the COVID-19 pandemic.: Design: Observational repeated cross-sectional study.: Setting: An online ... ...

    Abstract Objectives: This study aims to characterise the physical and psychological well-being of maternal and newborn healthcare workers (MNHCWs) during the COVID-19 pandemic.
    Design: Observational repeated cross-sectional study.
    Setting: An online questionnaire was distributed to MNHCWs around the globe in three separate rounds from March 2020 to March 2021.
    Participants: Total samples of N=1357 (round 1) and N=420 (round 3) primarily consisted of doctors, midwives and nurses in maternal and newborn specialties. Samples represented all WHO regions, with 33% (round 1) and 42% (round 3) from low- or middle-income countries (LMICs).
    Primary and secondary outcome measures: Responses from rounds 1 (March-June 2020) and 3 (December 2020-March 2021) were analysed to measure self-reported levels of relative stress and workplace protection from COVID-19, while associated factors were determined through multivariable ordinal logistic regression.
    Results: In round 1, 90% of MNHCWs reported increased stress levels and 45% reported insufficient personal protective equipment (PPE) access. Nurses and physicians were less likely to report increased stress than midwives at the pandemic onset. Factors associated with increased stress included being female, being from an LMIC and insufficient PPE. In round 3, 75% reported similar or increased stress while 10% reported insufficient PPE. In both rounds, over 50% of MNHCWs felt relatively or completely unprotected from COVID-19 in the workplace. Those from LMICs were more likely to report feeling unprotected, while receiving organisational information that valued safety was associated with better feelings of protection in the workplace.
    Conclusions: Among our international sample of MNHCWs, we observed high rates of self-reported stress increase at the start of the pandemic with persistence or increase up to a year later. High rates of feeling unprotected persisted even as PPE became more available. These results may inform interventions needed to support and protect MNHCWs during this and future pandemics.
    MeSH term(s) Infant, Newborn ; Humans ; Female ; Male ; COVID-19/epidemiology ; COVID-19/prevention & control ; Cross-Sectional Studies ; Pandemics ; Self Report ; Physicians
    Language English
    Publishing date 2023-08-28
    Publishing country England
    Document type Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2023-072155
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Maternal and newborn healthcare providers' work-related experiences during the COVID-19 pandemic, and their physical, psychological, and economic impacts: Findings from a global online survey.

    Kolié, Delphin / Semaan, Aline / Day, Louise-Tina / Delvaux, Thérèse / Delamou, Alexandre / Benova, Lenka

    PLOS global public health

    2022  Volume 2, Issue 8, Page(s) e0000602

    Abstract: The COVID-19 pandemic continues to have substantial impacts on health systems globally. This study describes experiences during the COVID-19 pandemic, and physical, psychological and economic impacts among maternal and newborn healthcare providers. We ... ...

    Abstract The COVID-19 pandemic continues to have substantial impacts on health systems globally. This study describes experiences during the COVID-19 pandemic, and physical, psychological and economic impacts among maternal and newborn healthcare providers. We conducted a global online cross-sectional survey of maternal and newborn healthcare providers. Data collected between July and December 2020 included demographic characteristics, work-related experiences, and physical, psychological, and economic impacts of COVID-19. Descriptive statistics of quantitative data and content analysis of qualitative data were conducted. Findings were disaggregated by country income-level. We analysed responses from 1,191 maternal and newborn healthcare providers from 77 countries: middle-income 66%, high-income 27%, and low-income 7%. Most common cadres were nurses (31%), midwives/nurse-midwives (25%), and obstetricians/gynaecologists (21%). Quantitative and qualitative findings showed that 28% of respondents reported decreased workplace staffing levels following changes in staff-rotation (53%) and staff self-isolating after exposure to SARS-CoV-2 (35%); this led to spending less time with patients, possibly compromising care quality. Reported insufficient access to personal protective equipment (PPE) ranged from 12% for gloves to 32% for N-95 masks. Nonetheless, wearing PPE was tiresome, time-consuming, and presented potential communication barriers with patients. 58% of respondents reported higher stress levels, mainly related to lack of access to information or to rapidly changing guidelines. Respondents noted a negative financial impact-a decrease in income (70% among respondents from low-income countries) concurrently with increased personal expenditures (medical supplies, transportation, and PPE). Negative physical, psychological and economic impacts of COVID-19 on maternal and newborn healthcare providers were ongoing throughout 2020, especially in low-income countries. This can have severe consequences for provision and quality of essential care. There is need to increase focus on the implementation of interventions aiming to support healthcare providers, particularly those in low- and middle-income countries to protect essential health services from disruption.
    Language English
    Publishing date 2022-08-05
    Publishing country United States
    Document type Journal Article
    ISSN 2767-3375
    ISSN (online) 2767-3375
    DOI 10.1371/journal.pgph.0000602
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Facilitators and barriers of implementation of routine postnatal care guidelines for women: A systematic scoping review using critical interpretive synthesis.

    Beňová, Lenka / Semaan, Aline / Portela, Anayda / Bonet, Mercedes / van den Akker, Thomas / Pembe, Andrea B / Moran, Allisyn / Duclos, Diane

    Journal of global health

    2023  Volume 13, Page(s) 4176

    Abstract: Background: Postnatal care (PNC) has the potential to prevent a substantial burden of maternal and newborn morbidity and mortality. This scoping review aimed to identify and synthesise themes related to facilitators and barriers of implementation of ... ...

    Abstract Background: Postnatal care (PNC) has the potential to prevent a substantial burden of maternal and newborn morbidity and mortality. This scoping review aimed to identify and synthesise themes related to facilitators and barriers of implementation of guidelines on routine PNC for women (postpartum care) in all settings.
    Methods: This is a scoping review guided by the standard principles of Arksey & O'Malley's framework. We used the critical interpretive synthesis method to synthesise the whole body of evidence. We searched four databases (Medline, Embase, Global Health, CINAHL Plus) using a combination of search terms comprising four key concepts: postnatal care, routine care, guidelines and implementation. No restrictions on country or language of publication were applied. We excluded studies not presenting findings about PNC for women. We thematically charted the themes of studies included based on title and abstract screening. All studies included after full text screening were described and their results synthesised using the socio-ecological model framework. We did not conduct a risk of bias analysis or quality assessment of included studies.
    Results: We identified a total of 8692 unique records and included 43 studies which identified facilitators and barriers to implementing routine guidelines in provision of PNC to women. Three quarters of studies pertained to PNC provision in high-income countries. Specific facilitators and barriers were identified and thematically presented based on whether they affect the provision of PNC or the intersection between provision of PNC and its use by women and families. We applied a critical global health lens to synthesise three constructs in the literature: finding a balance between standardisation and individualisation of PNC, the fragmented PNC provision landscape complicating the experiences of women with intersecting vulnerabilities, and the heavy reliance on the short postpartum period as an opportunity to educate and retain women and newborns in the health system.
    Conclusions: This interpretive synthesis of evidence shows that the fragmented and narrow nature of PNC provision presents specific challenges to developing, adapting and implementing routine PNC guidelines. This results in a lack of linkages to social support and services, fails to address intersecting vulnerabilities and inequities among women, and negatively influences care seeking. There is a lack of evidence on how processes of individualising PNC provision can be applied in practice to support health workers in providing woman-centered PNC in various global settings.
    Registration: https://www.protocols.io/private/C99DA688881F11EBB4690A58A9FEAC02.
    MeSH term(s) Pregnancy ; Female ; Humans ; Infant, Newborn ; Postnatal Care ; Postpartum Period ; Patient Acceptance of Health Care ; Health Personnel ; Social Support
    Language English
    Publishing date 2023-11-24
    Publishing country Scotland
    Document type Systematic Review ; Journal Article
    ZDB-ID 2741629-X
    ISSN 2047-2986 ; 2047-2986
    ISSN (online) 2047-2986
    ISSN 2047-2986
    DOI 10.7189/jogh.13.04176
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Neonatal and perinatal mortality in the urban continuum: a geospatial analysis of the household survey, satellite imagery and travel time data in Tanzania.

    Macharia, Peter M / Beňová, Lenka / Pinchoff, Jessie / Semaan, Aline / Pembe, Andrea B / Christou, Aliki / Hanson, Claudia

    BMJ global health

    2023  Volume 8, Issue 4

    Abstract: Introduction: Recent studies suggest that the urban advantage of lower neonatal mortality in urban compared with rural areas may be reversing, but methodological challenges include misclassification of neonatal deaths and stillbirths, and ... ...

    Abstract Introduction: Recent studies suggest that the urban advantage of lower neonatal mortality in urban compared with rural areas may be reversing, but methodological challenges include misclassification of neonatal deaths and stillbirths, and oversimplification of the variation in urban environments. We address these challenges and assess the association between urban residence and neonatal/perinatal mortality in Tanzania.
    Methods: The Tanzania Demographic and Health Survey (DHS) 2015-2016 was used to assess birth outcomes for 8915 pregnancies among 6156 women of reproductive age, by urban or rural categorisation in the DHS and based on satellite imagery. The coordinates of 527 DHS clusters were spatially overlaid with the 2015 Global Human Settlement Layer, showing the degree of urbanisation based on built environment and population density. A three-category urbanicity measure (core urban, semi-urban and rural) was defined and compared with the binary DHS measure. Travel time to the nearest hospital was modelled using least-cost path algorithm for each cluster. Bivariate and multilevel multivariable logistic regression models were constructed to explore associations between urbanicity and neonatal/perinatal deaths.
    Results: Both neonatal and perinatal mortality rates were highest in core urban and lowest in rural clusters. Bivariate models showed higher odds of neonatal death (OR=1.85; 95% CI 1.12 to 3.08) and perinatal death (OR=1.60; 95% CI 1.12 to 2.30) in core urban compared with rural clusters. In multivariable models, these associations had the same direction and size, but were no longer statistically significant. Travel time to the nearest hospital was not associated with neonatal or perinatal mortality.
    Conclusion: Addressing high rates of neonatal and perinatal mortality in densely populated urban areas is critical for Tanzania to meet national and global reduction targets. Urban populations are diverse, and certain neighbourhoods or subgroups may be disproportionately affected by poor birth outcomes. Research must capture, understand and minimise risks specific to urban settings.
    MeSH term(s) Pregnancy ; Infant, Newborn ; Female ; Humans ; Perinatal Mortality ; Perinatal Death ; Tanzania/epidemiology ; Satellite Imagery ; Infant Mortality
    Language English
    Publishing date 2023-04-06
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2059-7908
    ISSN 2059-7908
    DOI 10.1136/bmjgh-2022-011253
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Perspectives and experiences of healthcare providers on the response to the COVID-19 pandemic in three maternal and neonatal referral hospitals in Guinea in 2020: a qualitative study.

    Dioubaté, Nafissatou / Diallo, Mamadou Cellou / Maomou, Cécé / Niane, Harissatou / Millimouno, Tamba Mina / Camara, Bienvenu Salim / Sy, Telly / Diallo, Ibrahima Sory / Semaan, Aline / Delvaux, Thérèse / Beňová, Lenka / Béavogui, Abdoul Habib / Delamou, Alexandre

    BMC health services research

    2024  Volume 24, Issue 1, Page(s) 226

    Abstract: Background: The COVID-19 pandemic has adversely affected access to essential healthcare services. This study aimed to explore healthcare providers' perceptions and experiences of the response to the COVID-19 pandemic in three referral maternal and ... ...

    Abstract Background: The COVID-19 pandemic has adversely affected access to essential healthcare services. This study aimed to explore healthcare providers' perceptions and experiences of the response to the COVID-19 pandemic in three referral maternal and neonatal hospitals in Guinea.
    Methods: We conducted a longitudinal qualitative study between June and December 2020 in two maternities and one neonatology referral ward in Conakry and Mamou. Participants were purposively recruited to capture diversity of professional cadres, seniority, and gender. Four rounds of in-depth interviews (46 in-depth interviews with 18 respondents) were conducted in each study site, using a semi-structured interview guide that was iteratively adapted. We used both deductive and inductive approaches and an iterative process for content analysis.
    Results: We identified four themes and related sub-themes presented according to whether they were common or specific to the study sites, namely: 1) coping strategies & care reorganization, which include reducing staffing levels, maintaining essential healthcare services, suspension of staff daily meetings, insertion of a new information system for providers, and co-management with COVID-19 treatment center for caesarean section cases among women who tested positive for COVID-19; 2) healthcare providers' behavior adaptations during the response, including infection prevention and control measures on the wards and how COVID-19-related information influenced providers' daily work; 3) difficulties encountered by providers, in particular unavailability of personal protective equipment (PPE), lack of financial motivation, and difficulties reducing crowding in the wards; 4) providers perceptions of healthcare service use, for instance their fear during COVID-19 response and perceived increase in severity of complications received and COVID-19 cases among providers and parents of newborns.
    Conclusion: This study provides insights needed to be considered to improve the preparedness and response of healthcare facilities and care providers to future health emergencies in similar contexts.
    MeSH term(s) Humans ; Female ; Pregnancy ; Infant, Newborn ; Cesarean Section ; COVID-19/epidemiology ; Guinea/epidemiology ; Pandemics ; COVID-19 Drug Treatment ; Health Personnel ; Qualitative Research ; Hospitals ; Referral and Consultation
    Language English
    Publishing date 2024-02-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-024-10670-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Urban school neighbourhoods dominated by unhealthy food retailers and advertisements in Greater Tunis: a geospatial study in the midst of the nutrition transition.

    Akl, Christelle / El-Helou, Nehmat / Safadi, Gloria / Semaan, Aline / El Sammak, Aya / Trabelsi, Tarek / Sassi, Sonia / Akik, Chaza / El Ati, Jalila / Traissac, Pierre / Ghattas, Hala

    Public health nutrition

    2024  Volume 27, Issue 1, Page(s) e44

    Abstract: Objective: Food environments are a major determinant of children's nutritional status. Scarce evidence on food environments exists in low- and middle-income countries (LMIC). This study aims to fill this gap by documenting the obesogenicity of food ... ...

    Abstract Objective: Food environments are a major determinant of children's nutritional status. Scarce evidence on food environments exists in low- and middle-income countries (LMIC). This study aims to fill this gap by documenting the obesogenicity of food environments around schools in Greater Tunis, Tunisia - an LMIC of the Middle East and North Africa region with an ongoing nutrition transition and increasing rates of childhood obesity.
    Design: In this cross-sectional study, we assessed built food environments around fifty primary schools. Ground-truthing was performed to collect geographic coordinates and pictures of food retailers and food advertisement sets within an 800-m road network buffer of each school. Retailers and advertisement sets were categorised as healthy or unhealthy according to a NOVA-based classification. Associations between school characteristics and retailers or advertisement sets were explored using multinomial regression models.
    Setting: Greater Tunis, Tunisia.
    Participants: Random sample of fifty (thirty-five public and fifteen private) primary schools.
    Results: Overall, 3621 food retailers and 2098 advertisement sets were mapped. About two-thirds of retailers and advertisement sets were labelled as unhealthy. Most retailers were traditional corner stores (22 %) and only 6 % were fruit and vegetable markets. The prevailing food group promoted was carbonated and sugar-sweetened beverages (22 %). The proportion of unhealthy retailers was significantly higher in the richest
    Conclusions: School neighbourhood food environments included predominantly unhealthy retailers and advertisements. Mapping of LMIC food environments is crucial to document the impact of the nutrition transition on children's nutritional status. This will inform policies and interventions to curb the emergent childhood obesity epidemic.
    MeSH term(s) Humans ; Child ; Pediatric Obesity/epidemiology ; Pediatric Obesity/etiology ; Pediatric Obesity/prevention & control ; Advertising ; Nutritional Status ; Cross-Sectional Studies ; Schools ; Fruit
    Language English
    Publishing date 2024-01-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 1436024-x
    ISSN 1475-2727 ; 1368-9800
    ISSN (online) 1475-2727
    ISSN 1368-9800
    DOI 10.1017/S1368980023002860
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: "Separated during the first hours"-Postnatal care for women and newborns during the COVID-19 pandemic: A mixed-methods cross-sectional study from a global online survey of maternal and newborn healthcare providers.

    Semaan, Aline / Dey, Teesta / Kikula, Amani / Asefa, Anteneh / Delvaux, Thérèse / Langlois, Etienne V / van den Akker, Thomas / Benova, Lenka

    PLOS global public health

    2022  Volume 2, Issue 4, Page(s) e0000214

    Abstract: Routine postnatal care (PNC) allows monitoring, early detection and management of complications, and counselling to ensure immediate and long-term wellbeing of mothers and newborns; yet effective coverage is sub-optimal globally. The COVID-19 pandemic ... ...

    Abstract Routine postnatal care (PNC) allows monitoring, early detection and management of complications, and counselling to ensure immediate and long-term wellbeing of mothers and newborns; yet effective coverage is sub-optimal globally. The COVID-19 pandemic disrupted availability and quality of maternal and newborn care despite established guidelines promoting continuity of essential services. We conducted a cross-sectional global online survey of 424 maternal and newborn healthcare providers from 61 countries, to explore PNC provision, availability, content and quality following the early phase of the COVID-19 pandemic. The questionnaire (11 languages), included four multiple-choice and four open-text questions on changes to PNC during the pandemic. Quantitative and qualitative responses received between July and December 2020 were analysed separately and integrated during reporting. Tightened rules for visiting postpartum women were reported in health facilities, ranging from shorter visiting hours to banning supportive companions and visitors. A quarter (26%) of respondents reported that mothers suspected/confirmed with COVID-19 were routinely separated from their newborns. Early initiation of breastfeeding was delayed due to waiting for maternal SARS-CoV-2 test results. Reduced provision of breastfeeding support was reported by 40% of respondents in high-income countries and 7% in low-income countries. Almost 60% reported that women were discharged earlier than usual and 27% perceived a reduction in attendance to outpatient PNC. Telemedicine and home visits were mostly reported in high-income countries to ensure safe care provision. Beyond the early phase of the COVID-19 pandemic, severe disruptions to content and quality of PNC continued to exist, whereas disruptions in availability and use were less commonly reported. Depriving women of support, reducing availability of PNC services, and mother-newborn separation could lead to negative long-term outcomes for women, newborns and families, and deny their rights to respectful care. Protecting these essential services is imperative to promoting quality woman-centred PNC during and beyond the pandemic.
    Language English
    Publishing date 2022-04-28
    Publishing country United States
    Document type Journal Article
    ISSN 2767-3375
    ISSN (online) 2767-3375
    DOI 10.1371/journal.pgph.0000214
    Database MEDical Literature Analysis and Retrieval System OnLINE

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