Early indirect impact of COVID-19 pandemic on utilisation and outcomes of reproductive, maternal, newborn, child and adolescent health services in Kenya: A cross-sectional study

Abstract

The paper determined the initial impact of COVID-19 pandemic on reproductive, maternal, newborn, child and adolescent health (RMNCAH) services in Kenya. Hospital data for the first four months (March-June 2020) of the pandemic and the equivalent period in 2019 were compared using two-sample test of proportions. Despite the global projections for worse indicators, there were no differences in monthly mean ( SD) attendance between March-June 2019 vs 2020 for antenatal care (400,191.2 12,700.0 vs 384,697.3 20,838.6), hospital births (98,713.0 4,117.0 vs 99,634.5 3,215.5), family planning attendance (431,930.5 19,059.9 vs 448,168.3 31,559.8), post-abortion care (3,206.5 111.7 vs 448,168.3 31,559.8) and pentavalent 1 immunisation (114,701.0 3,701.1 vs 110,915.8 7,209.4), p>0.05. However, there were significant increases in FP utilisation among young people (25.7% to 27.0%), injectable (short-term) FP method uptake (58.2% to 62.3%), caesarean section rate (14.6% to 15.8%), adolescent maternal deaths (6.2% to 10.9%) and fresh stillbirths (0.9% to 1.0%) with a reduction in implants (long-term) uptake (16.5% to 13.0%) (p <0.05). With uncertainty around the duration of the pandemic, strategies to mitigate against catastrophic indirect maternal health outcomes are urgently needed.

Keywords: COVID-19; adolescent pregnancy; family planning; maternal and newborn health; maternal and perinatal mortality; reproductive health.