Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 10;13(12):e077583.
doi: 10.1136/bmjopen-2023-077583.

Measuring supply-side service disruption: a systematic review of the methods for measuring disruption in the context of maternal and newborn health services in low and middle-income settings

Catherine R McGowan  1 , Dhikshitha Gokulakrishnan  2 , Emily Monaghan  3   4 , Nada Abdelmagid  5 , Laura Romig  6 , Meghan C Gallagher  6 , Janet Meyers  6 , Rachael Cummings  3   7 , Laura J Cardinal  3
Affiliations

Measuring supply-side service disruption: a systematic review of the methods for measuring disruption in the context of maternal and newborn health services in low and middle-income settings

Catherine R McGowan et al. BMJ Open. .

Abstract

Objectives: During the COVID-19 pandemic, most essential services experienced some level of disruption. Disruption in LMICs was more severe than in HICs. Early reports suggested that services for maternal and newborn health were disproportionately affected, raising concerns about health equity. Most disruption indicators measure demand-side disruption, or they conflate demand-side and supply-side disruption. There is currently no published guidance on measuring supply-side disruption. The primary objective of this review was to identify methods and approaches used to measure supply-side service disruptions to maternal and newborn health services in the context of COVID-19.

Design: We carried out a systematic review and have created a typology of measurement methods and approaches using narrative synthesis.

Data sources: We searched MEDLINE, EMBASE and Global Health in January 2023. We also searched the grey literature.

Eligibility criteria: We included empirical studies describing the measurement of supply-side service disruption of maternal and newborn health services in LMICs in the context of COVID-19.

Data extraction and synthesis: We extracted the aim, method(s), setting, and study outcome(s) from included studies. We synthesised findings by type of measure (ie, provision or quality of services) and methodological approach (ie, qualitative or quantitative).

Results: We identified 28 studies describing 5 approaches to measuring supply-side disruption: (1) cross-sectional surveys of the nature and experience of supply-side disruption, (2) surveys to measure temporal changes in service provision or quality, (3) surveys to create composite disruption scores, (4) surveys of service users to measure receipt of services, and (5) clinical observation of the provision and quality of services.

Conclusion: Our review identified methods and approaches for measuring supply-side service disruption of maternal and newborn health services. These indicators provide important information about the causes and extent of supply-side disruption and provide a useful starting point for developing specific guidance on the measurement of service disruption in LMICs.

Keywords: COVID-19; Quality in health care; Systematic Review.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
PRISMA flow chart. LMIC, low-income and middle-income country. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. World health organization . Pulse survey on continuity of essential health services during the COVID-19 pandemic. Interim report. Geneva: WHO; 2020.
    1. World Health Organization . Fourth round of the global pulse survey on continuity of essential health services during the COVID-19 pandemic: November 2022–January 2023: interim report. Geneva: WHO; 2023.
    1. World Health Organization . Maintaining essential health services: operational guidance for the COVID-19 context: interim guidance. Geneva: WHO; 2020.
    1. World Health Organization . Maintaining the provision and use of services for maternal, newborn, child and adolescent health and older people during the COVID-19 pandemic: lessons learned from 19 countries. Geneva: WHO; 2021.
    1. World Health Organization . Continuity of essential health services: facility assessment tool. Geneva: WHO; 2021.

Publication types