Effects of COVID-19 on Maternal and Neonatal Outcomes and Access to Antenatal and Postnatal Care, Malawi

Leonard Mndala; Chikondi Chapuma; Jennifer Riches; Luis Gadama; Fannie Kachale; Rosemary Bilesi; Malangizo Mbewe; Andrew Likaka; Moses Kumwenda; Regina Makuluni; Bertha Maseko; Chifundo Ndamala; Annie Kuyere; Laura Munthali; Deborah Phiri; Edward J.M. Monk; Marc Y.R. Henrion; Maria L. Odland; David Lissauer

doi:10.3201/eid2910.230003

Effects of COVID-19 on Maternal and Neonatal Outcomes and Access to Antenatal and Postnatal Care, Malawi

Leonard Mndala, Chikondi Chapuma, Jennifer Riches, Luis Gadama, Fannie Kachale, Rosemary Bilesi, Malangizo Mbewe, Andrew Likaka, Moses Kumwenda, Regina Makuluni, Bertha Maseko, Chifundo Ndamala, Annie Kuyere, Laura Munthali, Deborah Phiri, Edward J.M. Monk, Marc Y.R. Henrion, Maria L. Odland, David Lissauer

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Abstract

We used national facility-level data from all government hospitals in Malawi to examine the effects of the second and third COVID-19 waves on maternal and neonatal outcomes and access to care during September 6, 2020-October 31, 2021. The COVID-19 pandemic affected maternal and neonatal health not only through direct infections but also through disruption of the health system, which could have wider indirect effects on critical maternal and neonatal outcomes. In an interrupted time series analysis, we noted a cumulative 15.4% relative increase (63 more deaths) in maternal deaths than anticipated across the 2 COVID-19 waves. We observed a 41% decrease in postnatal care visits at the onset of the second COVID-19 wave and 0.2% by the third wave, cumulative to 36,809 fewer visits than anticipated. Our findings demonstrate the need for strengthening health systems, particularly in resource-constrained settings, to prepare for future pandemic threats.

Original language	English
Pages (from-to)	1990-1998
Number of pages	9
Journal	Emerging Infectious Diseases
Volume	29
Issue number	10
DOIs	https://doi.org/10.3201/eid2910.230003
State	Published - Oct 2023
Externally published	Yes

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Mndala, L., Chapuma, C., Riches, J., Gadama, L., Kachale, F., Bilesi, R., Mbewe, M., Likaka, A., Kumwenda, M., Makuluni, R., Maseko, B., Ndamala, C., Kuyere, A., Munthali, L., Phiri, D., Monk, E. J. M., Henrion, M. Y. R., Odland, M. L., & Lissauer, D. (2023). Effects of COVID-19 on Maternal and Neonatal Outcomes and Access to Antenatal and Postnatal Care, Malawi. Emerging Infectious Diseases, 29(10), 1990-1998. https://doi.org/10.3201/eid2910.230003

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title = "Effects of COVID-19 on Maternal and Neonatal Outcomes and Access to Antenatal and Postnatal Care, Malawi",

abstract = "We used national facility-level data from all government hospitals in Malawi to examine the effects of the second and third COVID-19 waves on maternal and neonatal outcomes and access to care during September 6, 2020-October 31, 2021. The COVID-19 pandemic affected maternal and neonatal health not only through direct infections but also through disruption of the health system, which could have wider indirect effects on critical maternal and neonatal outcomes. In an interrupted time series analysis, we noted a cumulative 15.4% relative increase (63 more deaths) in maternal deaths than anticipated across the 2 COVID-19 waves. We observed a 41% decrease in postnatal care visits at the onset of the second COVID-19 wave and 0.2% by the third wave, cumulative to 36,809 fewer visits than anticipated. Our findings demonstrate the need for strengthening health systems, particularly in resource-constrained settings, to prepare for future pandemic threats.",

author = "Leonard Mndala and Chikondi Chapuma and Jennifer Riches and Luis Gadama and Fannie Kachale and Rosemary Bilesi and Malangizo Mbewe and Andrew Likaka and Moses Kumwenda and Regina Makuluni and Bertha Maseko and Chifundo Ndamala and Annie Kuyere and Laura Munthali and Deborah Phiri and Monk, {Edward J.M.} and Henrion, {Marc Y.R.} and Odland, {Maria L.} and David Lissauer",

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Mndala, L, Chapuma, C, Riches, J, Gadama, L, Kachale, F, Bilesi, R, Mbewe, M, Likaka, A, Kumwenda, M, Makuluni, R, Maseko, B, Ndamala, C, Kuyere, A, Munthali, L, Phiri, D, Monk, EJM, Henrion, MYR, Odland, ML & Lissauer, D 2023, 'Effects of COVID-19 on Maternal and Neonatal Outcomes and Access to Antenatal and Postnatal Care, Malawi', Emerging Infectious Diseases, vol. 29, no. 10, pp. 1990-1998. https://doi.org/10.3201/eid2910.230003

TY - JOUR

T1 - Effects of COVID-19 on Maternal and Neonatal Outcomes and Access to Antenatal and Postnatal Care, Malawi

AU - Mndala, Leonard

AU - Chapuma, Chikondi

AU - Riches, Jennifer

AU - Gadama, Luis

AU - Kachale, Fannie

AU - Bilesi, Rosemary

AU - Mbewe, Malangizo

AU - Likaka, Andrew

AU - Kumwenda, Moses

AU - Makuluni, Regina

AU - Maseko, Bertha

AU - Ndamala, Chifundo

AU - Kuyere, Annie

AU - Munthali, Laura

AU - Phiri, Deborah

AU - Monk, Edward J.M.

AU - Henrion, Marc Y.R.

AU - Odland, Maria L.

AU - Lissauer, David

PY - 2023/10

Y1 - 2023/10

N2 - We used national facility-level data from all government hospitals in Malawi to examine the effects of the second and third COVID-19 waves on maternal and neonatal outcomes and access to care during September 6, 2020-October 31, 2021. The COVID-19 pandemic affected maternal and neonatal health not only through direct infections but also through disruption of the health system, which could have wider indirect effects on critical maternal and neonatal outcomes. In an interrupted time series analysis, we noted a cumulative 15.4% relative increase (63 more deaths) in maternal deaths than anticipated across the 2 COVID-19 waves. We observed a 41% decrease in postnatal care visits at the onset of the second COVID-19 wave and 0.2% by the third wave, cumulative to 36,809 fewer visits than anticipated. Our findings demonstrate the need for strengthening health systems, particularly in resource-constrained settings, to prepare for future pandemic threats.

AB - We used national facility-level data from all government hospitals in Malawi to examine the effects of the second and third COVID-19 waves on maternal and neonatal outcomes and access to care during September 6, 2020-October 31, 2021. The COVID-19 pandemic affected maternal and neonatal health not only through direct infections but also through disruption of the health system, which could have wider indirect effects on critical maternal and neonatal outcomes. In an interrupted time series analysis, we noted a cumulative 15.4% relative increase (63 more deaths) in maternal deaths than anticipated across the 2 COVID-19 waves. We observed a 41% decrease in postnatal care visits at the onset of the second COVID-19 wave and 0.2% by the third wave, cumulative to 36,809 fewer visits than anticipated. Our findings demonstrate the need for strengthening health systems, particularly in resource-constrained settings, to prepare for future pandemic threats.

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JO - Emerging Infectious Diseases

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ER -

Effects of COVID-19 on Maternal and Neonatal Outcomes and Access to Antenatal and Postnatal Care, Malawi

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