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The perfect storm: ...
The perfect storm: Disruptions to institutional delivery care arising from the COVID-19 pandemic in Nepal.
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- KC, Ashish, 1982 (author)
- Uppsala universitet,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Global hälsa - implementering och hållbarhet
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- Swartling Peterson, Stefan, 1962- (author)
- Karolinska Institutet,Uppsala universitet,Internationell barnhälsa och nutrition,Karolinska Inst, Dept Global Publ Hlth, Stockholm, Sweden.
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- Gurung, Rejina (author)
- Uppsala universitet,Global hälsa - implementering och hållbarhet,Golden Community, Res Div, Lalitpur, Nepal.
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- Skalkidou, Alkistis, 1977- (author)
- Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning
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- Gautam, Jageshwar (author)
- Minist Hlth & Populat, Kathmandu, Nepal.
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- Malla, Honey (author)
- Golden Community, Res Div, Lalitpur, Nepal.
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- Paudel, Punya (author)
- Dept Hlth Serv, Family Welf Div, Kathmandu, Nepal.
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- Bhattarai, Kumari (author)
- Dept Hlth Serv, Family Welf Div, Kathmandu, Nepal.
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- Joshi, Nisha (author)
- Dept Hlth Serv, Family Welf Div, Kathmandu, Nepal.
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- Tinkari, Bhim Singh (author)
- Dept Hlth Serv, Family Welf Div, Kathmandu, Nepal.
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- Adhikari, Shree (author)
- Paropakar Matern & Womens Hosp, Kathmandu, Nepal.
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- Shrestha, Durgalaxmi (author)
- Bheri Hosp, Nepalganj, Nepal.
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- Ghimire, Binda (author)
- Nepal Nursing Council, Kathmandu, Nepal.
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- Sharma, Seema (author)
- Seti Prov Hosp, Dhangadi, Nepal.
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- Khanal, Laxmi (author)
- White Ribbon Alliance Nepal, Kathmandu, Nepal.
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- Shrestha, Sunil (author)
- White Ribbon Alliance Nepal, Kathmandu, Nepal.
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- Graham, Wendy Jane (author)
- London Sch Hyg & Trop Med, London, England.
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- Kinney, Mary (author)
- Univ Western Cape, Fac Community & Hlth Sci, Sch Publ Hlth, Cape Town, South Africa.
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(creator_code:org_t)
- 2021-05-11
- 2021
- English.
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In: Journal of global health. - : International Global Health Society. - 2047-2986 .- 2047-2978. ; 11
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Abstract
Subject headings
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- The COVID-19 pandemic has led to system-wide disruption of health services globally. We assessed the effect of the pandemic on the disruption of institutional delivery care in Nepal.We conducted a prospective cohort study among 52 356 women in nine hospitals to assess the disruption of institutional delivery care during the pandemic (comparing March to August in 2019 with the same months in 2020). We also conducted a nested follow up cohort study with 2022 women during the pandemic to assess their provision and experience of respectful care. We used linear regression models to assess the association between provision and experience of care with volume of hospital births and women's residence in a COVID-19 hotspot area.The mean institutional births during the pandemic across the nine hospitals was 24 563, an average decrease of 11.6% (P < 0.0001) in comparison to the same time-period in 2019. The institutional birth in high-medium volume hospitals declined on average by 20.8% (P < 0.0001) during the pandemic, whereas in low-volume hospital institutional birth increased on average by 7.9% (P = 0.001). Maternity services halted for a mean of 4.3 days during the pandemic and there was a redeployment staff to COVID-19 dedicated care. Respectful provision of care was better in hospitals with low-volume birth (β = 0.446, P < 0.0001) in comparison to high-medium-volume hospitals. There was a positive association between women's residence in a COVID-19 hotspot area and respectful experience of care (β = 0.076, P = 0.001).The COVID-19 pandemic has had differential effects on maternity services with changes varying by the volume of births per hospital with smaller volume facilities doing better. More research is needed to investigate the effects of the pandemic on where women give birth and their provision and experience of respectful maternity care to inform a "building-back-better" approach in post-pandemic period.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Keyword
- Adult
- COVID-19
- epidemiology
- Delivery
- Obstetric
- Female
- Follow-Up Studies
- Hospitals
- Humans
- Maternal Health Services
- organization & administration
- Nepal
- epidemiology
- Pandemics
- Pregnancy
- Prospective Studies
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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KC, Ashish, 1982
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Swartling Peters ...
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Gurung, Rejina
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Skalkidou, Alkis ...
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Gautam, Jageshwa ...
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Malla, Honey
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show more...
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Paudel, Punya
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Bhattarai, Kumar ...
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Joshi, Nisha
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Tinkari, Bhim Si ...
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Adhikari, Shree
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Shrestha, Durgal ...
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Ghimire, Binda
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Sharma, Seema
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Khanal, Laxmi
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Shrestha, Sunil
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Graham, Wendy Ja ...
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Kinney, Mary
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Public Health Gl ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Health Care Serv ...
- Articles in the publication
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Journal of globa ...
- By the university
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University of Gothenburg
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Uppsala University
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Karolinska Institutet