The perfect storm: Disruptions to institutional delivery care arising from the COVID-19 pandemic in Nepal
KC Ashish, Stefan Peterson, Rejina Gurung, Alkistis Skalkidou, Jageshwar Gautam, Honey Malla, Prayash Paudel, Kumari Bhattarai, Nisha Joshi, Bhim Singh Tinkari, Shree Adhikari, Durgalaxmi Shrestha, Binda Ghimire, Seema Sharma, Laxmi Khanal, Sunil Shrestha, Wendy Graham, Mary Kinney
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: = 0.001). CONCLUSIONS: 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.