Evidence of resiliency in maternal health services and outcomes in Kono District, Sierra Leone during the COVID-19 pandemic: an observational study
Notice bibliographique
Résumé
BACKGROUND: Following the Ebola outbreak in Sierra Leone, the post-Ebola recovery investments in Wellbody Clinic and Koidu Government Hospital provide an opportunity to conduct a more focused examination of facility-level maternal health services and outcomes in the context of COVID-19 pandemic. This study aimed to describe the use of maternal healthcare services and outcomes in these health facilities before, during, and after the COVID-19 pandemic. METHODS: The study involved analysis of routine programme data (March 2019 to February 2022) from two public health facilities supported by Partners In Health Sierra Leone: Koidu Government Hospital and Wellbody Clinic. Aggregated and de-identified secondary data was abstracted using a standardized tool. Descriptive statistics and bivariable negative binomial regression were used to assess the association between time periods ( pre-COVID-19 period [March 2019 to February 2020], during COVID-19 emergency period [March 2020 to February 2021], after COVID-19 emergency period [March 2021 to February 2022) and outcomes (antenatal care visit and facility deliveries). RESULTS: The study analyzed 3,204 fourth antenatal care visits and 7,369 deliveries over 36 months at both health facilities. The fourth antenatal care visits (from 947 to 920) and facility deliveries (from 2309 to 2221) decreased during COVID-19 compared to pre-COVID-19. However, maternal (from 32 to 23) and neonatal (36 to 26) deaths declined during COVID-19 compared to the pre-COVID-19 period at Koidu Government Hospital. Regression analysis showed that relative to the period of COVID-19 emergency period, there were no observable difference in the rate of fourth antenatal care visits in the pre-COVID-19 period [IRR = 1.02, 95%CI: 0.61, 1.72] and during the post-COVID-19 emergency period [IRR = 1.45, 95%CI: 0.87, 2.42]. Relative to the COVID-19 emergency period, there was also no difference observed in maternal deliveries: pre-COVID-19 [IRR = 1.03, 95%CI: 0.69, 1.56] and post-COVID-19 emergency [IRR = 1.28, 95%CI: 0.85, 1.92]. CONCLUSION: In Sierra Leone, the resources and efforts directed to the post-Ebola recovery strategy were tested during and after the COVID-19 pandemic. Our study demonstrates the resilience of maternal and neonatal services in two healthcare facilities in a less-affected region of Sierra Leone, to the anticipated disruptions due to the COVID-19 pandemic.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».