Dr. Steve Adudans @SteveAdudans
The recent closure of the Pumwani Maternity Hospital in Nairobi to new patients highlights how COVID-19 has left health facilities struggling to offer quality care during the pandemic. The hospital’s management was forced to take the painful step after 41 healthcare workers tested positive for the virus.
Pumwani is the largest maternity in the country and most pocket friendly especially for those in Nairobi and its vicinity. It is of concern that the pandemic is posing considerable challenges for us to maintain the provision of high quality, essential maternal and newborn health services. The country is already diverting significant resources, including midwives, from regular service delivery to response efforts.
The safest place for a woman to deliver her baby is at a functional health facility with a skilled birth attendant. However, during this global crisis, many women may end up delivering at home without appropriate support. Pregnant women and mothers with newborns are experiencing difficulties accessing services due to transport disruptions and lockdown measures or be reluctant to come to health facilities due to fear of infection.
Maternal and neonatal health needs are often neglected amid an emergency – and COVID-19 has been no different. A vital lesson from the West Africa Ebola outbreak of 2014-2016 is that the biggest threat to women’s and girls’ lives was not the Ebola virus, but the shutdown of routine health services and people’s fear of going to health facilities where they could get infected.
Thousands of more lives were lost when safe delivery, neonatal, and family planning services became inaccessible due to the outbreak. Right now, we are witnessing the same dynamic on a much larger scale. The Ebola epidemic and now the COVID19 exposes how weak our health systems are at protecting mothers, newborns, young children and adolescents. We are at a point where decades of progress for this group could be easily reversed.
Also of concern is the decline in access to life-saving vaccines for children and maternal health services due to closures and movement restrictions, staff and patients opting to stay away from health facilities for fear of contracting the virus.
The World Health Organization and UNICEF have already raised concerns about an alarming decline in the number of children receiving vaccines around the world. According to new data by WHO and UNICEF, shows that improvements such as the expansion of the HPV vaccine to 106 countries and greater protection for children against more diseases are in danger of lapsing.
Preliminary data for the first four months of 2020 points to a substantial drop in the number of children completing three doses of the vaccine against diphtheria, tetanus and pertussis (DTP3). This is the first time in 28 years that the world could see a reduction in DTP3 coverage – the marker for immunization coverage within and across countries.
These disruptions threaten to reverse hard-won progress to reach more children and adolescents with a wider range of vaccines, which has already been hampered by a decade of stalling coverage.
As the government prepares the system to deal with the surging numbers of the COVID-19 patients, it must also act to ensure that the gains made in the maternal and neonatal segment are not reversed and that mothers and babies are still able to access routine and emergency care whenever and wherever they need them. Efforts mist be made to ensure continuity of care with adequate funding for infection prevention and control supplies and equipment for healthcare workers. Health services must remain financially and physically accessible for women whose households may lose income or whose normal service delivery provider may no longer be available.
Referral pathways and transportation must remain intact to deal with obstetric emergencies and hospitals need to be able to properly screen, isolate, and care for infected pregnant women. Every Mother and child’s life matters.
Dr. Adudans is the executive director Center for Public Health and Development.