Women's experiences of receiving antenatal and intrapartum care during COVID-19 at public hospitals in the Sidama region, Ethiopia: A qualitative study using the combination of three delay and social-ecological framework (hybrid framework)

Womens Health (Lond). 2024 Jan-Dec:20:17455057241274898. doi: 10.1177/17455057241274898.

Abstract

Background: The COVID-19 pandemic, drought and internal conflict have worsened Ethiopia's already weak healthcare system. Antenatal and intrapartum care are especially prone to interruption under these circumstances.

Objective: To explore women's experiences receiving antenatal and intrapartum care during the pandemic.

Design: A descriptive qualitative approach was utilised.

Methods: We conducted in-depth interviews with 17 women and held 4 focus group discussions with women who gave birth at 4 public hospitals during the pandemic. A study was conducted at four public hospitals in the Sidama region of Ethiopia, during which data were collected from 14 February to 10 May 2022. Thematic analysis was performed to generate themes.

Results: The peak of the COVID-19 pandemic in Ethiopia presented several barriers to access and uptake of antenatal and intrapartum care at public hospitals. Four themes and 10 subthemes emerged from the thematic analysis. The themes were 'Barriers to maternity care uptake during COVID-19', 'Shortage of resources during COVID-19', 'Delays in maternity care uptake during COVID-19' and 'Mistreatment of women during maternity care during COVID-19'. The subthemes included 'Fear of contracting COVID-19', 'People in the hospital neglecting COVID-19 prevention', 'Women losing their job during COVID-19', 'Shortage of beds in the labour ward', 'Shortage of medical supplies', 'Delays in seeking care', 'Delays in receiving care', 'Complications during childbirth', 'disrespectful' and 'suboptimal care'.

Conclusion: The findings of this study underscore the impact of COVID-19 on antenatal and intrapartum care, leading to delays in seeking and receiving care due to reduced rapport, resource shortages, companion restrictions, disrespectful care and suboptimal care. These factors contribute to increased obstetric complications during COVID-19. It is imperative for policymakers to prioritise essential resources for antenatal and intrapartum care in the present and future pandemics. Moreover, healthcare providers should maintain respectful and optimal care even amid challenges.

Keywords: Ethiopia; antenatal and intrapartum care; during COVID-19; women’s experiences.

Plain language summary

Women’s experiences in receiving antenatal and intrapartum care during COVID-19The COVID-19 pandemic has posed a significant challenge in seeking and receiving care of antenatal care and institutional childbirth. Women could experience delays in booking antenatal care appointments, postponing antenatal care visits, and facing delays in receiving care at hospitals, which has disrupted their access to routine antenatal care and institutional birth during the pandemic. This study highlights a range of barriers that hinder access to and utilisation of antenatal care and institutional birth, including lack of transport, shortage of resources, fear of contracting the virus, companion restrictions, disrespectful care and suboptimal care that leads to increased obstetric complications during COVID-19. This study provides recommendations for policymakers to prioritise resources and enhance respectful and optimal care for pregnancy and institutional birth to lessen the indirect impact of present and future pandemics on pregnant women and their unborn babies.

MeSH terms

  • Adult
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Ethiopia
  • Female
  • Focus Groups*
  • Health Services Accessibility
  • Hospitals, Public*
  • Humans
  • Maternal Health Services
  • Patient Acceptance of Health Care
  • Perinatal Care
  • Pregnancy
  • Prenatal Care*
  • Qualitative Research*
  • SARS-CoV-2
  • Young Adult