Impact of COVID-19 on utilization of maternal, newborn and child health services in Nigeria: Protocol for a country-level mixed-methods study

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Study Justification:
– The study aims to evaluate the impact of COVID-19 on the utilization of maternal, newborn, and child health (MNCH) services in Nigeria.
– It seeks to understand the barriers faced by women and their families in accessing MNCH services during the pandemic.
– The study will also explore contextual factors that have influenced the utilization of MNCH services during COVID-19.
Highlights:
– The study will use a mixed-methods approach, combining quantitative and qualitative data, to provide a comprehensive understanding of the impact of COVID-19 on MNCH services.
– Longitudinal data will be collected from 18 healthcare facilities in six selected states across Nigeria.
– In-depth interviews will be conducted with stakeholders, including MNCH service users, health workers, and policymakers, to gather their perceptions on how COVID-19 has affected MNCH service utilization.
– The study will provide valuable evidence from an African setting, contributing to policy formulation for sustained MNCH service delivery.
Recommendations:
– Based on the study findings, policymakers should develop strategies to address the barriers faced by women and their families in accessing MNCH services during the COVID-19 pandemic.
– Efforts should be made to strengthen the healthcare system and ensure the continuity of MNCH services during similar crises in the future.
– Policies should be implemented to address the contextual factors that have influenced the utilization of MNCH services during COVID-19.
Key Role Players:
– MNCH service users
– Health workers
– Policymakers
– Researchers
– Ethical review committees
Cost Items for Planning Recommendations:
– Training and capacity building for healthcare staff
– Development and implementation of policies and guidelines
– Information and communication technology infrastructure for remote consultations
– Community engagement and awareness campaigns
– Monitoring and evaluation systems
– Research and data analysis
– Ethical review and approval processes

Background: Battling with COVID-19 and providing essential services along the continuum of care could be challenging. This study will evaluate the impact of COVID-19 on utilization of maternal, newborn and child health (MNCH) services in Nigeria and explore the barriers being experienced by women and their families in getting access to MNCH services, as well as other contextual factors that may have shaped the utilization of MNCH services during the COVID-19 pandemic. Methods and analysis: The study will adopt an observational mixed-methods study design involving 18 health care facilities delivering MNCH services in six selected states across six geopolitical zones of Nigeria. We will retrieve longitudinal data on MNCH services from all selected hospitals six months before and after the first recorded case of COVID-19 in Nigeria. Qualitative data will be collected using in-depth interviews conducted via mobile phones or ZOOM meeting platforms among stakeholder participants (users of MNCH services, health workers and policymakers) to ascertain their perceptions on how COVID-19 has shaped the utilization of MNCH services. We will triangulate quantitative and qualitative data to better understand the impact of COVID-19 on the utilization of MNCH services in Nigeria. Ethics and dissemination: Ethics approvals have been obtained from the Health Research Ethics Committee of the tertiary hospitals involved in the study. Our findings will provide the first evidence from an African setting on the impact of COVID-19 on the utilization of MNCH services using a mixed-methods study design for policy formulation towards sustained MNCH service delivery.

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Based on the provided description, it seems that the study is focused on evaluating the impact of COVID-19 on the utilization of maternal, newborn, and child health (MNCH) services in Nigeria. The study aims to explore the barriers faced by women and their families in accessing MNCH services during the pandemic. While the description does not explicitly mention innovations, here are some potential recommendations that could be considered to improve access to maternal health:

1. Telemedicine and virtual consultations: Implementing telemedicine platforms and virtual consultations can provide remote access to healthcare professionals, allowing pregnant women to receive medical advice, check-ups, and support without the need for in-person visits.

2. Mobile health applications: Developing mobile applications that provide information, guidance, and reminders for prenatal care, postnatal care, and child health can empower women with knowledge and help them stay connected to healthcare services.

3. Community health workers: Training and deploying community health workers who can provide basic maternal health services, education, and support at the community level can improve access to care, particularly in remote or underserved areas.

4. Transportation support: Establishing transportation programs or partnerships to ensure that pregnant women have access to reliable and affordable transportation to healthcare facilities for prenatal visits, delivery, and postnatal care.

5. Community engagement and awareness campaigns: Conducting targeted community engagement and awareness campaigns to educate women and their families about the importance of maternal health services, dispel myths, and address cultural barriers that may hinder access to care.

6. Strengthening referral systems: Enhancing the coordination and communication between different levels of healthcare facilities to ensure smooth referrals and timely access to specialized care when needed.

7. Mobile clinics: Deploying mobile clinics equipped with essential maternal health services to reach remote or underserved areas, providing on-site care and reducing the need for women to travel long distances for healthcare.

These recommendations aim to leverage technology, community involvement, and improved infrastructure to enhance access to maternal health services during the COVID-19 pandemic and beyond.
AI Innovations Description
The study described aims to evaluate the impact of COVID-19 on the utilization of maternal, newborn, and child health (MNCH) services in Nigeria. It also seeks to explore the barriers faced by women and their families in accessing MNCH services during the pandemic, as well as other contextual factors that may have influenced service utilization.

To develop this study into an innovation that improves access to maternal health, the following recommendations can be considered:

1. Telemedicine and virtual consultations: Implementing telemedicine and virtual consultations can help overcome barriers to accessing MNCH services during the pandemic. This innovation allows pregnant women to receive medical advice, prenatal care, and postnatal care remotely, reducing the need for in-person visits and minimizing the risk of exposure to COVID-19.

2. Mobile health applications: Developing mobile health applications specifically designed for maternal health can provide women with access to information, resources, and support throughout their pregnancy journey. These apps can offer personalized care plans, educational materials, appointment reminders, and communication channels with healthcare providers.

3. Community-based outreach programs: Establishing community-based outreach programs can help bridge the gap in accessing MNCH services, particularly in remote or underserved areas. These programs can involve trained community health workers who provide essential maternal health services, conduct health education sessions, and facilitate referrals to healthcare facilities when necessary.

4. Strengthening healthcare infrastructure: Investing in and improving healthcare infrastructure, particularly in rural areas, can enhance access to MNCH services. This includes ensuring the availability of well-equipped facilities, skilled healthcare providers, and essential medical supplies and equipment.

5. Public awareness campaigns: Conducting public awareness campaigns about the importance of maternal health and the availability of MNCH services can help increase utilization. These campaigns can address misconceptions, promote early and regular prenatal care, and encourage women to seek timely medical assistance during pregnancy and childbirth.

By implementing these recommendations, the study can contribute to the development of innovative solutions that improve access to maternal health services, not only during the COVID-19 pandemic but also in the long term.
AI Innovations Methodology
The study described aims to evaluate the impact of COVID-19 on the utilization of maternal, newborn, and child health (MNCH) services in Nigeria. It also seeks to explore the barriers faced by women and their families in accessing MNCH services during the pandemic. The study will use a mixed-methods approach, combining quantitative and qualitative data.

Methodology:
1. Study Design: The study will adopt an observational mixed-methods study design.
2. Sample: The study will involve 18 healthcare facilities delivering MNCH services in six selected states across six geopolitical zones of Nigeria.
3. Data Collection:
a. Quantitative Data: Longitudinal data on MNCH services will be retrieved from all selected hospitals. Data will be collected for six months before and after the first recorded case of COVID-19 in Nigeria.
b. Qualitative Data: In-depth interviews will be conducted with stakeholder participants, including users of MNCH services, health workers, and policymakers. Interviews will be conducted via mobile phones or ZOOM meeting platforms.
4. Data Analysis:
a. Quantitative Data: The quantitative data on MNCH service utilization will be analyzed to assess the impact of COVID-19. Statistical methods, such as descriptive statistics and regression analysis, may be used.
b. Qualitative Data: The qualitative data from the interviews will be analyzed thematically. Themes and patterns will be identified to understand the perceptions of stakeholders regarding the impact of COVID-19 on MNCH service utilization.
5. Triangulation: The quantitative and qualitative data will be triangulated to gain a comprehensive understanding of the impact of COVID-19 on MNCH services in Nigeria.
6. Ethics and Dissemination: Ethics approvals have been obtained from the Health Research Ethics Committee of the tertiary hospitals involved in the study. The findings of the study will contribute to policy formulation for sustained MNCH service delivery in Nigeria.

In summary, this study will use a mixed-methods approach to assess the impact of COVID-19 on the utilization of MNCH services in Nigeria. It will combine quantitative data analysis with qualitative interviews to provide a comprehensive understanding of the barriers and contextual factors affecting access to MNCH services during the pandemic. The findings will inform policy formulation for improved MNCH service delivery.

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