Effect of the COVID-19 pandemic on women's, maternal and child health services in Tshwane District, South Africa

BACKGROUND : The COVID-19 pandemic severely impacted healthcare service delivery globally. The aim of this study was to assess effects of the COVID-19 pandemic on the uptake of routine healthcare services related to maternal, newborn, child, and women’s health (MNCWH) in Tshwane District, an urban locality in Gauteng Province, South Africa. METHODS : As part of the observational Tshwane Maternal-Child COVID-19 study, routine data sources, including the District Health Information System and other district-based datasets, were studied from April 2019 to March 2022, to describe the impact of the first four COVID-19 waves in Tshwane District. The year pre-pandemic was used as a baseline. Data included MNCWH data elements/indicators, child health data elements/indicators, and COVID-19 surveillance data. Data analysis included descriptive statistics, together with visual analysis of trends over time. Statistical investigation included testing of differences between data from the pre-pandemic year (as baseline) and data from the following two pandemic years (2020/2021 and 2021/2022), as per the National Department of Health’s financial years (from April to March of the following year). RESULTS : Multiple MNCWH health elements/indicators showed major decreases during the COVID-19 pandemic period, with preventive services rendered at primary healthcare and community level more severely affected than facility-based clinical services. The most significant decreases were recorded during the first pandemic year, most notably during the first strict lockdown period, with partial or complete recovery in the second pandemic year, while selected indicators saw large impacts during the actual COVID-19 waves. CONCLUSIONS : The COVID-19 pandemic severely impacted the ability of women and children to access healthcare services in this large urban district in South Africa. Health system strengthening measures and adequate planning for future emergency situations are crucial to mitigate the negative impact on maternal and child ...