COVID-19 restrictions plummet antenatal care registrations

Covid-19 and the lockdown restrictions have resulted in a sharp decline of mothers registering for antenatal care and institutional deliveries in Zimbabwe, a development which may affect the country’s target to eliminate mother to child transmission (EMTCT) of HIV, The Chronicle has reported.

Statistics from the National Aids Council show that this year from the estimated 254 476 pregnancies recorded between January and June, about 23 000 of the women did not book for antenatal care (ANC).

ANC coverage is an indicator of access and use of health care during pregnancy and the antenatal period presents opportunities for reaching pregnant women with interventions that may be vital to their health and wellbeing and that of their infants.

Last year in March when the first Covid-19 case was recorded in Zimbabwe, 36 825 women registered for ANC in health institutions.

However, in April after the first lockdown was implemented the figure plummeted to 19 651. The country has also recorded an increase in home births and women who only visited health centres for delivery which put them and unborn babies at risk of developing fatal complications or transmission of the deadly HIV and congenital syphilis.

Zimbabwe is aiming to have reduced new paediatric HIV cases and congenital syphilis to less than 250 per 100 000 live births by 2022 to achieve EMTCT.

The initiative to eliminate mother-to-child transmission (EMTCT) of HIV and syphilis focuses on a harmonised approach to improving health outcomes for mothers and children.

The rationale for the elimination of MTCT of HIV and syphilis is that dual elimination will help to improve a broad range of maternal and child health (MCH) outcomes.

Maternal mortality last year dropped from 614 deaths per 100 000 live births, to 462 and experts have raised alarm that increase in teenage pregnancies could see a spike in deaths.

A majority of teenagers are reportedly concealing pregnancies and do not access medical care for expecting mothers.

The teenagers, out of fear of being denounced by their families, try unsafe abortions.

Speaking during a NAC media workshop last week, the Ministry of Health and Child Care EMTCT officer Ms Rumbidzai Mugwagwa said there were about 58 742 pregnant women in need of PMTCT in 2020 in Zimbabwe. She said of the 77 692 children living with HIV aged between zero- and 14-years Zimbabwe, only 72 percent have access to antiretroviral therapy.

“Late or no ANC booking was observed in all facilities and more bookings by teenagers were recorded during the Covid-19 lockdown. Some ANC clinics were closed during Covid-19 which resulted in a sharp decline of women booking for ANC,” said Ms Mugwagwa.

“Travel restrictions and emergency regulations have had significant impacts on maternity services, including resource stock-outs, and closure of antenatal clinics during the lockdown period. Estimates of the indirect impact of Covid-19 on maternal and perinatal mortality were expected to be considerable, but more data is yet to be availed.”

She said low ANC booking will have an impact on the rate at which the country achieves EMTCT.

“Covid-19 really affected service delivery and some pregnant women could not be tested for HIV and syphilis although that is expected to reduce chances of transmission to the unborn baby.

We now hope that since services are open, we will see every woman going to a health centre to register pregnancies and attending at least three ANC visits,” added Ms Mugwagwa.

In a study carried out by Bulawayo health practitioners, it was noted that between January-March and April-June 2020, the mean monthly deliveries reduced from 747,3 in the first quarter of 2020 to 681.

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