Many sub-Saharan African countries have experienced various challenges that threaten the quality of health services offered to the population. The COVID-19 pandemic disrupted access to healthcare services in many countries as they grappled with implementing measures to curb its spread. The consequences of COVID-19 have been catastrophic for maternal and newborn health. There is a dearth of information on expectant mothers’ negotiation mechanisms to access maternal health services during COVID-19 in Kenya. This rapid qualitative study draws data from purposefully selected 15 mothers who were either pregnant or had newborn babies during the COVID-19 pandemic in Kilifi county in Kenya. Data were analyzed thematically and presented in a textual description. Women used the following alternatives to access maternal health: giving birth at the homes of traditional birth attendants (TBAs), substituting breastfeeding with locally available food supplements, relying on limited resources and neighbours for delivery and local savings and rotating credit associations. This study shows that urgent measures are needed to provide high quality maternal and child health services during and after the COVID-19 pandemic. These include but are not limited to developing special interventions for the pregnant women for any emergency and establishing trust between communities and individuals through the TBAs. (Afr J Reprod Health 2022; 26[12s]: 57-65).

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Ogunkola IO, Adebisi YA, Imo UF, Odey GO, Esu E and

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Lucero-Prisno D El. Impact of COVID-19 pandemic

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on antenatal healthcare services in Sub-Saharan

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Africa. Public Heal. Pract 2021; (2): 100076.

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Kimani RW, Maina R, Shumba C and Shaibu S. Maternal

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and newborn care during the COVID-19 pandemic in

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Kenya: Re-contextualising the community midwifery

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model. Human Resource Health 2020; (18): 3–8.

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Power K. The COVID-19 pandemic has increased the care

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burden of women and families. Sustain. Sci. Pract.

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Policy. 2020; (6): 67–73.

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The United Nations Population Fund (UNFPA). Maternal ,

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Newborn and Adolescent Health During Pandemics.

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https://wcaro.unfpa.org/sites/default/files/pub-pdf/enrmnah-web_2.pdf

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Simba H and Ngcobo S. Are Pandemics Gender Neutral ?

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Women ’ s Health and COVID- Front. Glob. Womens

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Health. 2020; (19)1: 1–6.

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Wenham C, Smith J and Morgan R. COVID-19: the

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gendered impacts of the outbreak. Lancet. 2020;

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(395): 846–848.

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George AS, Amin A, GarcÍa-Moreno C and Sen G. Gender

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equality and health: laying the foundations for change.

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Lancet. 2019; (393): 2369–2371.

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Heise L, Greene ME, Opper NS, Maria H, Caroline N,

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Marcos Z, Debrework D, Gary LG, Margaret EH,

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Sarah H, Sarah H, Jody K, Jeni L, Ruth R, Anita R and

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Geeta RG. Gender inequality and restrictive gender

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norms: framing the challenges to health. Lancet. 2019;

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(393): 2440–2454.

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Smith J. Overcoming the ‘tyranny of the urgent’: integrating

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gender into disease outbreak preparedness and

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response. Gend. Dev. 2019; (27): 355–369.

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World Health Organization (WHO). Maternal health. 2018.

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Available from:

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https://www.who.int/westernpacific/healthtopics/maternal-health 2018.

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Lawn, JE, Lee AC, Kinney M, Sibley L, Carlo WA, Paul

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VK, Pattinson R and Darmstadt GL. Two million

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intrapartum-related stillbirths and neonatal deaths:

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Where, why, and what can be done? Int. J. Gynecol.

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Obstet. 2009; (107): S5–S19.

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Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Alison

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G, Fat DM, Boerma T, Temmerman M, Mathers C,

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Say L. Global , regional , and national levels and

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trends in maternal mortality between 1990 and 2015 ,

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with scenario-based projections to 2030 : a systematic

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analysis by the UN Maternal Mortality Estimation

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Inter-Agency Group. Lancet. 2015; (6736): 1–13.

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Office for National Statistics ONS and Committee on

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Health Care for Underserved Women. American

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College of Obstetricians and Gynecologists [ACOG].

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Committee OpinionNo. 649: racial and ethnic

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disparities in obstetrics and gynecology. Obstet.

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Gynecol. 2015; (126): 130–134.

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Moaddab A, Dildy GA, Brown HL, Bateni ZH, Belfort MA,

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Sangi-Haghpeykar HC and Steven L. Health care

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disparity and pregnancy-related mortality in the

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United States, 2005-2014. Obstet. Gynecol. 2018;

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(131): 707–712.

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Caul S. Deaths Involving COVID-19 by Local Area and

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Socioeconomic Deprivation: Deaths Occurring

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Between 1 March and 30 June 2020. 2020. Available

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from:

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https://www.ons.gov.uk/peoplepopulationandcommu

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nity/birthsdeathsandmarriages/deaths/bulletins/deaths

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involvingcovid19bylocalareasanddeprivation/deathso

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ccurringbetween1marchand30june2020.

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Ahinkorah BO, Elvis J, Hagan J, Ameyaw EK, Seidu A,

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(mysql): SELECT * FROM citation_settings WHERE citation_id = '103691'  

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Schack T, Elvis J and Jr H. COVID-19 Pandemic

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Worsening Gender Inequalities for Women and Girls

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in Sub-Saharan Africa. Front. Glob. Women’s Heal.

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; (2): 1–6.

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UNFPA. COVID-19 Technical Brief for Maternity

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Services - Update 1: May 2020. 1–55. 2020. Available

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from: https://www.unfpa.org/resources/covid-19-

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technical-brief-maternity-services.

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(mysql): SELECT * FROM citation_settings WHERE citation_id = '103699'  

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McQuilkin PA, Udhayashankar K, Niescierenko M and

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Maranda L. Health-care access during the Ebola virus

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epidemic in Liberia. Am. J. Trop. Med. Hyg. 2017;

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(97): 931–936.

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Iyengar P, Kerber K, Howe CJ and Dahn B. Services for

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mothers and newborns during the Ebola outbreak in

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Liberia: The need for improvement in emergencies.

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PLoS Curr. 2015; (7).

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Ombere SO. Access to Maternal Health Services During

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the COVID-19 Pandemic: Experiences of Indigent

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(mysql): SELECT * FROM citation_settings WHERE citation_id = '103709'  

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Mothers and Health Care Providers in Kilifi County,

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(mysql): SELECT * FROM citation_settings WHERE citation_id = '103710'  

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Kenya. Front. Sociol. 2021; (6): 1–8.

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Wangamati CK and Sundby J. The ramifications of

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COVID-19 on maternal health in Kenya The

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ramifications of COVID-19 on maternal health in

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Kenya. Sex. Reprod. Heal. Matters. 2020.

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Ombere SO. Negotiating Access to Maternal Health

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Services During COVID-19 Pandemic in Kilifi

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County, Kenya: Rapid Qualitative Study. In: Roy, S.,

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Nandy, D. (eds) Understanding Post-COVID-19

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Social and Cultural Realities: Global Context.

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(Springer Nature). 2022; https://doi.org/10.1007/978-

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Gitobu CM, Gichangi PB and Mwanda WO. The effect of

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Kenya’s free maternal healthcare policy on the

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utilization of health facility delivery services and

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maternal and neonatal mortality in public health

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facilities. BMC Pregnancy Childbirth. 2018;

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https://doi.org/10.1186/s12884-018-1708-2.

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Kenya National Bureau of Statistics (KNBS), Ministry of

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Health/Kenya, National AIDS Control

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Council/Kenya, Kenya Medical Research Institute &

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National Council for Population and Development/Kenya. Kenya Demographic and

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Health Survey 2014. 2015.

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Kenya National Bureau of Statistics & ICF International.

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Kenya 2014 Demographic and Health Survey Key

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Findings. vol. 6 KNBS and ICF International. 2015.

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Pyone T, Smith H and Van Den Broek N. Implementation

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of the free maternity services policy and its

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implications for health system governance in Kenya.

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BMJ Glob. Heal. 2017; (2): 1–11.

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Nyadera IN and Onditi F. COVID-19 experience among

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slum dwellers in Nairobi: A double tragedy or useful

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lesson for public health reforms? Int. Soc.

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Work.2020;(63): 838–841.

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Oluoch-Aridi J, Chelagat T, Nyikuri MM, Onyango J,

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Guzman D, Makanga C, Miller-Graff L and Dowd R.

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Services in Kenya. Front. Glob. Women’s Heal.

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Oluoch-Aridi J, Chelagat T, Nyikuri MM, Onyango J,

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Guzman D, Makanga C, Miller-Graff L, and Dowd R.

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Services in Kenya. Front. Glob. Women’s Heal. 2020:

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(1); 1–9.

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Mbugua S and Kerry M. Maternal Health Indicators in

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High-Priority Counties of Kenya: Levels and

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Inequities. DHS Further Analysis Reports No.110.

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Braun V and Clarke V. Successful qualitative research: A

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practical guide for beginners.2013. Available at:

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https://www.researchgate.net/profile/Nur-AfifahAbas/post/The_role_of_the_conceptual_framework_i

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n_abductive_explorative_research_using_reflexive_t

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earch+a+practical+guide+for+beginners+-

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+Clarke+%26+Braun.pdf

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Kimani RW, Maina R, Shumba C and Shaibu S. Maternal

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and newborn care during the COVID-19 pandemic in

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Kenya: Re-contextualising the community midwifery

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model. Hum. Resour. Health. 2020; (18): 3–7.

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Delamou A, Ayadi AMEl, Sidibe S, Delvaux T, Camara

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BS, Sandouno SD, Beavogui AH, Rutherford GW,

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Okumura J, Zhang WH and De Brouwere V. Effect of

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Ebola virus disease on maternal and child health

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services in Guinea: a retrospective observational

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cohort study. Lancet Glob. Heal. 2017; (5); e448–

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Ombere SO, Haller T, Nyambedha EO and Merten S.

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Cultural Practices During Pregnancy and Birth

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Among the Giriama Community in Coastal Kenya : A

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Qualitative Study. Int. J. Childbirth. 2021; (11): 154–

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Byrne A, Caulfield T, Onyo P, Nyagero J, Morgan A,

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Nduba J and Kermode M. Community and provider

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perceptions of traditional and skilled birth attendants

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providing maternal health care for pastoralist

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communities in Kenya: A qualitative study. BMC

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Pregnancy Childbirth. 2016; (16): 1–12.

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Lubbe W, Botha E, Niela-Vilen H and Reimers P.

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Breastfeeding during the COVID-19 pandemic - a

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literature review for clinical practice. Int. Breastfeed.

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Latorre G. Martinelli D, Guida P, Masi E, De Benedictis R

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and Maggio L. Impact of COVID-19 pandemic

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lockdown on exclusive breastfeeding in non-infected

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mothers. Int. Breastfeed. J. 2021; (16): 1–7.

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Verduci E. Lorella M, Vizzari G, Vizzuso S, Cerasani J,

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Mosca F and Zuccotti GV. The Triad Mother-Breast

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Milk-Infant as Predictor of Future Health : A

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Narrative Review. Nutrients. 2021; (13): 1–15.

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Victora CG, Bahl R, Barros AJD, França GVA, Horton S,

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Krasevec J, Murch S, Sankar MJ and Walker N.

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Breastfeeding 1 Breastfeeding in the 21st century :

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epidemiology , mechanisms , and lifelong eff ect.

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Lancet. 2016; (387): 475–490.

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Morgan R, Tetui M, Kananura RM, Ekirapa-Kiracho E and

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George AS. Gender dynamics affecting maternal

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health and health care access and use in Uganda.

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Health Policy Plan. 2017; (32): v13–v21.

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Connor J, Madhavan S, Mokashi M, Amanuel H, Johnson

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NR, Pace LE and Bartz D. Health risks and outcomes

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that disproportionately affect women during the

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Covid-19 pandemic: A review. Social Science and

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Medicine vol. 2020; (266).

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Chattopadhyay A and Govil D. Men and maternal health

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care utilization in India and in selected less-developed

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states: Evidence from a large-scale survey 2015-16. J.

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Biosoc. Sci. 2020;

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https://doi.org/10.1017/S0021932020000498.

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Sedai AK, Vasudevan R and Alves Pena A. Friends and

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benefits? Endogenous rotating savings and credit

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associations as alternative for women’s empowerment

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in India. World Dev. 2021; (145): 105515.

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Darmenova Y and Koo EJ. Towards local sustainability:

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Social capital as a community insurance in

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Kazakhstan. J. Eurasian Stud. 2021; (12): 113–121.

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Sivakami M and Rai S. What Do We Know About Sexual

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and Reproductive Health of Adolescents and Youth in

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India : A Synthesis of Literature. (Springer). 2019;

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