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  2. Vol 26, No 12s (2022)
  3. Ombere

Measures adopted by indigent mothers in Kilifi County to tackle maternal health challenges during the COVID-19 pandemic: A qualitative study

Stephen O. Ombere(1), Erick O. Nyambedha(2), Tobias Haller(3), Sonja Merten(4),


(1) Centre for the advancement of Scholarships, University of Pretoria; Department of Sociology and Anthropology, Maseno University, Kenya
(2) Department of Sociology and Anthropology, Maseno University, Kenya
(3) Centre for the advancement of Scholarships, University of Pretoria
(4) Institute of Social Anthropology University of Bern, Switzerland
Corresponding Author

Abstract


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).

References


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

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

on antenatal healthcare services in Sub-Saharan

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

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

and newborn care during the COVID-19 pandemic in

Kenya: Re-contextualising the community midwifery

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

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

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

Policy. 2020; (6): 67–73.

The United Nations Population Fund (UNFPA). Maternal ,

Newborn and Adolescent Health During Pandemics.

Available from:

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

Simba H and Ngcobo S. Are Pandemics Gender Neutral ?

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

Health. 2020; (19)1: 1–6.

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

gendered impacts of the outbreak. Lancet. 2020;

(395): 846–848.

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

equality and health: laying the foundations for change.

Lancet. 2019; (393): 2369–2371.

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

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

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

Geeta RG. Gender inequality and restrictive gender

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

(393): 2440–2454.

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

gender into disease outbreak preparedness and

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

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

Available from:

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

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

VK, Pattinson R and Darmstadt GL. Two million

intrapartum-related stillbirths and neonatal deaths:

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

Obstet. 2009; (107): S5–S19.

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

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

Say L. Global , regional , and national levels and

trends in maternal mortality between 1990 and 2015 ,

with scenario-based projections to 2030 : a systematic

analysis by the UN Maternal Mortality Estimation

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

Office for National Statistics ONS and Committee on

Health Care for Underserved Women. American

College of Obstetricians and Gynecologists [ACOG].

Committee OpinionNo. 649: racial and ethnic

disparities in obstetrics and gynecology. Obstet.

Gynecol. 2015; (126): 130–134.

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

Sangi-Haghpeykar HC and Steven L. Health care

disparity and pregnancy-related mortality in the

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

(131): 707–712.

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

Socioeconomic Deprivation: Deaths Occurring

Between 1 March and 30 June 2020. 2020. Available

from:

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

nity/birthsdeathsandmarriages/deaths/bulletins/deaths

involvingcovid19bylocalareasanddeprivation/deathso

ccurringbetween1marchand30june2020.

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

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

Worsening Gender Inequalities for Women and Girls

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

; (2): 1–6.

UNFPA. COVID-19 Technical Brief for Maternity

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

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

technical-brief-maternity-services.

McQuilkin PA, Udhayashankar K, Niescierenko M and

Maranda L. Health-care access during the Ebola virus

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

(97): 931–936.

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

mothers and newborns during the Ebola outbreak in

Liberia: The need for improvement in emergencies.

PLoS Curr. 2015; (7).

Ombere SO. Access to Maternal Health Services During

the COVID-19 Pandemic: Experiences of Indigent

Mothers and Health Care Providers in Kilifi County,

Kenya. Front. Sociol. 2021; (6): 1–8.

Wangamati CK and Sundby J. The ramifications of

COVID-19 on maternal health in Kenya The

ramifications of COVID-19 on maternal health in

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

https://doi.org/10.1080/26410397.2020.1804716.

Ombere SO. Negotiating Access to Maternal Health

Services During COVID-19 Pandemic in Kilifi

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

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

Social and Cultural Realities: Global Context.

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

-19-0809-5_7.

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

Kenya’s free maternal healthcare policy on the

utilization of health facility delivery services and

maternal and neonatal mortality in public health

facilities. BMC Pregnancy Childbirth. 2018;

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

Kenya National Bureau of Statistics (KNBS), Ministry of

Health/Kenya, National AIDS Control

Council/Kenya, Kenya Medical Research Institute &

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

Health Survey 2014. 2015.

Kenya National Bureau of Statistics & ICF International.

Kenya 2014 Demographic and Health Survey Key

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

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

of the free maternity services policy and its

implications for health system governance in Kenya.

BMJ Glob. Heal. 2017; (2): 1–11.

Nyadera IN and Onditi F. COVID-19 experience among

slum dwellers in Nairobi: A double tragedy or useful

lesson for public health reforms? Int. Soc.

Work.2020;(63): 838–841.

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

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

COVID-19 Effect on Access to Maternal Health

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

: 1.

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

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

COVID-19 Effect on Access to Maternal Health

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

(1); 1–9.

Mbugua S and Kerry M. Maternal Health Indicators in

High-Priority Counties of Kenya: Levels and

Inequities. DHS Further Analysis Reports No.110.

Braun V and Clarke V. Successful qualitative research: A

practical guide for beginners.2013. Available at:

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

n_abductive_explorative_research_using_reflexive_t

hematic_analysis/attachment/61517623b3729f0f618

/AS%3A1072555687436291%4016327286117

/download/Important+Successful+Qualitative+Res

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

+Clarke+%26+Braun.pdf

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

and newborn care during the COVID-19 pandemic in

Kenya: Re-contextualising the community midwifery

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

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

BS, Sandouno SD, Beavogui AH, Rutherford GW,

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

Ebola virus disease on maternal and child health

services in Guinea: a retrospective observational

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

e457.

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

Cultural Practices During Pregnancy and Birth

Among the Giriama Community in Coastal Kenya : A

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

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

Nduba J and Kermode M. Community and provider

perceptions of traditional and skilled birth attendants

providing maternal health care for pastoralist

communities in Kenya: A qualitative study. BMC

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

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

Breastfeeding during the COVID-19 pandemic - a

literature review for clinical practice. Int. Breastfeed.

J. 2020; (15): 1–9.

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

and Maggio L. Impact of COVID-19 pandemic

lockdown on exclusive breastfeeding in non-infected

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

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

Mosca F and Zuccotti GV. The Triad Mother-Breast

Milk-Infant as Predictor of Future Health : A

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

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

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

Breastfeeding 1 Breastfeeding in the 21st century :

epidemiology , mechanisms , and lifelong eff ect.

Lancet. 2016; (387): 475–490.

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

George AS. Gender dynamics affecting maternal

health and health care access and use in Uganda.

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

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

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

that disproportionately affect women during the

Covid-19 pandemic: A review. Social Science and

Medicine vol. 2020; (266).

Chattopadhyay A and Govil D. Men and maternal health

care utilization in India and in selected less-developed

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

Biosoc. Sci. 2020;

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

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

benefits? Endogenous rotating savings and credit

associations as alternative for women’s empowerment

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

Darmenova Y and Koo EJ. Towards local sustainability:

Social capital as a community insurance in

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

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

and Reproductive Health of Adolescents and Youth in

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

https://doi.org/10.1007/978-981-13-6593-5.


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