Presenter: Dr. Rijuta Sawant Co-authors: Ms. Sushmita Das Dr. Manjula Bahuguna Dr. Anuja Jayaraman

1. DELIVERING FOR NUTRITION IN SOUTH ASIA
Implementation Research in the Context of COVID-19
2 December,2021
Presenter: Dr. Rijuta Sawant
Co-authors: Ms. Sushmita Das
Dr. Manjula Bahuguna
Dr. Anuja Jayaraman
COVID-19: Access to maternal
health service in informal
settlements of Mumbai
SNEHA: Society for Nutrition, Education & Health Action

2. • COVID-19 outbreak overwhelmed the health systems
• Nationwide lockdowns, disruption of health-care
services, and financial hardships resulted in poor
uptake of health services especially among pregnant
women in Mumbai - one of the hotspots of COVID-19
cases
Rationale

3. Objective
To assess the uptake of maternal health
services and related experiences of
expectant and new mothers residing in
informal settlements of Mumbai during
COVID-19 pandemic

4.  Study: Cross-sectional survey
 Study period: July-August 2020
 Study area: 3 informal settlements in
SNEHA’s project implementation area
 Sampling method: Simple random
 Sample size: 436
Methods
 Study participants: Pregnant women and
postpartum women who had delivered
between April-August 2020
 Questionnaire:
oAdapted from Coronavirus Perinatal
Experiences Impact Survey (COPE-IS)
 Telephonic interviews with informed, verbal
consent
*Thomason, M.E., Graham, A., VanTieghem, M.R. (2020). The COPE-IS: Coronavirus Perinatal
Experiences – Impact Survey. University Langone Health, New York

5. Results

6. Pregnancy details
 Pregnancy status: Pregnant-226 (52%)
Post-partum-210 (48%)
 Parity: Primipara-155 (36%)
 Pregnancy associated risk factor: Anemia-93 (21%)
Profile of respondents
(N=226)
Demography
 Age group: 86% belong to 20-30 years age group
 Education: 61% completed secondary schooling
 Occupation: 5% had a paid employment

7. Post-partum mothers
(N=210)
• Institution delivery-168 (80%)
Pregnant women
(N=226)
• Registration for ANC-209 (92%)
Antenatal and Delivery care
69%
25%
6%
PREFERRED HEALTH FACILITY
FOR ANTENATAL CARE
Government hospitals Private hospitals Others
64%
35%
1%
PREFERRED HEALTH FACILITY
FOR DELIVERY CARE
Government hospitals Private hospitals Other
*ANC: Antenatal care
*LSCS: Lower segment Cesarian section

8.  179 (85%) had regular antenatal check ups
 193 (92%) availed laboratory & diagnostic
services
Access to Antenatal care services
63%
53%
51%
51%
Change in hospital/care provider
Changed format of ANC visits
Reduction in ANC visits
No outreach/field camps in area
(N=226)
*ANC: Antenatal care
20% reported uninterrupted delivery care services, 80%
experienced unavailable/changed ANC services during pandemic
*Multiple choices

9. Postnatal care
Delivery care
Access to Delivery and Postnatal care services
(N=210)
50%
23%
13%
9%
Change in planned delivery
Denial/referral to other
facility
Change in type of delivery
Unavailability of planned
healthcare provider
15% reported uninterrupted Delivery and Postnatal care services while 84% faced unavailability or changed
services during pandemic
49%
26%
25%
11%
No outreach by frontline
workers
Incomplete/postponed
immunization
Unavailability of healthcare
provider/services
In-person to virtual
postpartum visit
*Multiple choices

10. Perception about Health service status during pandemic
Pregnant women
(Antenatal care services)
N=226
Health service
status
Post-Partum women
(Delievery care services)
N=210
47% No change 48%
46% Worsened 40%
7% Improved 12%

11. Support received from health providers
Pregnant women
(Antenatal care services)
N=226
Support from health
providers
Post-Partum women
(Delievery care services)
N=210
47% Very well supported 56%
51% Somewhat well supported 40%
2% Not very well supported 4%

12. • Our findings indicate that lack of information on the status of available services was one
of the major limiting factors for accessing services.
• Effective communication channels to make this information publicly available to all for
ease of accessing services is required.
• Additionally, health care systems can be strengthened by the government in order to
cope with any shocks in the future.
• Advocacy with the health system on resumption of outreach services
• Frontline workforce of the community-based or non-governmental organizations can be
reached for this purpose along with the use of different social media platforms
Policy implications

13. Thank You!!!