Abstract:
Global response to COVID-19 pandemic has inadvertently undermined the achievement of existing public health
priorities and laregely overlooked local context. Recent evidence suggests that this will cause additional maternal
and childhood mortality and morbidity especially in low- and middle-income countries (LMICs). Here we have
explored the contextual factors influencing maternal, neonatal and children health (MNCH) care in Bangladesh,
Nigeria and South Africa amidst the pandemic. Our findings suggest that between March and May 2020, there was
a reduction in utilisation of basic essential MNCH services such as antenatal care, family planning and immunization
due to: a) the implementation of lockdown which triggered fear of contracting the COVID-19 and deterred people
from accessing basic MNCH care, and b) a shift of focus towards pandemic, causing the detriment to other health
services, and c) resource constraints. Taken together these issues have resulted in compromised provision of basic
general healthcare. Given the likelihood of recurrent waves of the pandemic globally, COVID-19 mitigation plans
therefore should be integrated with standard care provision to enhance system resilience to cope with all health
needs. This commentary suggests a four-point contextualised mitigation plan to safeguard MNCH care during the
pandemic using the observed countries as exemplars for LMIC health system adaptations to maintain the trajectory
of progress regarding sustainable development goals (SDGs).
