Maternal Health Service Utilization in Rural Districts of Jimma Zone in the Context of COVID-19 Pandemic: A Qualitative Study

Abstract

Background: Maternal health service utilization is very low in Ethiopia. Appropriate utilization of it can play a crucial role in preventing maternal morbidity and mortality. Currently, the COVID-19 Pandemic is emerged globally and challenging the utilization of maternal health care services. Thus, exploring barriers, impacts of COVID 19 pandemic on maternal health service utilization could help to design appropriate strategies and policies. Objective: To explore barriers, impacts and facilitating factors to maternal health service utilization in Jimma Zone rural districts during COVID -19 pandemic, 2021. Methods: Qualitative Study was conducted in three rural districts of Jimma zone, Oromia region. Twenty seven (27) key informant interviews were conducted with community and health care workers. The data six month before and during the pandemic reviewed. In addition nine (9) Focus Group Discussions were conducted with selected pregnant and lactating mothers, husbands and Women’s Health Development army leaders. The data were transcribed verbatim and then translated into English language for analysis and analysed using ATLAS.ti Software. Result: During the first six month of COVID 19 Pandemic, Maternal health care services were declined from 47% to 33%. Due to health system and individual/community related set of barriers, health care seeking behaviour of women were decreased, home deliveries were increased, facilities were closed and maternal complications were happened. Husband support in birth preparation, existence of community structures and home to home visits by health care providers are good practices found as facilitating factor for maternal health service utilization. Conclusion: There were interruption of maternal health services which was attributed to COVID-19 state emergency, closed facility, mandatory use of face masks and other restrictions. The major impacts of COVID-19 identified were: increased home delivery, maternal health complication, and scarcity of drugs & supplies. COVID-19 interplays negatively with other factors to affect maternal health service utilization