Background
The COVID-19 pandemic response is affecting maternal and neonatal health services all over the world. Authors aimed to assess the number of institutional births, their outcomes (institutional stillbirth and neonatal mortality rate), and quality of intrapartum care before and during the national COVID-19 lockdown in Nepal.
Methods
In this prospective observational study, we collected participant-level data for pregnant women enrolled in the SUSTAIN and REFINE studies between Jan 1 and May 30, 2020, from nine hospitals in Nepal. This period included 12·5 weeks before the national lockdown and 9·5 weeks during the lockdown.
Women were eligible for inclusion if they had a gestational age of 22 weeks or more, a fetal heart sound at time of admission, and consented to inclusion. Women who had multiple births and their babies were excluded. Researchers collected information on demographic and obstetric characteristics via extraction from case notes and health worker performance via direct observation by independent clinical researchers.
Authors used regression analyses to assess changes in the number of institutional births, quality of care, and mortality before lockdown versus during lockdown.