The experiences of women in accessing maternal health care services during Covid-19 : a case study of Mmabatho, North-West

Abstract

Access to maternal healthcare has been a challenge for women historically, particularly those residing in marginal rural communities in Africa. Scholars have shown that the challenge of access and utilisation of maternal healthcare services was further compounded by additional factors such as the outbreak of the Coronavirus disease of 2019 (Covid-19) pandemic. Measures put in place during the pandemic such as lockdowns, stay at home orders and curfews resulted in women failing to access maternal health care services and protracted delays in receiving care at health centres due to shortages of health care workers. Regarding expectant mothers a number of scholars have argued that there was an increase of complications during pregnancy and childbirth as more resources were diverted to the Covid-19 pandemic. However, there is a dearth of knowledge with respect to experiences and health seeking behaviours of women during pregnancy, childbirth and new-born care during the Covid-19 pandemic. To this end, this study aimed to examine the experiences of women accessing maternal health care services during the Covid-19 pandemic outbreak. Andersen’s behavioural model and Bourdieu’s theory of social practice were used to interpret and understand the experiences of women accessing maternal health care during the Covid-19 pandemic. The study used the qualitative research method, and this was done using the in-depth interview method. The study was undertaken in Mmabatho Unit 9 and in Montshioa unit 1 clinics which are major service providers of maternal health care services within Mmabatho, North-West. Thirty women in their reproductive years who were aged between 20-55 years old both from the lower- and middle-income classes participated in the study. Non-probability methods such as purposive and snowball sampling techniques were utilised in selecting participants for the study. Findings from this study revealed that the experiences of women in accessing and providing maternal healthcare services play a vital role in guiding healthcare practices. It also found both negative and positive experiences in accessing maternal health care services. For instance,

cases of nervousness were reported because some women reported having been anxious because of different reasons other than possibly being infected with the Covid-19 virus. Most women expressed concerns regarding the impact of reduced contact on access and quality of maternal health care services. On the other hand, the findings from the study indicated that the pandemic gave them the opportunity to spend more time with their families which also resulted in an upsurge of intimate partner violence during the same period. The government implemented various programs to cater for expectant mothers during the Covid-19 pandemic. The study recommends adequate funding to ensure continuity of maternal health care in terms of prevention of infection, adequate supplies, and control of Personal Protective Equipment. The study also recommend that the government ensure that health centers use mobile health including but not limited to, m-health services and telemedicine so as to ensure the continuity of service provision during pandemics or crisis periods where in-person visits are difficult.