Impact of COVID-19 Pandemic on the Utilization of Maternal Health Services in Chandigarh and Kalyani, West Bengal, India: A Retrospective Cross-Sectional Study.

Introduction: Maternal health services may be adversely impacted during pandemics especially in the low- and middle-income countries. COVID-19 pandemic was such a situation. Here, we describe the status of maternal health services prior to and during the COVID-19 pandemic in India.

Methods: A retrospective cross-sectional household-based survey was conducted among randomly selected 820 mothers with children less than 2 years in Chandigarh and Kalyani, West Bengal, to assess the utilization of antenatal, intrapartum and postnatal care services before March 2020 (pre-pandemic period, n = 413) and after March 2020 (pandemic period, n = 407). Data were managed using REDCap and were analyzed using Statistical Package for Social Sciences (version 25.0). Multivariate logistic regression analysis was used to estimate the adjusted odds ratios (aOR) and significant differences between groups at 95% confidence intervals (CIs).

Results: There was a significant increase in the reporting of pregnancy-related complications during the pandemic (aOR 1.45; 95% CI 1.08-1.94) and a significant increase in utilization of supplementary nutrition services from anganwadis (aOR 1.81; 95% CI 1.33-2.46) during the pandemic. There was a significant decrease in the proportion of women who received financial assistance during delivery in the pandemic period (aOR 0.36; 95% CI 0.17-0.79). Postpartum checkups by healthcare workers significantly decreased during the pandemic period (82.6%) as compared with the pre-pandemic period (82.6%) [aOR 0.84; 95% CI 0.71-0.97].

Conclusions: The COVID-19 pandemic significantly changed the utilization of antenatal, intrapartum and postpartum services in our study areas. While the existing national program and timely pandemic guidelines helped ensure that some services remained uninterrupted, postpartum care was the most affected possibly due to restrictions of field visits by the healthcare workers. Financial assistance for delivery care was also heavily affected during the pandemic.