Streamline
maternal health care provision to mitigate the risk for pregnant women
under COVID-19 pandemic
Hong Jiang1, Mu Li2, Huijing
Shi1*, Xu Qian1
1School of Public Health; Global Health Institute;
National Health Commission Key Laboratory of Health Technology
Assessment, Fudan University, Mailbox 175, No. 138 Yixueyuan Road,
Shanghai 200032, China;
2School of Public Health; China Studies Centre, Room
313, Edward Ford Building, University of Sydney, Sydney 2006, Australia
*Corresponding author: Huijing Shi,
hjshi@fudan.edu.cn,
School of Public Health; Global Health Institute; NHC Key Laboratory of
Health Technology Assessment, Fudan University, Mailbox 175, No. 138
Yixueyuan Road, Shanghai 200032, China;
The
novel
Coronavirus Disease 2019 (COVID-19) outbreak started in Wuhan City China
in early December 20191,2, and has rapidly spread
across the world. The pandemic has strained health
system3, which presents a huge challenge to maintain
other essential health services, including maternal health care. As the
first country to experience the COVID-19 outbreak, there are lessons
could be learnt for establishing a better preparedness mechanism from a
service delivery perspective to provide essential maternal health care
and mitigate health risk for pregnancy women.
First, all health facilities providing antenatal care should apply high
standard of precaution to ensure pregnant women are not exposed to the
COVID-19 transmission. This includes
setting
up a triage area to screen for COVID-19 symptoms and contact history
with confirmed cases before pregnant women entering antenatal clinics.
People with COVID-19 exposure history, suspected cases or COVID-19
patients should be separated from other pregnant women and placed in
designated areas. This will also protect antenatal care providers.
Appointment is required in advance for antenatal service to ensure
adequate social distancing and manage the patient flow in health
facilities.
Second, as routine service provision might be disrupted, perinatal care
availability and any changes to service provision should be disseminated
widely, preferably through online platforms4.
Women with low risk pregnancy may
reduce the risk of contracting COVID-19 by reducing the number of
antenatal visits. Women with pregnancy complications and other health
conditions should contact their antenatal care provider to seek specific
advice. Communication and counselling can be provided to pregnant and
postnatal women online, including recognizing warning signs of going to
hospital urgently. During movement restriction or self-isolation
guidance of keeping healthy diet and physical activity, and mental
health support are important for the well-being of pregnant women.
Third, balancing the demands of emergency responding to COVID-19 and
maintaining essential perinatal health service at national, provincial
and local levels. Guidelines on conditions that require continuing
antenatal care and those can be delayed should be
developed5. Designated hospitals for treating pregnant
women with COVID-19 should be enlisted to ensure they will receive
appropriate care from a multi-disciplinary team6. At
the provincial/regional level, health authorities should adapt to local
context and develop uniformed perinatal operational guidelines across
all local health facilities and monitor the equitable access to service
and service quality. Local health facilities are responsible for
disseminating service information via official channels, e.g. account on
social media platforms such as WhatsApp, Facebook, and providing
services following the provincial/regional operational guidelines.
As the pandemic intensifies globally7,8, the
experience and lessons of China on the response and streamline health
system may help other counties to mitigate adverse impact of the
pandemic on maternal and newborns.
Disclosure
of interests
We declare no competing interests.