Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

Type Journal Article Author Aline Semaan Author Constance Audet Author Elise Huysmans Author Bosede Afolabi Author Bouchra Assarag Author Aduragbemi Banke-Thomas Author Hannah Blencowe Author Séverine Caluwaerts Author Oona Maeve Renee Campbell Author Francesca L. Cavallaro Author Leonardo Chavane Author Louise Tina Day Author Alexandre Delamou Author Therese Delvaux Author Wendy Jane Graham Author Giorgia Gon Author Peter Kascak Author Mitsuaki Matsui Author Sarah Moxon Author Annettee Nakimuli Author Andrea Pembe Author Emma Radovich Author Thomas van den Akker Author Lenka Benova URL https://gh.bmj.com/content/5/6/e002967 Rights © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Volume 5 Issue 6 Pages e002967 Publication BMJ Global Health ISSN 2059-7908 Date 24/06/2020 Extra Publisher: BMJ Specialist Journals Section: Original research PMID: 32586891 DOI 10.1136/bmjgh-2020-002967 Library Catalog gh.bmj.com Language en Abstract Introduction The COVID-19 pandemic has substantially impacted maternity care provision worldwide. Studies based on modelling estimated large indirect effects of the pandemic on services and health outcomes. The objective of this study was to prospectively document experiences of frontline maternal and newborn healthcare providers. Methods We conducted a global, cross-sectional study of maternal and newborn health professionals via an online survey disseminated through professional networks and social media in 12 languages. Information was collected between 24 March and 10 April 2020 on respondents’ background, preparedness for and response to COVID-19 and their experience during the pandemic. An optional module sought information on adaptations to 17 care processes. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregating by low-income and middle-income countries (LMICs) and high-income countries (HICs). Results We analysed responses from 714 maternal and newborn health professionals. Only one-third received training on COVID-19 from their health facility and nearly all searched for information themselves. Half of respondents in LMICs received updated guidelines for care provision compared with 82% in HICs. Overall, 47% of participants in LMICs and 69% in HICs felt mostly or completely knowledgeable in how to care for COVID-19 maternity patients. Facility-level responses to COVID-19 (signage, screening, testing and isolation rooms) were more common in HICs than LMICs. Globally, 90% of respondents reported somewhat or substantially higher levels of stress. There was a widespread perception of reduced use of routine maternity care services, and of modification in care processes, some of which were not evidence-based practices. Conclusions Substantial knowledge gaps exist in guidance on management of maternity cases with or without COVID-19. Formal information-sharing channels for providers must be established and mental health support provided. Surveys of maternity care providers can help track the situation, capture innovations and support rapid development of effective responses. Short Title Voices from the frontline