Continuity of Essential Health Services (CES) Study
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Date
2021-06-04
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kamuzu University of Health Sciences
Abstract
Type of Study
This is a Qualitative study in selected geographical areas including key informant interviews (KIIs),
focus group discussions (FDGs) and in-depth interviews with specific target groups (e.g. women living
with HIV/AIDS). The scope will include data collection, data quality monitoring,
transcription/translation, data analysis and reports on study results.
BACKGROUND RATIONALE
Malawi registered its first Covid-19 cases in March 2020. A Presidential Taskforce on Covid -19 was
immediately set up and Covid-19 prevention measures were put in place and these included: Closing
down of schools, social distancing, wearing of masks, self- quarantine for all who tested COVID positive
and all in-coming travelers, public gatherings were initially limited to 100 people and this was
suspended due to injunctions. While government public health and social measures have likely
forestalled some COVID-19 spread, they also have deleterious indirect social, economic and health
impacts. While attention is understandably focused on the direct impact of the COVID-19
pandemic, it is essential to see the health crisis from a broader perspective. In Malawi, health
systems are already fragile and people often live in extremely precarious conditions. The
coronavirus pandemic risks further reducing vulnerable people’s already limited access to
healthcare, as resources – both human and financial – get diverted from regular healthcare to the
COVID-19 response.
OBJECTIVES
The overall study objective is:
• To investigate the effect of COVID-19 pandemic on people’s willingness and ability to access
essential MNCH services, their experiences of care and the perspectives of staff on MNCH services’
readiness to provide essential care during the pandemic.
Specific study objectives are to:
1. Comprehend how COVID-19 has affected pregnant and breastfeeding women’s access to
maternal and newborn health services.
2. Comprehend how COVID-19 has affected access to child health services for the under-fives.
3. Comprehend any specific challenges faced by vulnerable groups during COVID-19 with regard
to access to MNCH services.
METHODS
The methodology will include focus group discussions (FGDs) and key informant interviews (KIIs),
followed by in-depth interviews (IDIs) to capture respondents of vulnerable groups. The data will be
collected from Mchinji and Blantyre Districts (indicative locations to be confirmed following
consultation) and the study population will include adult pregnant/breastfeeding women,
parents/caretakers of children under five years of age, adolescents (15 to 19 years of age,companions/partners of pregnant/breastfeeding women and pregnant/breastfeeding adolescents,
community-based health workers, health workers and facility based managers.
DATA MANAGEMENT AND ANALYSIS
All audio and handwritten data collected from the FGDs and interviews will be stored securely.
Electronic notes, transcripts and translations will be stored electronically and protected by a
password. Only members of the research team will have access to these documents. As soon as the
audio-recordings have been transcribed and verified, they will be destroyed by erasing the voice
recordings.
Framework analysis will be used for cross-sectional analysis of data from FGDs, IDIs and KIIs. The focus
will be on understanding the demand and supply-side barriers to seeking routine and emergency
health care services, the extent to which the pandemic has impacted people’s willingness and ability
to access MNCH services and how service readiness and provision has changed as a result of COVID-
19 and its effects. A combination of deductive and inductive themes will be included.
POSSIBLE CONSTRAINTS
COVID-19 situation might require adaptation of study methods using more or only virtual methods for
interviews and FDGs; virtual FDGs might be not ideal given that moderators should be physically
present to be able to catch the dynamics in the groups and to be able to guide and facilitate
appropriately. However, the research teams will only do virtual FDGs in case there is no alternative.
RESULTS PRESENTATION
Key findings will be presented during a webinar with a UN, participating districts and MoH audience.
All data collected, analytical memos and framework analysis files will be de-identified and shared with
UNICEF alongside draft reports. The report will also be shared with COMREC.
IMPLICATIONS OF THIS STUDY
We anticipate that findings from this study will highlight the impact of Covid-19 on people’s willingness
and ability to access essential MNCH services, their experiences of care and the perspectives of staff
on MNCH services’ readiness to provide essential care during the pandemic.
Description
Keywords
Research Subject Categories::MEDICINE