COVID-19 restricts antenatal care, family planning services

DATA from the Jamaica Family Planning Association (FAMPLAN/JFPA) has revealed that the COVID-19 restrictions faced in 2020 negatively impacted the antenatal care (ANC) services and family planning services the institution offers.

Last year the restrictions led to concern for the quality of care being offered by the association during the period and led the association – a member of the International Planned Parenthood Federation/Western Hemisphere Region – to conduct a study of ANC users.

The study, titled Comparing the health-seeking behaviours of pregnant women in two JFPA clinics in the time of COVID-19, led by Dr Pauline Russell-Brown, executive director of FAMPLAN, aimed to explore the effect of COVID-19 restrictions on pregnant women’s health-seeking behaviours.

The study relied on a mixed-method data collection approach. Secondary quantitative data – demographic data, information on gestation at registration and appointment dates – for each client were abstracted from the association’s electronic database.

The study revealed that between April and June 2020, 15 women were scheduled for an ANC visit at Clinic A and 16 at Clinic B. However, 13 or 89 per cent of the 15 pregnant women who used Clinic A missed their scheduled appointments. They did not call the clinic. All of them returned for services within two months of the missed visit.

Ten or 67 per cent of the 16 pregnant women who used the services of Clinic B called ahead to determine if services were being offered or to speak with the nurse/midwife. One of the 10 women was in her third trimester. She was referred to the hospital. Women in their first and second trimester of pregnancy were encouraged to keep their appointments

Data from conversations between women and the respective nurse or midwife revealed that all women had concerns for the safety of their babies and themselves. Those who did not call in or keep their appointments later admitted to having financial challenges.

Additional data from FAMPLAN, comparing 2019 and 2020 ANC visits for two static JFPA clinics, showed a small decline in ANC visits in 2020 compared to 2019 at Lenworth Jacobs Clinics (LJC) in Kingston. In 2019, LJC had 418 ANC visits and 2020 saw 207 women visiting for ANC services.

The Beth Jacobs Clinic (BJC) in St Ann’s Bay saw an increase in the number of ANC visits in 2020 compared to 2019. In 2020 BJC saw 171 women for ANC services compared to 67 in 2019.

Further data comparing family planning visits at BJC and LJC showed a slight increase in the number of family planning visits at BJC in 2020 compared with 2019, and a decrease in visits at LJC for the same periods.

In 2019, BJC saw 691 family planning visits compared to 755 in 2020. At LJC, 1051 family planning visits were had in 2019, compared to 912 visits in 2020. Meanwhile, one woman of reproductive age who spoke to the Jamaica Observer on condition of anonymity said since COVID-19 hit and restrictions have been in place, she has not followed through on her family planning visits and would “rather breed” than catch COVID-19.

“When you see the crowds at clinics you can’t help but be afraid. Despite the social distancing rules, there is a line of people in your ‘neck back’ same way. Before I catch COVID like that, mi rather breed,” she said.

Another woman echoed similar sentiments while clarifying that she has changed her contraceptive methods.

“I just get a prescription for the pill now and use one of those delivery services to fill it. I used to go for the injection but I too am afraid of COVID. However, we have to be responsible so it’s the pill or condoms for me,” she shared.

Moreover, FAMPLAN said telephone follow-ups may have made the difference at BJC, while financial constraints and a number of social and economic factors accounted for the decline.

“For Kingston, the lockdown seemed to have [kept] clients away longer. Some people who were on oral contraceptive methods came and got their methods before the lockdown and wouldn’t need to come back before the next cycle. But, there were a number of people who didn’t show up at all during that period and we had to follow [up] by telephone to some of them. Some were due to financial reasons. In St Ann we had a telecommunication element, so clients were asked to call in if they needed to. They did and got counselling by phone and then they came as necessary for their supplies. There are some other social factors that would explain the urban/rural differences,” Dr Russell-Brown said.

The entity said more in-depth research to understand the differences between its rural and urban clients is needed to ensure they serve them better.

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