Evidence of Resiliency in Maternal Health Services and Outcomes in Kono District, Sierra Leone during the COVID-19 Pandemic: An Observational Study

BackgroundThis study evaluated the resilience and outcomes of maternal health services during the COVID-19 pandemic in two health facilities in eastern Sierra Leone. Its aims to describe the use of maternal healthcare services and maternal and neonatal outcomes in these two facilities before, during, and after the COVID-19 pandemic. MethodsThe study involved analysis of routine programme data (March 2019 to February 2022) from two public-funded health facilities supported by a non-governmental organization (Partners In Health in Sierra Leone): Koidu Government Hospital and Wellbody Clinic. Aggregated and de-identified secondary data from the Partner In Health Maternal Health Database was abstracted using a standardized tool. Descriptive statistics and bivariable negative binomial regression were used to assess the association between time periods (before COVID-19 [March 2019 to February 2020], during COVID-19 emergency [March 2020 to February 2021], after COVID-19 emergency [March 2021 to February 2022) and outcomes each month (fourth antenatal care visit and facility deliveries). ResultsThe study analyzed 3,204 fourth antenatal care visits and 7,369 deliveries over 36 months at both health facilities. Fourth antenatal care visits (from 947 to 920) and facility deliveries (from 2309 to 2221) decreased during COVID-19 compared to pre-COVID-19. However, maternal (from 32 to 23) and neonatal (36 to 26) deaths declined during COVID-19 compared to the pre-COVID-19 period at Koidu Government Hospital. ConclusionIn Sierra Leone, the resources and efforts directed to the post-Ebola recovery strategy were tested during and after the COVID-19 pandemic. Our study demonstrates the resilience of maternal and neonatal services in two healthcare facilities in a less-affected region of Sierra Leone, to the anticipated disruptions due to the COVID-19 pandemic.