Perinatal Dönemdeki Kadınların Anne Sağlığı Hizmetlerine İlişkin Deneyimleri: COVID-19 Pandemisi Döneminde Niteliksel Bir Çalışma
Yıl 2024,
, 260 - 271, 05.07.2024
Meltem Aydın Beşen
,
Gözde Gökçe İşbir
Öz
Amaç: Bu araştırma, COVİD-19 salgını sırasında perinatal dönemdeki kadınların anne sağlığı hizmetlerine ilişkin deneyimlerini belirlemek amacıyla yapılmıştır.
Yöntemler: Bu nitel tanımlayıcı bir çalışmadır. Araştırmaya pandemi döneminde perinatal dönemde olan 19 kadın dahil edildi. Veriler yarı yapılandırılmış görüşme soruları kullanılarak toplanmıştır.
Bulgular: Bu çalışmada elde edilen veriler üç temaya ayrılmıştır: Birinci - anne sağlığı hizmetlerinin değişmesine yönelik deneyimler, ikinci - anne sağlığı hizmetlerinin yetersizliğinin sonuçları ve üçüncü -anne sağlığı hizmetlerine erişimi kolaylaştıracak öneriler.
Sonuç: Pandemi döneminde perinatal dönemdeki kadınların anne sağlığı hizmetlerine erişimi değerlendirilmeli ve bu hizmetlere erişimi engelleyen durumlar ele alınırken toplum ebelerinin de katkısıyla yeni stratejiler geliştirilip uygulanarak hizmetlere erişim sağlanmalıdır.
Kaynakça
- Ahmed, Z., & Sonfield , A. (2020). The COVID-19 outbreak: potential fallout for sexual and reproductive health andrights. Available: https://www.guttmacher.org/article/2020/03/covid-19-outbreak-potential-fallout-sexual-and-reproductive-health-and-rights .
- American College of Obstetricians and Gynecologists. (2020). COVID-19 FAQs for obstetricians-gynecologists, obstetrics. Retrieved April 22, 2021 from https://www.acog.org/clinical-information/physician-faqs/covid-19-faqs-for-ob-gyns-obstetrics ,
- Aranda, Z., Binde, T., &Tashman, K., et al. (2022). Disruptions in maternal health service use during the COVID-19 pandemic in 2020: experiences from 37 health facilities in low-income and middleincome countries. BMJ Global Health, 7, e007247. doi:10.1136/ bmjgh-2021-007247.
- Arora, KS., Mauch, J.T., & Gibson, K.S. (2020). Labor and delivery visitor policies during the COVID-19 pandemic balancing risks and benefits. JAMA, 323, (24), 2468-2469. DOI: 10.1001 / jama.2020.7563.
- Ashish, K.C., Gurung, R., & Kinney, M.V., et al. (2020). Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study. Lancet Glob Health, 8, e1273--81. DOI: https://doi.org/10.1016/S2214-109X(20)30345-4
- Bohren, M.A., Berger, B.O., Munthe-Kaas, H., & Tunçalp, Ö. (2019). Perceptions and experiences of labor companionship: a qualitative evidence synthesis. Cochrane Database of Systematic Reviews, Issue 3. Art. No .: CD012449. DOI: 10.1002 / 14651858.CD012449.pub2
- Bohren, MA., Hofmeyr, GJ., Sakala, C., Fukuzawa, RK., & Cuthbert, A. (2017). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, Issue 7. Art. No.: CD003766. DOI: 10.1002 / 14651858.CD003766.pub6.
- Burt, J.F., Ouma, J., Lubyayi, L., Amone, A., Aol, L., Sekikubo, M., & Nakimuli, A., et al. (2021). Indirect effects of COVID-19 on maternal, neonatal, child, sexual and reproductive health services in Kampala, Uganda. BMJ Glob Health, 6(8), e006102. doi: 10.1136/bmjgh-2021-006102. PMID: 34452941; PMCID: PMC8406460.
- Castro, A. (2020). Challenges posed by the COVID-19 pandemic in the health of women, children, and adolescents in Latin America and the Caribbean. Retrieved April 22, 2021 from https://www.latinamerica.undp.org/content/rblac/en/home/library/crisis_prevention_and_recovery/desafios-de-la-pandemia-de-covid-19-en-la-salud-de-la- mujer - de-.html
- Centers for Disease Control and Prevention. (2020). Considerations for inpatient obstetric healthcare settings. Published April 4, 2020. Retrieved April 22, 2021 from https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html#anchor_1582067966715 .
- Correia, L.L., Machado, M.M.T., Araújo, D.A.B.S., Gomes, Y.V.C., Pinheiro, M.S.N., Rocha, H.A.L., et al. (2022). Primary Health Care during the COVID-19 pandemic in Fortaleza, Brazil: associated factors and pattern of use by mothers and children up to 18 months of age. Rev Bras Epidemiol., 25, e220036. https://doi.org/10.1590/1980-549720220036
- Dana, P.M., Kolahdooz, F., & Sadoughi, F., et al. (2020). COVID-19 and pregnancy: a review of current knowledge. Le İnfezioni in Medicina, 28 (suppl 1), 46-51.
- Delamou, A., Ayadi, A.M.E., & Sidibe, S., et al. (2017). Effect of Ebola virus disease on maternal and child health services in Guinea: a retrospective observational cohort study. Lancet Glob Health., 5 (4), e448 – e457. DOI: 10.1016 / S2214-109X (17) 30078-5.
- Fernandes, B.A., Alves, B., & Matosinhos, A.C., et al. (2023). The use and role of telemedicine in maternal fetal medicine around the world: an up-to-date. Health Technol (Berl)., 21,1-8. doi: 10.1007/s12553-023-00742-6.
- Fryer, K., Delgado, A., & Foti, T. et al. (2020). Implementation of obstetric telehealth during COVID - 19 and beyond. Maternal and Child Health Journal, 24(9), 1104-1110. https://doi.org/10.1007/s10995-020-02967-7 .
- Galle, A., Semaan, A., & Huysmans, C. et al. (2021). A double-edged sword—telemedicine for maternal care during COVID-19: findings from a global mixed-methods study of healthcare providers. BMJ Global Health, 6, e004575. doi:10.1136/ bmjgh-2020-004575.
- International Confederation of Midwives. (2020). Women's rights in childbirth must be upheld during the coronavirus pandemic. Retrieved April 22, 2021 from https://www.internationalmidwives.org/assets/files/news-files/2020/03/icm-statement_upholding-womens-rights-during-covid19-5e83ae2ebfe59.pdf .
- Islek, E., Ozatkan, Y., & Bilir, M.K. et al. (2020). Covidien-19 pandemic Turkey case management: Strategies for health policy and practice. TÜSPE Report: 2020/2, TÜSPE Publications, Ankara. Retrieved April 22, 2021 from https://www.tuseb.gov.tr/tuspe/uploads/yayinlar/makaleler/pdf/21-08-2020__5f3f6e1402cc2__tusperapor02_covid-19_pandemi_yonetiminde_turkiye_ornegi.pdf .
- Jones, I.H.M., Thompson, A., & Dunlop, C.L., et al. (2022). Midwives’ and maternity support workers’ perceptions of the impact of the first year of the COVID-19 pandemic on respectful maternity care in a diverse region of the UK: a qualitative study. BMJ Open, 12, e064731. doi:10.1136/ bmjopen-2022-064731.
- Karavadra, B., Stockl, A., & Prosser-Snelling, E., et al. (2020). Women's perceptions of COVID-19 and their healthcare experiences: a qualitative thematic analysis of a national survey of pregnant women in the United Kingdom. BMC Pregnancy and Childbirth, 20, 600. https://doi.org/10.1186/s12884-020-03283-2
- Lega, I., Bramante, A., & Lauria, L., et al. (2022) The psychological impact of COVID- 19 among women accessing family care centers during pregnancy and the postnatal period in Italy. Int. J. Environ. Res. Public Health, 19, 1983. https:// doi.org/10.3390/ijerph19041983
- Musiimenta, A., Tumuhimbise, W., & Atukunda, R. et al. (2022). Challenges in accessing maternal and child health services during COVID-19 and the potential role of social networking technologies. Digital Health, 8, 1–10.
- Narang, K., Enninga, E.A.L., & Gunaratne, M.D.S.K., et al. (2020). SARS-CoV-2 ınfection and COVID-19 during pregnancy: A multidisciplinary review. Mayo Clin Proc., 95 (8), 1750-1765. DOI: 10.1016 / j.mayocp.2020.05.011 .
- Padmaja, M., & Behera, D.K. (2023). Disruptions in accessing women’s health care services: Evidence using COVID-19 health services disruption survey. Maternal and Child Health Journal, 27, 395–406. https://doi.org/10.1007/s10995-022-03585-1
- Pant, S., Koirala, S., & Subedi, M. (2020). Access to maternal health services during COVID-19. Europasian J Med Sci., 2 (Covid-19 Special Issue), 48-52. https://doi.org/10.46405/ejms.v2i2.110 .
- Parahoo, K. (2014). Nursing research principles: Processes and issues , 3rd ed. Palgrave Macmillan, Basingstoke UK.
- Queensland Clinical Guidelines. (2020). Maternity care for mothers and babies during COVID-19 pandemic. Retrieved April 22, 2021 from https://www.health.qld.gov.au/__data/assets/pdf_file/0033/947148/g-covid-19.pdf .
- Rasmussen, S.A., Smulian, J.C., & Lednicky, J.A. et al (2020). Coronavirus Disease 2019 (COVID-19) and pregnancy: what obstetricians need to know. American Journal of Obstetrics and Gynecology, 222 (5), 415–426. DOI: 10.1016 / j.ajog.2020.02.017
- Reingold, R.B., Barbosa, I., & Mishor , R. (2020). Respectful maternity care in the context of COVID ‐ 19: A human rights perspective. Int J Gynecol Obstet, 151, 319-321.
- Reisinger-Kindle, K., Qasba, N., & Cayton, C. (2021). Evaluation of rapid telehealth implementation for prenatal andpostpartum care visits during the COVID-19 pandemic in anacademic clinic in Springfield, Massachusetts, United Statesof America. Health Sci Rep., 4, e455.
- Royal College of Midwives and Royal College of Obstetricians and Gynecologists. (2020). Coronavirus (COVID-19) Infection in pregnancy. Information for health professionals. Version 12: Published Wednesday 14 October 2020. Retrieved April 22, 2021 from https://www.rcog.org.uk/globalassets/documents/guidelines/2020-10-14-coronavirus-covid-19-infection-in-pregnancy-v12. pdf .
- Royal College of Midwives and Royal College of Obstetricians and Gynecologists. (2022). Coronavirus (COVID-19) Infection in pregnancy. Information for health professionals. Version 16: Published December 2022. Retrieved December 25, 2022 from https://www.rcog.org.uk/media/ftzilsfj/2022-12-15-coronavirus-covid-19-infection-in-pregnancy-v16.pdf
- Saccone, G., Florio, A., & Aiello, F., et al. (2020). Psychological impact of coronavirus disease 2019 in pregnant women. Am. J. Obstet. Gynecol. 223, 2, 293-295. DOI: https: // doi.org/10.1016/j.ajog.2020.05.003
- Sadler, M., Leiva, G., & Olza, I. (2020) COVID-19 as a risk factor for obstetric violence, Sexual and Reproductive Health Matters, 28, 1, 1785379, DOI: 10.1080 / 26410397.2020.1785379.
- Saunders, B., Sim, J., & Kingstone, T., et al. (2018). Saturation in qualitative research: exploring its conceptualization and operationalization. Quality & Quantity, 52 (4), 1893–1907. https://doi.org/10.1007/s11135-017-0574-8 .
- Sharma, S., Aggarwal, S., & Kulkarni, R., et all. (2023). Challenges in accessing and delivering maternal and child health services during the COVID-19 pandemic: A cross-sectional rapid survey from six states of India. Int. J. Environ. Res. Public Health, 20, 1538. https://doi.org/10.3390/ ijerph20021538
- Suárez-Cortés, M., Castaño-Molina, M., & Ramos-Morcillo., et al. (2023). Impact of COVID-19 restrictions in childbirth and puerperium: A cross-sectional study. Healthcare, 11, 249. https://doi.org/10.3390/ healthcare11020249
- UNICEF. (2020). Pregnant mothers and babies born during COVID-19 pandemic threatened by strained health systems and disruptions in services. Retrieved April 25, 2020 from https://www.unicef.org/press-releases/pregnant-mothers-and-babies-born-during-covid-19-pandemic-threatened-strained-health
- WHO. (2020a). Clinical management of COVID-19: interim guidance. Retrieved April 25, 2020 from https://www.who.int/publications/i/item/clinical-management-of-covid-19
- WHO. (2020b) Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report. Retrieved April 25, 2020 from https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-survey-2020.1
- WHO. (2023). Reorienting health systems to primary health care as a resilient foundation for universal health coverage and preparations for a high-level meeting of the United Nations General Assembly on universal health coverage. Seventy-Sıxth World Health Assembly A76/6. Retrieved December 03, 2023 from https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_6-en.pdf.
- Yassa, M., Birol, P., & Yirmibes, C., et al (2020). Near-term pregnant women's attitude toward, concern about and knowledge of the COVID-19 pandemic. The Journal of Maternal-Fetal & Neonatal Medicine, 33(22), 3827-3834. DOI: 10.1080 / 14767058.2020.1763947
- Zewdie, A., Mose, A., & Yimer, A., et al., (2022). Essential maternal health service disruptions in Ethiopia during COVID 19 pandemic: a systematic review. BMC Women’s Health, 22, 496. https://doi.org/10.1186/s12905-022-02091-4
The Experiences of Women in The Perinatal Period Regarding Maternal Health Services: A Qualitative Study During The Covıd-19 Pandemic
Yıl 2024,
, 260 - 271, 05.07.2024
Meltem Aydın Beşen
,
Gözde Gökçe İşbir
Öz
Objective: This research was conducted to determine the experiences of women in the perinatal period regarding maternal health services during the COVID-19 pandemic.
Methods: This is a qualitative descriptive study. The study included 19 women who were in the perinatal period during the pandemic. Data were collected using semi-structured interview questions.
Results: In this study, data obtained were divided into three themes: first- experiences toward changing maternal health services, second - results of lack of maternal health services, and third - suggestions to facilitate the accessibility of maternal health services.
Conclusion: Access to maternal health services of women in the perinatal period during the pandemic should be evaluated and access to services should be ensured by developing and implementing new strategies with the contribution of community midwives while addressing situations that prevent access to these services.
Kaynakça
- Ahmed, Z., & Sonfield , A. (2020). The COVID-19 outbreak: potential fallout for sexual and reproductive health andrights. Available: https://www.guttmacher.org/article/2020/03/covid-19-outbreak-potential-fallout-sexual-and-reproductive-health-and-rights .
- American College of Obstetricians and Gynecologists. (2020). COVID-19 FAQs for obstetricians-gynecologists, obstetrics. Retrieved April 22, 2021 from https://www.acog.org/clinical-information/physician-faqs/covid-19-faqs-for-ob-gyns-obstetrics ,
- Aranda, Z., Binde, T., &Tashman, K., et al. (2022). Disruptions in maternal health service use during the COVID-19 pandemic in 2020: experiences from 37 health facilities in low-income and middleincome countries. BMJ Global Health, 7, e007247. doi:10.1136/ bmjgh-2021-007247.
- Arora, KS., Mauch, J.T., & Gibson, K.S. (2020). Labor and delivery visitor policies during the COVID-19 pandemic balancing risks and benefits. JAMA, 323, (24), 2468-2469. DOI: 10.1001 / jama.2020.7563.
- Ashish, K.C., Gurung, R., & Kinney, M.V., et al. (2020). Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study. Lancet Glob Health, 8, e1273--81. DOI: https://doi.org/10.1016/S2214-109X(20)30345-4
- Bohren, M.A., Berger, B.O., Munthe-Kaas, H., & Tunçalp, Ö. (2019). Perceptions and experiences of labor companionship: a qualitative evidence synthesis. Cochrane Database of Systematic Reviews, Issue 3. Art. No .: CD012449. DOI: 10.1002 / 14651858.CD012449.pub2
- Bohren, MA., Hofmeyr, GJ., Sakala, C., Fukuzawa, RK., & Cuthbert, A. (2017). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, Issue 7. Art. No.: CD003766. DOI: 10.1002 / 14651858.CD003766.pub6.
- Burt, J.F., Ouma, J., Lubyayi, L., Amone, A., Aol, L., Sekikubo, M., & Nakimuli, A., et al. (2021). Indirect effects of COVID-19 on maternal, neonatal, child, sexual and reproductive health services in Kampala, Uganda. BMJ Glob Health, 6(8), e006102. doi: 10.1136/bmjgh-2021-006102. PMID: 34452941; PMCID: PMC8406460.
- Castro, A. (2020). Challenges posed by the COVID-19 pandemic in the health of women, children, and adolescents in Latin America and the Caribbean. Retrieved April 22, 2021 from https://www.latinamerica.undp.org/content/rblac/en/home/library/crisis_prevention_and_recovery/desafios-de-la-pandemia-de-covid-19-en-la-salud-de-la- mujer - de-.html
- Centers for Disease Control and Prevention. (2020). Considerations for inpatient obstetric healthcare settings. Published April 4, 2020. Retrieved April 22, 2021 from https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html#anchor_1582067966715 .
- Correia, L.L., Machado, M.M.T., Araújo, D.A.B.S., Gomes, Y.V.C., Pinheiro, M.S.N., Rocha, H.A.L., et al. (2022). Primary Health Care during the COVID-19 pandemic in Fortaleza, Brazil: associated factors and pattern of use by mothers and children up to 18 months of age. Rev Bras Epidemiol., 25, e220036. https://doi.org/10.1590/1980-549720220036
- Dana, P.M., Kolahdooz, F., & Sadoughi, F., et al. (2020). COVID-19 and pregnancy: a review of current knowledge. Le İnfezioni in Medicina, 28 (suppl 1), 46-51.
- Delamou, A., Ayadi, A.M.E., & Sidibe, S., et al. (2017). Effect of Ebola virus disease on maternal and child health services in Guinea: a retrospective observational cohort study. Lancet Glob Health., 5 (4), e448 – e457. DOI: 10.1016 / S2214-109X (17) 30078-5.
- Fernandes, B.A., Alves, B., & Matosinhos, A.C., et al. (2023). The use and role of telemedicine in maternal fetal medicine around the world: an up-to-date. Health Technol (Berl)., 21,1-8. doi: 10.1007/s12553-023-00742-6.
- Fryer, K., Delgado, A., & Foti, T. et al. (2020). Implementation of obstetric telehealth during COVID - 19 and beyond. Maternal and Child Health Journal, 24(9), 1104-1110. https://doi.org/10.1007/s10995-020-02967-7 .
- Galle, A., Semaan, A., & Huysmans, C. et al. (2021). A double-edged sword—telemedicine for maternal care during COVID-19: findings from a global mixed-methods study of healthcare providers. BMJ Global Health, 6, e004575. doi:10.1136/ bmjgh-2020-004575.
- International Confederation of Midwives. (2020). Women's rights in childbirth must be upheld during the coronavirus pandemic. Retrieved April 22, 2021 from https://www.internationalmidwives.org/assets/files/news-files/2020/03/icm-statement_upholding-womens-rights-during-covid19-5e83ae2ebfe59.pdf .
- Islek, E., Ozatkan, Y., & Bilir, M.K. et al. (2020). Covidien-19 pandemic Turkey case management: Strategies for health policy and practice. TÜSPE Report: 2020/2, TÜSPE Publications, Ankara. Retrieved April 22, 2021 from https://www.tuseb.gov.tr/tuspe/uploads/yayinlar/makaleler/pdf/21-08-2020__5f3f6e1402cc2__tusperapor02_covid-19_pandemi_yonetiminde_turkiye_ornegi.pdf .
- Jones, I.H.M., Thompson, A., & Dunlop, C.L., et al. (2022). Midwives’ and maternity support workers’ perceptions of the impact of the first year of the COVID-19 pandemic on respectful maternity care in a diverse region of the UK: a qualitative study. BMJ Open, 12, e064731. doi:10.1136/ bmjopen-2022-064731.
- Karavadra, B., Stockl, A., & Prosser-Snelling, E., et al. (2020). Women's perceptions of COVID-19 and their healthcare experiences: a qualitative thematic analysis of a national survey of pregnant women in the United Kingdom. BMC Pregnancy and Childbirth, 20, 600. https://doi.org/10.1186/s12884-020-03283-2
- Lega, I., Bramante, A., & Lauria, L., et al. (2022) The psychological impact of COVID- 19 among women accessing family care centers during pregnancy and the postnatal period in Italy. Int. J. Environ. Res. Public Health, 19, 1983. https:// doi.org/10.3390/ijerph19041983
- Musiimenta, A., Tumuhimbise, W., & Atukunda, R. et al. (2022). Challenges in accessing maternal and child health services during COVID-19 and the potential role of social networking technologies. Digital Health, 8, 1–10.
- Narang, K., Enninga, E.A.L., & Gunaratne, M.D.S.K., et al. (2020). SARS-CoV-2 ınfection and COVID-19 during pregnancy: A multidisciplinary review. Mayo Clin Proc., 95 (8), 1750-1765. DOI: 10.1016 / j.mayocp.2020.05.011 .
- Padmaja, M., & Behera, D.K. (2023). Disruptions in accessing women’s health care services: Evidence using COVID-19 health services disruption survey. Maternal and Child Health Journal, 27, 395–406. https://doi.org/10.1007/s10995-022-03585-1
- Pant, S., Koirala, S., & Subedi, M. (2020). Access to maternal health services during COVID-19. Europasian J Med Sci., 2 (Covid-19 Special Issue), 48-52. https://doi.org/10.46405/ejms.v2i2.110 .
- Parahoo, K. (2014). Nursing research principles: Processes and issues , 3rd ed. Palgrave Macmillan, Basingstoke UK.
- Queensland Clinical Guidelines. (2020). Maternity care for mothers and babies during COVID-19 pandemic. Retrieved April 22, 2021 from https://www.health.qld.gov.au/__data/assets/pdf_file/0033/947148/g-covid-19.pdf .
- Rasmussen, S.A., Smulian, J.C., & Lednicky, J.A. et al (2020). Coronavirus Disease 2019 (COVID-19) and pregnancy: what obstetricians need to know. American Journal of Obstetrics and Gynecology, 222 (5), 415–426. DOI: 10.1016 / j.ajog.2020.02.017
- Reingold, R.B., Barbosa, I., & Mishor , R. (2020). Respectful maternity care in the context of COVID ‐ 19: A human rights perspective. Int J Gynecol Obstet, 151, 319-321.
- Reisinger-Kindle, K., Qasba, N., & Cayton, C. (2021). Evaluation of rapid telehealth implementation for prenatal andpostpartum care visits during the COVID-19 pandemic in anacademic clinic in Springfield, Massachusetts, United Statesof America. Health Sci Rep., 4, e455.
- Royal College of Midwives and Royal College of Obstetricians and Gynecologists. (2020). Coronavirus (COVID-19) Infection in pregnancy. Information for health professionals. Version 12: Published Wednesday 14 October 2020. Retrieved April 22, 2021 from https://www.rcog.org.uk/globalassets/documents/guidelines/2020-10-14-coronavirus-covid-19-infection-in-pregnancy-v12. pdf .
- Royal College of Midwives and Royal College of Obstetricians and Gynecologists. (2022). Coronavirus (COVID-19) Infection in pregnancy. Information for health professionals. Version 16: Published December 2022. Retrieved December 25, 2022 from https://www.rcog.org.uk/media/ftzilsfj/2022-12-15-coronavirus-covid-19-infection-in-pregnancy-v16.pdf
- Saccone, G., Florio, A., & Aiello, F., et al. (2020). Psychological impact of coronavirus disease 2019 in pregnant women. Am. J. Obstet. Gynecol. 223, 2, 293-295. DOI: https: // doi.org/10.1016/j.ajog.2020.05.003
- Sadler, M., Leiva, G., & Olza, I. (2020) COVID-19 as a risk factor for obstetric violence, Sexual and Reproductive Health Matters, 28, 1, 1785379, DOI: 10.1080 / 26410397.2020.1785379.
- Saunders, B., Sim, J., & Kingstone, T., et al. (2018). Saturation in qualitative research: exploring its conceptualization and operationalization. Quality & Quantity, 52 (4), 1893–1907. https://doi.org/10.1007/s11135-017-0574-8 .
- Sharma, S., Aggarwal, S., & Kulkarni, R., et all. (2023). Challenges in accessing and delivering maternal and child health services during the COVID-19 pandemic: A cross-sectional rapid survey from six states of India. Int. J. Environ. Res. Public Health, 20, 1538. https://doi.org/10.3390/ ijerph20021538
- Suárez-Cortés, M., Castaño-Molina, M., & Ramos-Morcillo., et al. (2023). Impact of COVID-19 restrictions in childbirth and puerperium: A cross-sectional study. Healthcare, 11, 249. https://doi.org/10.3390/ healthcare11020249
- UNICEF. (2020). Pregnant mothers and babies born during COVID-19 pandemic threatened by strained health systems and disruptions in services. Retrieved April 25, 2020 from https://www.unicef.org/press-releases/pregnant-mothers-and-babies-born-during-covid-19-pandemic-threatened-strained-health
- WHO. (2020a). Clinical management of COVID-19: interim guidance. Retrieved April 25, 2020 from https://www.who.int/publications/i/item/clinical-management-of-covid-19
- WHO. (2020b) Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report. Retrieved April 25, 2020 from https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-survey-2020.1
- WHO. (2023). Reorienting health systems to primary health care as a resilient foundation for universal health coverage and preparations for a high-level meeting of the United Nations General Assembly on universal health coverage. Seventy-Sıxth World Health Assembly A76/6. Retrieved December 03, 2023 from https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_6-en.pdf.
- Yassa, M., Birol, P., & Yirmibes, C., et al (2020). Near-term pregnant women's attitude toward, concern about and knowledge of the COVID-19 pandemic. The Journal of Maternal-Fetal & Neonatal Medicine, 33(22), 3827-3834. DOI: 10.1080 / 14767058.2020.1763947
- Zewdie, A., Mose, A., & Yimer, A., et al., (2022). Essential maternal health service disruptions in Ethiopia during COVID 19 pandemic: a systematic review. BMC Women’s Health, 22, 496. https://doi.org/10.1186/s12905-022-02091-4