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      Reproductive Maternal and Newborn Health Providers’ Assessment of Facility Preparedness and Its Determinants during the COVID-19 Pandemic in Lagos, Nigeria

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          ABSTRACT

          The global COVID-19 pandemic is predicted to compromise the achievement of global reproductive, maternal, and newborn health (RMNH) targets. The objective of this study was to determine the health facility (HF) preparedness for RMNH service delivery during the outbreak from the perspective of RMNH providers and to determine what factors significantly predict this. An anonymous cross-sectional online survey of RMNH providers was conducted from to July 1–21, 2020 in Lagos State, Nigeria. We conducted a descriptive and ordinal regression analysis, with RMNH worker perception of HF preparedness for RMNH service delivery during the outbreak as the dependent variable. In all, 256 RMNH workers participated, 35.2% reported that RMNH services were unavailable at some time since March 2020, 87.1% felt work-related burnout, 97.7% were concerned about the availability of personal protective equipment (PPE) and related guidelines, and only 11.7% were satisfied with the preparedness of their HFs. Our final model was a statistically significant predictor of RMNH worker perception of HF preparedness explaining 54.7% of the variation observed. The most significant contribution to the model was communication by HF management (likelihood ratio chi-square [LRCS]: 87.94, P < 0.001) and the availability of PPE and COVID-19 guidelines (LRCS: 15.43, P < 0.001). A one-unit increase in the level of concern about the availability of PPE and COVID-19 guidelines would increase the odds of observing a higher category of satisfaction with HF COVID-19 preparedness. Adequate support of RMNH providers, particularly provision of PPE and guidelines, and appropriate communications about COVID-19 should be prioritized as part of HF preparedness.

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          Most cited references35

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          Applied Logistic Regression

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            Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study

            Summary Background While the COVID-19 pandemic will increase mortality due to the virus, it is also likely to increase mortality indirectly. In this study, we estimate the additional maternal and under-5 child deaths resulting from the potential disruption of health systems and decreased access to food. Methods We modelled three scenarios in which the coverage of essential maternal and child health interventions is reduced by 9·8–51·9% and the prevalence of wasting is increased by 10–50%. Although our scenarios are hypothetical, we sought to reflect real-world possibilities, given emerging reports of the supply-side and demand-side effects of the pandemic. We used the Lives Saved Tool to estimate the additional maternal and under-5 child deaths under each scenario, in 118 low-income and middle-income countries. We estimated additional deaths for a single month and extrapolated for 3 months, 6 months, and 12 months. Findings Our least severe scenario (coverage reductions of 9·8–18·5% and wasting increase of 10%) over 6 months would result in 253 500 additional child deaths and 12 200 additional maternal deaths. Our most severe scenario (coverage reductions of 39·3–51·9% and wasting increase of 50%) over 6 months would result in 1 157 000 additional child deaths and 56 700 additional maternal deaths. These additional deaths would represent an increase of 9·8–44·7% in under-5 child deaths per month, and an 8·3–38·6% increase in maternal deaths per month, across the 118 countries. Across our three scenarios, the reduced coverage of four childbirth interventions (parenteral administration of uterotonics, antibiotics, and anticonvulsants, and clean birth environments) would account for approximately 60% of additional maternal deaths. The increase in wasting prevalence would account for 18–23% of additional child deaths and reduced coverage of antibiotics for pneumonia and neonatal sepsis and of oral rehydration solution for diarrhoea would together account for around 41% of additional child deaths. Interpretation Our estimates are based on tentative assumptions and represent a wide range of outcomes. Nonetheless, they show that, if routine health care is disrupted and access to food is decreased (as a result of unavoidable shocks, health system collapse, or intentional choices made in responding to the pandemic), the increase in child and maternal deaths will be devastating. We hope these numbers add context as policy makers establish guidelines and allocate resources in the days and months to come. Funding Bill & Melinda Gates Foundation, Global Affairs Canada.
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              The Copenhagen Burnout Inventory: A new tool for the assessment of burnout

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                Author and article information

                Journal
                Am J Trop Med Hyg
                Am J Trop Med Hyg
                tpmd
                tropmed
                The American Journal of Tropical Medicine and Hygiene
                The American Society of Tropical Medicine and Hygiene
                0002-9637
                1476-1645
                April 2021
                26 February 2021
                26 February 2021
                : 104
                : 4
                : 1495-1506
                Affiliations
                [1 ]International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;
                [2 ]LSE Health, London School of Economics and Political Science, London, United Kingdom;
                [3 ]Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria;
                [4 ]Department of Obstetrics and Gynaecology, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
                Author notes
                [* ]Address correspondence to Charles Ameh, International Public Health Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, United Kingdom. E-mail: charles.ameh@ 123456lstmed.ac.uk

                Disclosure: The dataset used and/or analyzed during the current study is available from the corresponding author on reasonable request.

                Authors’ addresses: Charles Ameh, International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom, E-mail: charles.ameh@ 123456lstmed.ac.uk . Aduragbemi Banke-Thomas, LSE Health, London School of Economics and Political Science, London, United Kingdom, E-mail: a.bankethomas@ 123456lse.ac.uk . Mobolanle Balogun, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria, E-mail: mbalogun@ 123456cmul.edu.ng . Christian Chigozie Makwe and Bosede Bukola Afolabi, Department of Obstetrics and Gynaecology, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria, E-mails: ccmakwe@ 123456unilag.edu.ng and bbafolabi@ 123456unilag.edu.ng .

                Article
                tpmd201324
                10.4269/ajtmh.20-1324
                8045608
                33635826
                742e9da1-b5eb-4e91-a7cf-1693511401af
                © The American Society of Tropical Medicine and Hygiene

                Open Access statement. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                : 09 October 2020
                : 18 February 2021
                Page count
                Pages: 12
                Categories
                Articles

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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