A Review of the Impact of Covid-19 On Maternal and Child Health Service Utilization in Bangladesh

Abstract

The COVID-19 pandemic created unprecedented challenges for healthcare systems worldwide, significantly affecting the delivery and utilization of essential maternal and child health services. This study reviewed the impact of COVID-19 on maternal and child health service utilization in Bangladesh through a comprehensive quantitative synthesis of published empirical evidence. A quantitative review design was adopted, and relevant studies published between 2020 and 2022 were systematically identified using predefined inclusion and exclusion criteria. A total of 72 quantitative studies involving an estimated 512,486 participants were included in the final analysis. The synthesized evidence covered maternal health indicators, including antenatal care, skilled birth attendance, institutional delivery, postnatal care, emergency obstetric care, and family planning, together with child health indicators such as neonatal healthcare, routine childhood immunization, growth monitoring, nutritional assessment, pediatric outpatient attendance, and healthcare-seeking for common childhood illnesses. Descriptive and inferential statistical approaches were used to summarize healthcare utilization patterns, compare pre-pandemic and pandemic service utilization, and examine determinants of healthcare access. The findings demonstrated a statistically significant decline in maternal and child health service utilization during the COVID-19 pandemic (p < 0.001). Overall essential healthcare utilization decreased by 18.9%, while maternal health services declined by 19.8% and child health services by 17.9%. Preventive healthcare services experienced the greatest reduction (20.6%), whereas curative services declined by 11.7%. Growth monitoring and pediatric outpatient consultations exhibited the largest reductions among child health indicators, while postnatal care showed the greatest decline among maternal health services. Regression analysis indicated that healthcare accessibility, educational attainment, household income, and health system readiness were significant positive predictors of healthcare utilization, whereas transportation barriers and perceived COVID-19 infection risk exerted significant negative effects. The regression model explained 68.4% of the variation in maternal and child health service utilization (Adjusted R² = 0.684).