The Landscape on Access to Maternal and Child Health Services During the COVID-19 Pandemic in South Africa: A Scoping Review.
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BACKGROUND: In early March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. In South Africa, the first case was confirmed in early March 2020. According to the WHO, disruptions in essential services due to the COVID-19 pandemic occurred worldwide. The COVID-19 pandemic affected access to maternal and child health (MCH) services in many countries, including South Africa. The study aimed to map and describe the existing evidence on the impact of the COVID-19 pandemic on the access to and delivery of maternal, neonatal, and child health (MNCH) services in South Africa. METHODOLOGY: This was a scoping review of studies published between 2020 and 2023. We searched databases such as PubMed, MEDLINE, EBSCOhost, and Google Scholar. Data were exported to the Rayyan software, where screening, checking of duplicates, and selection of final studies for review were performed. The information from the identified studies was exported to ATLAS.ti 23.1 software for analysis. Content analysis was performed, and data were presented in predetermined themes using the MCH cascade. RESULTS: The results from 25 articles showed a mixed view, whereby some studies showed a decrease at the beginning of the pandemic in April 2020, in the uptake of family planning, antenatal care, labor and delivery, postnatal care, under-five immunizations, and cervical cancer screening services. However, other studies found increased uptake of family planning, antenatal care, labor and delivery, and under-five immunization services. Some studies showed resilience in the overall first antenatal visits, adolescents' visits to family planning, and postnatal care, as they remained constant. CONCLUSION: The findings show both positive and negative impacts of the COVID-19 pandemic on MNCH services in South Africa. While the pandemic significantly disrupted access to essential services, some areas demonstrated resilience, with increased visits for antenatal care, adolescent family planning, and postnatal services. These insights are critical for guiding decision-makers, health managers, and frontline healthcare workers in preparing for future public health emergencies. Ensuring continuity of MNCH services during crises must be a priority. Strengthening the health system and building resilience are essential to safeguard MCH, even in the face of disruptions.