A Description of Experiences of Women and Significant others in Accessing Comprehensive Healthcare in the First 1000 Days of Life Post-conception During COVID-19 in Rural Uganda

Abstract Background: COVID-19 presented an unprecedented global public health challenge because of its rapid and relentless spread, and many countries instituted lockdowns to prevent the spread of infection. Although this strategy may have been appropriate to reduce infection, it presented unintended difficulties in rural Uganda, especially in maternal and newborn care. For example, some services were suspended, meaning the nearest health facility was at a considerable distance. Aim: This study explored the experiences of women and their significant others of comprehensive care in the first 1000 days of life post-conception during the COVID-19 pandemic in Bunghokho-Mutoto sub-county, Mbale District, Uganda.Methodology: A qualitative exploratory descriptive design was used with data collected in semi-structured interviews. Women (pregnant or with a child under 2 years) and their significant others were purposively recruited for this study. The sample size (N=14) was determined by data saturation. Results: Data were analysed using thematic analysis. One theme emerged ‘Increasing barriers to healthcare’, which encompassed six sub-themes: accessing healthcare, distressing situations, living in fear, making forced choices, and navigating the gatekeepers, and ‘coping with increased poverty.Conclusion: This study found that the COVID-19 pandemic increased barriers to accessing healthcare services in the region. Participants’ narratives emphasised the lack of access to expert care and the shortage of skilled health workers, especially midwives.