A comparative trend analysis of maternal and child health service utilization before and during Covid-19 at Dire Dawa administration public health facilities, Ethiopia, 2021

Maternal health refers to the health of women during pregnancy, childbirth and the postnatal period. While child health encompasses health care services ranging from neonatal to under five years old. Evidences has shown that, the presence of Covid-19 has resulted significant disruption in the health service utilization. This study aims to describe maternal and child health service utilization before and during Covid-19 announcement in Ethiopia and forecast 12 months client flow, at Dire Dawa Public Health Facilities. We used Interrupted time series analysis to examine two years trend of maternal and child health service utilization. The interruption point was set be Covid-19 announced to Ethiopia. Data was extracted from client registers. Kobo toolbox was used to collect the data. Microsoft Excel and statistical package for social sciences version 26 were used for data management and analysis. Traditional Expert Modeler and one way ANOVA were used for data analysis. Findings are presented in tables, means, point percentages, time line plots and sequence charting. A total of 34,576 client registers were reviewed, where 17,100 (49.5%) and 17,476 (50.5%) had visited the MCH service before and during Covid-19 announcement in Ethiopia respectively. Total services utilization has shown a steady fall during the interruption point. Family planning, Institutional delivery, and child immunization has shown sharp fall during Covid-19 announcement to Ethiopia. Though the total client visit has shown an increase in percentage point of 2%, postnatal care and child immunization has shown 30% and 16% percentage point drop respectively. The total client visit has shown a difference in client visit before and during the time of covid-19 (f=4.6 , p<0.4). It is evidenced that maternal and child health services are highly impacted by the presence of covid-19, where family planning, institutional delivery, and child immunization has shown sharp fall. Forecasting to the next 12 months has also shown no promising improvement in service visits. Hence the health system should mobilize the work force and resources to the lower service delivery inlet, health post, and directs its approach to community-based service to access missed mothers and children who had not come to facility.