Community perspectives on access to maternal health services during the COVID-19 pandemic in rural Western Kenya: a qualitative study

作者：Neema Kaseje, George Odhiambo, Beldine Omondi, Andy Haines, Meghna Ranganathan · 发表于：BMC Health Services Research · 年份：2025 · DOI：10.1186/s12913-025-13162-1 · 被引用次数：2 · 研究领域：COVID-19 Impact on Reproduction、Global Maternal and Child Health、Telemedicine and Telehealth Implementation

BACKGROUND: Globally, maternal and child health outcomes were negatively affected during the COVID-19 pandemic. There is limited qualitative evidence focused on access to maternal health services during the COVID-19 pandemic in rural sub-Saharan African populations. This study aims to fill this gap by exploring key community perspectives on access to maternal health services during the COVID-19 pandemic in rural western Kenya. METHODS: We conducted five focus group discussions and sixty one in-depth interviews. Participants were mothers who delivered in 2020 during the acute phase of the COVID-19 pandemic and rural community health workers (CHWs) in Siaya and Kisii counties. The three-delay model framework helped to guide discussions around access to maternal health services during the COVID-19 pandemic in rural western Kenya. We transcribed the data and conducted a thematic content analysis. RESULTS: According to CHWs and expectant mothers, fear and misconceptions about COVID-19 were associated with delays in making the decision to seek maternal health care. Lockdowns, movement restrictions, and curfews made it challenging to physically reach health facilities. The shortage of drugs and supplies and an insufficient number of healthcare workers in health facilities were barriers to care seeking. The quality of maternal health services was perceived to have declined during the COVID-19 pandemic. Mothers reported the Linda Mama health insurance program helped them pay for mater...