Impact of Pandemics on Maternal and Child Health Services

Pandemics exert profound direct and indirect effects on services for mothers and children, undermining routine care and amplifying risks of morbidity and mortality. Disruptions arise from a convergence of factors: diversion of healthcare workers to outbreak response, interruptions in supply chains for essential medicines and vaccines, restrictions on movement that hinder access to clinics, and widespread fear of infection in healthcare settings. Antenatal visits, skilled birth attendance, postnatal checks, immunisation schedules and family planning services have all been shown to decline during crises, with particularly severe consequences in low- and middle-income countries. Simultaneously, reduced service utilisation and weakened trust can provoke increases in unplanned pregnancies, vaccine-preventable diseases and complications of childbirth. The severity of impact varies by region and by the resilience of health systems prior to the shock. Evidence from Ebola-affected West African districts and from global analyses of the COVID-19 pandemic highlights the cascading effects on maternal mortality ratios, child vaccination coverage and contraceptive uptake. To mitigate such disruptions, policymakers and practitioners have adopted adaptive measures—telemedicine, mobile clinics, community engagement strategies and targeted catch-up campaigns—to restore essential services and bolster preparedness for future health emergencies.

Research from Nature Portfolio

Recent analyses using robust quasi-experimental designs have quantified the causal effects of epidemic intensity on child immunisation. A difference-in-differences study in West Africa demonstrated that districts with higher Ebola incidence experienced significant reductions in routine vaccination rates for BCG, DPT, measles and polio, with effects persisting several years after the outbreak. This work underscores how localised epidemics can erode service provision and community trust long term. Complementing this, an interrupted time series analysis across ten countries of varied income levels revealed that maternal health services endured declines of 5–33% during the early waves of COVID-19. Although some services such as HIV treatment were maintained, antenatal care and facility births were disrupted in roughly half the studied settings. The study emphasises that even well-resourced health systems can fall short of resilience, and that timely compensatory measures are required to prevent backlog and adverse outcomes.

Impact of Pandemics on Maternal and Child Health Services publication trend

The graph below shows the total number of articles in impact of pandemics on maternal and child health services across all publications each year (not limited to Nature Index journals).

Technical terms

Interrupted time series design: A statistical approach that analyses data points collected at intervals before and after an intervention or event to assess its immediate and sustained impact.

Difference-in-differences analysis: An econometric method comparing changes over time between a group exposed to an intervention (or event) and an unexposed control group to infer causal effects.

Health system resilience: The capacity of health services to absorb shocks, adapt operations and recover functionality while maintaining access to essential care.

Contraceptive uptake: The rate at which individuals initiate or continue use of family planning methods within a population over a given period.

References

1. COVID‐19 and Contraceptive Use in Two African Countries: Examining Conflicting Pressures on Women. Population and Development Review (2024).
2. Community stressors and coping mechanisms in accessing the health system during a double crisis: a qualitative case study from Yangon Region, Myanmar. International Journal for Equity in Health (2023).
3. Higher local Ebola incidence causes lower child vaccination rates. Scientific Reports (2024).
4. COVID-19 and resilience of healthcare systems in ten countries. Nature Medicine (2022).