COVID-19 PANDEMIC AND MATERNAL HEALTH SERVICES IN PLATEAU STATE, NIGERIA

Abstract

Nigeria’s high maternal mortality rate remains a pressing public health issue.

Although multiple interventions have been implemented, improvements have been modest. The

emergence of COVID-19 further disrupted the healthcare system, redirecting resources and

impacting essential services, including maternal care. This study investigated the impact of the

COVID-19 pandemic on maternal health service delivery across primary, secondary, and tertiary

care levels in Plateau State, Nigeria. It also assessed patient flow patterns during the pandemic

compared to the pre-COVID period. The study was guided by Andersen’s Behavioural Model of

Health Services Use (1968). A cross-sectional survey design and mixed-methods approach were

employed. Using multistage sampling, 296 service users and 75 service providers were selected

from health facilities across the three levels of care to participate in the study. Data were collected

through structured questionnaires. Maternal services largely remained available during the

pandemic. However, there was a notable decline in service utilisation due to movement

restrictions, fear of infection, and facility-imposed limits on patient numbers. Temporary closures

of some health centres were reported following confirmed COVID-19 cases. Although patient flow

has since improved, many now face financial barriers to accessing care. While service availability

was maintained during the pandemic, access was significantly constrained. With the resumption

of routine healthcare, cost has become a primary barrier to maternal service utilisation. Addressing

these financial constraints is crucial for improving maternal health outcomes in the post-pandemic

period. The authors recommended emergency health system strengthening, socioeconomic support

for vulnerable groups and capacity building for health workers: