Maternal and Child Health Care Outcomes in Kenya Before and During COVID-19a

AverageSDP ValueAverageSDP ValueAverageSDP Value
Panel A. Percentage of women with a skilled/complicated/normal/cesarean/referred delivery out of all women who enrolled in MomCare during the
control or study period with an expected delivery date before the end of the study period.
Percentage of skilled deliveriesBefore12.23.190.000b9.03.160.000b8.21.720.000b
Percentage of complicated deliveriesBefore3.11.970.012b,c2.02.100.067c1.01.550.175c
Percentage of normal deliveriesBefore77.63.410.67885.37.810.51978.311.080.010
Percentage of cesarean deliveriesBefore19.33.490.17212.35.990.00b20.510.580.000b
Percentage of deliveries through referralBefore17.83.130.3290.81.170.001b0.00.000.102c
Panel B. Percentage of women who were classified at some point during their pregnancy as having a medium- or high-risk pregnancy out of all women who
enrolled in MomCare during the control or study period.
Percentage of medium-risk mothersBefore32.53.210.61616.51.380.15737.24.070.000b
Percentage of high-risk mothersBefore35.22.640.32443.23.600.84836.04.340.000b
Panel C. Percentage of women (newborns) who received the listed diagnostic tests and supplements out of all women who enrolled in MomCare
(newborns in a MomCare clinic) during the control or study period.
Percentage of mothers with ANC profile testBefore73.38.380.000b69.06.900.36870.33.780.000b
Percentage of mothers with blood pressure at each visitBefore19.07.240.000b92.71.750.99185.715.630.000b
Percentage of mothers with at least one ultrasoundBefore18.25.490.000b28.85.490.041b25.57.640.000b
Percentage of mothers with
folic/ferrous supplement
Percentage of mothers with urine analysis at each visitsBefore60.39.930.000b89.23.370.94884.53.270.881
Percentage of mothers with oxytocin at deliveryBefore11.83.430.5469.32.160.3458.21.720.170
Percentage of mothers with hemoglobin test at deliveryBefore35.07.480.001b51.33.980.75044.53.990.354
Percentage of newborns with vitamin KBefore93.73.440.61087.07.010.69295.23.600.033b
  • Abbreviation: ANC, antenatal care; COVID-19, coronavirus disease; SD, standard deviation; VDRL, venereal disease research laboratory.

  • a Results of Chi-squared test comparisons across the 6 months before the first case of COVID-19 in Kenya (September 2019–February 2020) and the following 6 months (March 2020–August 2020) (data derived as per February 15, 2021).

  • b Significant differences.

  • c P values based on a heteroscedastic unpaired t-test instead of a Chi-squared test since the latter is inconclusive when one of the comparison groups has mean zero throughout.

  • d Definitions: skilled deliveries=births that occur in a health facility connected to MomCare; complicated deliveries=births that include prepartum complications (e.g., obstructed labor) or intrapartum or postpartum hemorrhage; normal delivery=spontaneous or induced vaginal births; medium-risk mothers=mothers whose pregnancies include non-severe complications, including but not limited to asthma, urinary tract infection, candidiasis, or female genital mutilation; high-risk mothers=mothers whose pregnancies include severe complications or high-risk factors including but not limited to: pregnancies in women aged 19 years and younger, pregnancies in women aged 35 years and older; history of cesarean delivery, anemia, hypertension, diabetes, HIV, or pre-eclampsia; mothers with ANC profile test=mothers who received tests to determine blood grouping, hemoglobin (Hb), hepatitis B antigen, HIV test, VDRL test, and a urine analysis.