Table 4 Factors related to continuing services versus preventing COVID-19 in ANC policy guidance
| Â | Continuation of Services | Prevention of COVID-19 Transmission | |||
|---|---|---|---|---|---|
| Â | Multimonth dispensing | Telemedicine | 8- or 4-visit schedule of ANC visits for pregnant womena | Physical distancing and other preventive measures during ANC services | Addressing COVID-19 driven stigma and/or psychosocial needs |
Kenya RMNFP Guidelines | Women attending ANC be provided up to 3 months of supplements or medication, including antiretrovirals (ARVs) | ANC schedule to include phone-based consultations | The 8-visit schedule should be maintained, with modification of 4 health facility visits and 4 via phone if possible | ANC patients to visit clinics unaccompanied; telephone referrals and counseling encouraged | Not mentioned |
Kenya Community Health Services | Not mentioned | A list of messages for VHWs to provide to pregnant women via phone consults. Guidance also promotes phone registration and follow-up of pregnant women. | Not mentioned | Not mentioned | Not mentioned |
Mozambique Care of Pregnant Women Circular | Not mentioned | Pregnant women advised to call health care provider for minor complaints rather than visit health facility | Pregnant women to continue routine prenatal consultations (currently recommended at 4 focused ANC visits) | Keep distance of 1.5 m during facility ANC visits | Not mentioned |
Uganda Continuity of Essential Health Services | Not mentioned | Not mentioned | Not mentioned | Ensure distancing (4 m) at ANC clinics | Psychosocial counseling and support to women with suspected / confirmed COVID-19 infection. Sensitize patients on mitigation of COVID-19-related stigma and discrimination and fear of mother-to-child transmission. |
Zimbabwe RMNCAH-N Guidelines | Not mentioned | Phone consultations should be done as possible, either at nearby health facility or using a call center | 8-visit schedule should be maintained; visit 3 (26 weeks) and visit 5 (34 weeks) should be conducted via phone (this may vary by level of health facility) | Ensure distancing, especially during triage at clinic arrival | Psychosocial support provided to women to reduce COVID-19 anxiety and fear, and to explain the changes in care management during COVID-19 |