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Table 4 Factors related to continuing services versus preventing COVID-19 in ANC policy guidance

From: Keeping essential reproductive, maternal and child health services available during COVID-19 in Kenya, Mozambique, Uganda and Zimbabwe: analysis of early-pandemic policy guidelines

  Continuation of Services Prevention of COVID-19 Transmission
  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
  1. aAll countries have adopted the WHO-recommended eight-visit schedule except for Mozambique, which recommends an ANC visit every 3 months