Table 6 Factors related to continuing services versus preventing COVID-19 in intra- and postpartum care policy guidance
Continuation of Services | Prevention of COVID-19 Transmission | |||||
|---|---|---|---|---|---|---|
Birth companions | Immediate breastfeeding (BF) | Maternity waiting homes | Postpartum family planning | PNC | Triage procedures for women admitted for birth | |
Kenya RMNFP Guidelines | Birthing partners or companions discouraged from entering the intrapartum area | Immediate BF advised and preferred; COVID-19 confirmed or suspected women to be counseled | Not mentioned | Postpartum FP (and postabortion FP) will continue to be offered in all health facilities currently providing | 2- and 6- weeks postpartum evaluation should be conducted. Women in a low-risk category should attend PNC at lower-level facilities, while women in high risk or who had cesarean section should be seen at Comprehensive Emergency Obstetric and Newborn Care (CEmONC) facilities | Screening for COVID-19 symptoms and exposure to someone with COVID-19 should be conducted before woman enter labor and delivery (L&D) room, and every 12 h after |
Kenya Community Health Services | Annex on phone-based guidance for advising expectant mothers includes discussion of a support person/birth companion | Not mentioned | Not mentioned | Not mentioned | Annex on phone-based guidance for advising expectant mothers includes discussion of postnatal follow-up | Not mentioned |
Mozambique Care of Pregnant Women Circular | Does not allow for the presence of birth companion during labor | BF encouraged with handwashing, masking, avoiding coughing or sneezing, cleaning surfaces | Not mentioned | Not mentioned | PNC recommended; specific guidance provided for postnatal follow-up with COVID-positive women | Women to be screened for COVID-19 symptoms upon arrival at health facility |
Mozambique Mitigation Measures Circular | Prohibited for the duration of the pandemic | Promotion and counseling continued, exclusive BF recommended | Not mentioned | Not mentioned | Suspension of all home visits | Not mentioned |
Uganda Continuity of Essential Health Services | Not mentioned | BF encouraged with handwashing, mask recommended; counseling on safe BF practices | Not mentioned | Not mentioned | Home PNC visits to mothers and newborns are temporarily suspended | Triage procedures for all patients, separate and dedicated entry to be established for “critical outpatient visits” including ANC |
Zimbabwe RMNCAH-N Guidelines | Birth companions are discouraged during labor and delivery | Immediate BF encouraged for all, initiated 1 h after birth with hand and breast washing, mask wearing, physical distancing from others while feeding | Maternity waiting homes to be kept open | Not mentioned | PNC home visits to be conducted by VHWs; focus on BF promotion and neonatal and maternal health education | COVID-19 symptom screening for all patients, separate admitting area for suspected COVID-19 cases, different algorithms for different levels of health facility. Psychosocial support to be provided to L&D clients. |