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Table 6 Factors related to continuing services versus preventing COVID-19 in intra- and postpartum care 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
  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.