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Table 7 Selected WHO policy guidance recommendationsa for intra- and postpartum care compared to country 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

WHO Recommendation

Related Guidance in Country Policies

Kenya

Mozambique

Uganda

Zimbabwe

Maintain maternity waiting homes where they exist, ensuring IPC standards

Not mentioned

Not mentioned

Not mentioned

Maternity waiting homes to be kept open

Screen birth companions for COVID-19

Birth companions not allowed during pandemic

Birth companions not allowed during pandemic

Birth companions not allowed during pandemic

Birth companions not allowed during pandemic

Ensure safe transport for mothers and newborns

Not mentioned

Not mentioned

At community level, coordinate boda boda cyclists for transport of pregnant women, newborns and children to facilities, especially in emergency situations. This may include mapping routes to facilities, creating rosters of boda boda riders, and securing emergency travel permits for riders.

Not mentioned

Prioritize skin-to-skin contact and early and exclusive breastfeeding

Promoted with infection prevention measures advised. Skin-to-skin contact not mentioned.

Promoted with infection prevention measures advised. Skin-to-skin contact not mentioned.

Promoted with infection prevention measures advised. Skin-to-skin contact not mentioned.

Promoted with infection prevention measures advised. Skin-to-skin contact not mentioned.

Cesarean section should be performed based solely on obstetric indications independent of COVID-19 status or transmission scenario

Deliver per pre-existing protocols

Caesarean section should be performed if indicated based on maternal and fetal status, as in normal practice

For elective cesarean procedures, case-by-case determination made to delay

At district, provincial, and tertiary levels, delay cesarean section for patients suspected to have COVID-19 to reduce risk associated with procedure (3 h for nulliparous, 2 h for multiparous)

Prioritize PNC contact with women and newborns during first week after birth, including contact within 24 h for home birth

Low-risk women with cesarean delivery review at 2 and 6 weeks; high-risk women determined individually

Not mentioned

Not mentioned

Follow-up by VHWs on day 7; no mention of contact within 24 h

Where feasible, use digital health platforms for PNC counseling and screening

Not mentioned

Not mentioned

Not mentioned

Not mentioned

Where in-person PNC visits are necessary, provide all relevant care in a single visit

Not mentioned

Not mentioned

Not mentioned

Not mentioned

At PNC, offer 2–3 months of micronutrient supplements, ITNs, and contraceptives as relevant, and consider offering LARCs

Not mentioned

Not mentioned

Not mentioned

Not mentioned

At PNC, ensure that complication readiness plans are adapted to take into account changes to services based on COVID-19

Not mentioned

Not mentioned

Not mentioned

Not mentioned

  1. a Maintaining essential health services: operational guidance for the COVID-19 context (WHO, June 2020)