In their systematic review and meta-analysis, Barbara Chmielewska and colleagues1 note significant increases in maternal death and stillbirths during the COVID-19 pandemic. They link these outcomes to reduced access to maternal health services, stating that in low-income and middle-income countries (LMICs), remote antenatal care appointments are less feasible because of technological shortcomings in these countries.
As the authors note, the experiences and outcomes in different countries have varied widely during the pandemic and their review only included a few papers from LMICs. For this reason, we find it crucial to share our experiences at our six Partners In Health project sites in Haiti, Lesotho, Liberia, Malawi, Mexico, and Sierra Leone. Since May, 2020, we have continuously monitored health services using the model described by Fulcher and colleagues.2 In four sites (Haiti, Liberia, Mexico, and Sierra Leone), we did observe moderate declines in antenatal care and facility-based deliveries, but in most cases services rebounded back to what was expected by mid-2020. In the other sites, we did not observe any significant decline in maternal health services during the pandemic.