Accessing maternal and child health services during the Covid-19 lockdown: experiences of teenage mothers in Uganda

Abstract

Teenage pregnancies remain one of the most pressing issues in the world today. The teenage mothers have been reported to have faced constraints in accessing MCH services. These were worsened by the COVID-19 lockdowns which involved stringent measures to curb the spread of COVID-19 in several countries. This study aimed at assessing the experiences of teenage mothers in accessing MCH services during the COVID- 19 lockdown with two specific objectives of identifying the constraints teenage mothers faced in accessing MCH and the strategies used by teenage mothers to access MCH services amidst the access barriers posed by the COVID-19 lockdown. The study adopted an exploratory research design and was purely qualitative. Data were collected from eight teenage mothers, two MCH service providers and two caretakers from Namugongo Fund for Special Children located in Kimbejja, Kira division and Municipality. The study identified that teenage mothers were constrained with individual, Interpersonal or family, organisational, and socio-cultural constraints in accessing MCH services during COVID-19. The individual constraints included limited financial resources, lack of transport, lack of adequate knowledge about MCH services, lack of preventive information about COVID-19, fear of disclosing pregnancy, fear to contact COVID-19, negative perception towards health facilities, and poor experience. The Interpersonal or family level constraint of disapproval to access MCH services by parents and partners and lack of support in accessing MCH services. The organisation constraints included government restrictions of curfew and social distancing, police harassment and violence, shortage of maternal services and medicine, and negative attitude by MCH service providers. Lastly, the teenage mothers were constrained with the socio-cultural level constraints, but these have always been the general. The teenage mothers adopted a wide range of strategies to access MCH amidst these challenges. These strategies included accessing MCH services without the consent or knowledge of the parents and partners, camping at health facility, negotiating with the parents and partners that disproved access to MCH services, enduring walking long distances, engaging in small scale business, buying their own and stocking tablets, going to government and charity health facilities, seeking for financial support from friends and relatives, using free government public transport means and seeking MCH services through telephone. The study recommends the government of Uganda under its Ministry of Health should always come up with a program of how special groups will access health facilities when there are lockdowns.