COVID-19 lockdown and coverage of maternal health and nutrition care in rural West Bengal, India: a single interrupted time-series analysis

Abstract While COVID-19 lockdowns globally disrupted healthcare, the extent of changes in India’s maternal health and nutrition services coverage in rural settings requires further empirical investigation. Utilizing data from 57,371 pregnancies recorded between January 2012 and December 2023, by a health and demographic surveillance system in rural West Bengal, India, this study employed a single interrupted time-series analysis to examine changes in coverage of three key indicators following the COVID-19 lockdown (during March 25- May 31, 2020): receipt of ≥ 4 antenatal care visits (ANC), consumption of ≥ 100 iron-and-folic acid (IFA) tablets/ equivalent syrup, and institutional delivery. Of 57,371 pregnancies, 34.5% (95%CI: 34.1, 34.9%) accessed ≥ 4 ANC visits, 38.7% (95%CI: 38.3, 39.1%) consumed ≥ 100 IFA tablets/ equivalent syrup, and 87.3% (95%CI: 87.0, 87.5%) had institutional delivery. Between January 2012 and December 2023, relative to the pre-lockdown trend, a decreasing trend in the coverage of ≥ 4 ANC visits (β: -0.22, 95%CI: -0.31, -0.12, p < 0.001) and in the prevalence of institutional delivery (β: -0.17, 95%CI: -0.21, -0.13, p < 0.001) was observed. A downward trend in consumption of ≥ 100 IFA tablets/ equivalent syrup was observed (β: -0.58, 95%CI: -0.89, -0.27, p = 0.001) for a narrower time frame of January 2019 to December 2021.