Disruption and recovery of maternal and child health services following COVID-19 emergency measures in Zimbabwe

COVID-19 emergency measures disrupted access to essential health services in many low- and middle-income countries. In Zimbabwe, maternal and child health (MCH) services are central to primary healthcare, yet evidence on the magnitude of disruption and recovery remains limited. This study assessed changes in selected MCH service indicators before, during, and after COVID-19 lockdown measures across Zimbabwe’s ten provinces. We conducted a secondary analysis of monthly provincial DHIS2 data from January 2016 to December 2024. Segmented interrupted time-series regression with generalized estimating equations with a Poisson distribution and log link to estimate immediate lockdown and post-lockdown recovery effects for first antenatal care (ANC) visits, completion of at least four ANC visits, institutional deliveries, newborn postnatal care within three days, primary immunisation course completion, and neonatal deaths. Models adjusted for province, calendar month, and within-province correlation. Completion of at least four ANC visits declined during lockdown (aRR 0.68, 95% CI 0.61–0.76), as did newborn postnatal care within three days (aRR 0.81, 95% CI 0.76–0.87). First ANC visits remained stable during lockdown (aRR 0.99, 95% CI 0.84–1.16) but increased post-lockdown (aRR 1.23, 95% CI 1.05–1.43). Institutional deliveries also increased during recovery (aRR 1.25, 95% CI 1.11–1.40), while neonatal deaths increased post-lockdown (aRR 1.38, 95% CI 1.17–1.62). Provincial patterns indicated heterogeneous disruption and recovery. COVID-19 lockdown measures disrupted selected routine MCH services, particularly continued antenatal and early postnatal care, whereas institutional deliveries and childhood immunisation were comparatively resilient. Strengthening emergency preparedness and recovery planning is essential to maintaining continuity of MCH services during future public health emergencies.