Use of routine health information systems to monitor disruptions of coverage of maternal, newborn, and child health services during COVID-19: A scoping review

Background The COVID-19 pandemic is a unique global health challenge which disrupt-ed essential health services (EHS). Most early data related to EHS during the COVID-19 pandemic came from country and regional pulse surveys conducted by the World Health Organization (WHO) and United Nations Children's Fund (UNICEEF), which relied on respondent perceptions and not necessarily routine health information system (RHIS) data. By conducting a scoping review, we aimed to describe the use of RHIS data for monitoring changes in EHS coverage for maternal, newborn, and child health (MNCH) during the COVID-19 pandemic.Methods We performed a scoping review using Sample, Phenomenon of Interest, De -sign, Evaluation, Research type (SPIDER) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Scoping Review (PRISMA-SCR) guidelines. We includ-ed descriptive or analytic reports on the availability and use of RHIS data published in peer-reviewed, pre-publication, or gray literature on MNCH essential health services cov-erage during the COVID-19 pandemic. The following databases were searched for studies published between January 2020 and May 2022: PubMed/MEDLINE, Google Scholar, Google, MedRXiv (pre-publication), Embase, CINAHL, Cochrane, Campbell, and Open-Grey. A single reviewer screened the titles, abstracts, and full texts of the retrieved pub-lications, while a second reviewer screened 20% of the total sample. Publications were tabulated by WHO Region, World Bank income group, country, data sources, study top-ic, and period. We used content analysis to qualitatively describe the trends and use of data for policy or programming in the studies.Results We included 264 publications after the full-text review. The publications came from 81 countries, covering all WHO regions and World Bank income groups. The most common data sources were hospital information systems (27%) and primary health care management information systems (26%). Most studies examined data trends before COVID-19 compared to periods during COVID-19. Most publications reported a de-crease in MNCH services (45%). Reports with follow-up beyond August 2020 (first six months of pandemic) were significantly more likely to report recovery of service coverage (8% vs 30%, P< 0.001). Low-and middle-income countries reported significantly higher morbidity and/or mortality in COVID-19 periods than high-income countries (54% vs 30%, P < 0.001). Less than 10% of reports described RHIS data quality specifically during the COVID-19 period and only 22% reported program mitigation strategies to address reductions noted from routine data.Conclusion Results suggest awareness and usefulness of RHIS to monitor MNCH service disruptions during the COVID-19 pandemic. However, with only 22% of reports includ-ing descriptions of policy or program adaptations, use of RHIS data to monitor MNCH service disruptions was not necessarily followed by data-informed policies or program adaptations. RHIS data on MNCH services should be strengthened to enable its use by program man-agers and policymakers to respond to direct and indirect effects of future public health emergencies.Registration: Open Science Framework (available at: https://osf.io/usqp3/?view_only=94731785fc-ba4377adfa1bdf5754998d).

Automated summary

By conducting a scoping review, the study aimed to describe the use of routine health information system (RHIS) data for monitoring changes in essential health services (EHS) coverage for maternal, newborn, and child health (MNCH) during the COVID-19 pandemic. The results showed that while RHIS can be used to monitor disruptions in MNCH services, there is a need to strengthen RHIS data for future public health emergencies.