Impact on the Utilization of Reproductive, Maternal, Newborn and Child Health Care Services at Primary Health Care Level During First Wave of COVID-19 Outbreak in Pakistan.

INTRODUCTION: Very little is known and predictable on how long the COVID-19 pandemic will last, even though dramatic preventive measures to flatten the curve and stop its transmission have been taken worldwide periodically since its start. These preventive measures coupled with people's fear of COVID-19, significantly altered people's health-seeking behavior and healthcare accessibility. This study aims to measure the impact of the COVID-19 pandemic on the utilization of reproductive, maternal, newborn, and child health (RMNCH) care services at primary health care (PHC) facilities in Pakistan.  Methods: A retrospective study was conducted in 22 districts using data from 1169 primary health care facilities. The District Health Information System (DHIS) was used to retrieve district-wise services utilization data from January to April 2020 i.e. January to February 2020 (pre-COVID-19) and March to April 2020 (during COVID-19). The monthly difference (in percentage change) for selected RMNCH services indicators was calculated using the expected number of clients (January to February average) versus the actual number of clients for March and April 2020. RESULTS:  We observed a decrease of 12.5% for March and 33% for April 2020 in the total number of clients who availed of primary health care services in Sindh as compared to the pre-COVID-19 monthly average. A decrease in first antenatal care visits (15.6% and 16.3%), delivery coverage (12.8% and 17.9%) and family planning client visits (31.6% and 36.3%) were observed for March and April 2020 respectively. The pentavalent vaccine results revealed a decrease of 19.3% and 63.1%, while a decrease of 17.3% and 54.3% were observed for children receiving the first dose of measles vaccine in March and April, respectively.  Conclusions: Our findings show that the number of clients who avail of routine care or RMNCH services at the primary health care level considerably declined during the initial phase of the first wave of the COVID-19 outbreak in Sindh, Pakistan. These results highlight a rising threat to poor RMNCH and outcomes.

Teachers' attitudes towards social media (SM) use in online learning amid the COVID-19 pandemic: the effects of SM use by teachers and religious scholars during physical distancing.

The adoption of physical distancing and quarantine amid the COVID-19 pandemic to contain virus spread has left the world with schools' closure. In response, schools have shifted into online learning in developed societies while the developing world struggles to opt for online learning due to limited infrastructure and capacity and religious beliefs, in some communities, that discourage online learning. However, there has been a significant increase in the use of Social Media (SM) observed across developing and developed societies and religious communities amid physical distancing. This study was conducted to explore the possibility of SM use in online learning by exploring teachers' attitudes in relation to the effects of physical distancing and increased SM use, SM knowledge and religious leaders' SM use. In a quantitative investigation method, the researchers used a questionnaire as a primary tool to collect the data from 252 teachers of both public and private schools. Partial Least Square Structural Modeling (PLS-SEM) was used as an analysis method to assess and measure the proposed model. The findings are significant to inform how physical distancing amid the pandemic has influenced teachers' attitudes to opt for social media use in online learning. The findings have implications for teachers worldwide, particularly in developing countries, to switch to online learning using SM under challenging situations like the COVID-19 pandemic.