Background: The COVID-19 pandemic has had a multifaceted impact on maternal and child services and adversely influenced pregnancy outcomes. This systematic review aims to determine the impact of the COVID-19 pandemic on access to and delivery of maternal and child healthcare services in low- and middle-income countries.Methods: The review was reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A primary search of electronic databases was performed using a combination of search terms related to the following areas of interest: “impact’ AND ‘COVID-19’ AND ‘maternal and child health services’ AND ‘low- and middle-income countries. A narrative synthesis approach was used to analyse and integrate the results.Results: Overall, 45 unique studies conducted across 28 low- and middle-income countries met the inclusion criteria for the review. The findings suggest the number of family planning visits, antenatal and postnatal care visits, consultations for sick children, paediatric emergency visits and child immunisation levels decreased compared to the pre-pandemic levels in the majority of included studies. An analytical framework including four main categories was developed based on the concepts that emerged from included studies: the anxiety of not knowing (1), overwhelmed healthcare systems (2), challenges perceived by healthcare professionals (3) and difficulties perceived by service users (4).Conclusion: The COVID-19 pandemic disrupted family planning services, antenatal and postnatal care coverage, and emergency and routine child services. Generalised conclusions are tentative due to the heterogeneity and inconsistent quality of the included studies. Future research is recommended to define the pandemic’s impact on women and children worldwide and prepare healthcare systems for future resurgences of COVID-19 and potential challenges beyond.Systematic review registration: PROSPERO (CRD42021285178).

Despite the high rate of economic growth and electrification in the last two decades in Tanzania, only 6.9 % of the nation's households have access to clean cooking fuel technology which is concentrated among the rich urban households. Analysing data from two waves of the Tanzania National Panel Survey (2014/15 and 2020/21), we estimate the economic and rural-urban inequalities in the use of clean cooking fuel. Using the concentration curve, Erreygers concentration index and non-linear Fairlie decomposition, we find an increase in economic inequality and rural-urban inequality in the use of clean cooking fuel. Based on our analysis, factors such as the household head's education, household economic status and household connection to electricity contribute to the rural-urban inequality in the use of clean cooking fuel. Policy changes are vital for ensuring both rural and urban households have equitable access to education, electricity connection and household economic status to address inequality in the use of clean cooking fuel.

Introduction: Maternal mortality remains a public health issue in developing countries, with rural areas having higher rates as compared to the urban areas. Since effective utilization of maternal health-care services has the potential to reduce maternal mortality, this study measures the factors contributing to the existing rural − urban differences in the utilization of maternal healthcare services in Tanzania. Methods: We used Tanzania Demographic and Health Survey 2015/2016 data. Multi-stage stratified sampling was used to select the study participants and we estimated a Fairlie decomposition to understand the factors that contribute to inequality in maternal health-care services utilization between the rural and urban areas in Tanzania using Stata 17. Results: The study findings revealed a considerably wide rural-urban disparity in the utilization of maternal health-care services. As the findings indicated, household wealth status is the major factor for that disparity. Other factors are women's exposure to the media, women's working status, and distance from the homesteads to the health facilities. Conclusion: Therefore, any policy geared toward bridging the gap between the rural and urban areas in the utilization of maternal health-care services should focus on empowering women in terms of household economic status, media exposure, and employment.

Poverty reduction has been a difficult milestone for Tanzania to achieve despite recording remarkable economic growth over the past decade. This is because the attained growth is not inclusive, in that sectors contributing to this growth employ fewer people. Given the fact that agriculture continues to employ the majority of people in Tanzania, efforts to improve livelihoods should necessarily be geared towards transforming the sector. It is in this context that using a sample of 3,000 farmers from 13 regions of Tanzania; this Tanzania, this study set out to examine challenges facing farmers and their respective solutions following the sustainable livelihood framework. Findings show that improving farmers’ livelihoods would entail concerted efforts by the government to avail to farmers, quality and affordable seeds, fertilizer, agricultural infrastructures, subsidies, extension services, markets, information alert, affordable loans, and areas for pastures. This implies that the government needs to allocate enough funds to the agricultural sector if farmers’ needs are to be met. We note, however, that government’s allocation to the sector has alarmingly generally been exhibiting a declining trend for the past four years. It is against this background that we strongly recommend that the government rethinks its position and prioritize the agricultural sector in its budget.