Impact of the COVID-19 pandemic on women’s contraceptive use: a mixed-methods study in South Africa and Zambia

Gates Open Research

article

Rebecca L. Callahan¹  Alice F. Cartwright¹  Mags Beksinska²  Margaret Kasaro³  Jennifer H. Tang³  Cecilia Milford²  Christina Wong¹  Marissa Velarde¹  Virginia Maphumulo²  Maria Fawzy¹  Manze Chinyama⁴  Esther Chabu⁴  Mayaba Mudenda⁴  Jennifer Smit² 

[1] FHI 360;MatCH Research Unit ,(MRU), Department of Obstetrics and Gynecology, University of the Witwatersrand;Division of Global Women’s Health, Department of Obstetrics and Gynecology, The University of North Carolina at Chapel Hill;UNC Global Projects

关键词: family planning;    contraception;    COVID-19;    South Africa;    Zambia;    Long-acting reversible contraception (LARC);    LARC removal;    mixed methods;   

DOI  :  10.12688/gatesopenres.14590.1

学科分类：电子与电气工程

来源: American Journal Of Pharmtech Research

【 摘 要 】

Background: The COVID-19 pandemic affected global access to health services, including contraception We sought to explore effects of the pandemic on family planning (FP) service provision and use in South Africa and Zambia, including on implant and intrauterine device (IUD) users’ desire and ability to obtain removal. Methods: Between August 2020 and April 2021, we conducted surveys with 537 women participating in an ongoing longitudinal contraceptive continuation study. We also carried out in-depth interviews with 39 of the survey participants and 36 key informants involved in FP provision. We conducted descriptive analysis of survey responses and thematic analysis of interviews. Results: Contraceptive use changed minimally in this sample with the emergence of COVID-19. Fewer than half of women (n=220) reported attempting to access FP since the start of the pandemic, the vast majority using short-acting methods. Among those who sought services, 95% obtained their preferred method. The proportion of women not using a method before and after pandemic start did not change in Zambia (31%); in South Africa, the proportion increased from 8% to 10%. Less than 7% of implant or IUD users in either country reported wanting removal. Among those who sought removal (n=22), 91% (n=10) in Zambia and 55% (n=6) in South Africa successfully obtained removal. In qualitative interviews, women with challenges accessing FP services mentioned long queues, deprioritization of contraceptive services, lack of transportation, stock-outs, and fear of contracting COVID-19 at a facility. Key informants reported stock-outs, especially of injectables, and staff shortages as barriers. Conclusions: We did not find a substantial impact of COVID-19 on contraceptive access among this sample; however, providers and others involved in service provision identified risks to continuity of care. As the COVID-19 pandemic wanes, it continues to be important to monitor people’s ability to access their preferred contraceptive methods.

【 授权许可】

CC BY