Sexual and reproductive health services access and provision in Cambodia during the COVID-19 pandemic: a mixed-method study of urban–rural differences

Reproductive Health

Research

Pheak Chhoun¹  Virak Prum¹  Sovannary Tuot¹  Mengieng Ung²  Michiko Nagashima-Hayashi²  Pearlyn Neo²  Manar Marzouk²  Sze Tung Lam³  Anna Durrance-Bagale³  Natasha Howard³  Siyan Yi⁴  Davide De Beni⁵ 

[1] KHANA Center for Population Health Research, #33, Street 71, Phnom Penh, Cambodia;Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549, Singapore, Singapore;Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549, Singapore, Singapore;Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK;Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549, Singapore, Singapore;KHANA Center for Population Health Research, #33, Street 71, Phnom Penh, Cambodia;Center for Global Health Research, Touro University California, Vallejo, CA, USA;United Nations Population Fund, Asia and Pacific Regional Office, 4th Floor, UN Service Building, 10200, Bangkok, Thailand;

关键词: Sexual and reproductive health;    COVID-19;    Access;    Women;    Adolescents;   

DOI  :  10.1186/s12978-023-01614-y

 received in 2022-08-07, accepted in 2023-04-28,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe COVID-19 pandemic pushed governments worldwide to implement unprecedented mitigation measures, including safe-distancing, lockdowns, disruption of non-essential services, border closures and travel restrictions, with both potential to affect rural and urban service-users differently and unintended consequences including reductions in sexual and reproductive health (SRH) services. We aimed to explore rural–urban differences in progress and challenges in SRH services provision in Cambodia, particularly during initial months of the COVID-19 pandemic.MethodsWe used a mixed-methods study design, including a household survey of 423 adolescents and women aged 18–49 and semi-structured interviews with 21 healthcare providers. We analysed survey data using multivariable logistic regression to identify associations between rural–urban setting and contraceptive perceptions or access. We analysed interview data thematically.ResultsRural–urban residence was significantly associated with reported perceptions about and access to contraceptives. Rural participants had higher odds of stating it was possible to change contraceptive methods early in the COVID-19 pandemic, compared with urban participants. Qualitative data showed that although SRH services continued, health-workers faced differential challenges in rural and urban areas, e.g. service-users not attending due to job losses in urban areas and not complying with safe-distancing and mask-wearing requests in rural areas.ConclusionsCOVID-19 and inadequate mitigation responses differentially affected rural and urban SRH service providers and service-users, exacerbating existing socioeconomic stressors while adding new fears of infection, transport constraints, and reduced livelihoods. Added financial support could help mitigate challenges in both rural and urban areas.

【 授权许可】

CC BY   
© The Author(s) 2023