Abstract:

The indirect health impacts include diversion or depletion of resources to provide routine care and decreased access to routine care resulting from an inability to travel due to restriction, fear, or other factors. This paper presents the findings of a cross-sectional quantitative study exploring systemic effects on access to and utilization of quality contraceptive services by women of reproductive age during the Covid-19 pandemic in Oyo State, Nigeria. A purposive sampling technique was used to select 471 users of users of MNCH services (postnatal clinic and family planning services and immunization uptakes) that responded to 43 structured questionnaires that included socio-demographical characteristics, knowledge of contraceptive products and service availability, contraceptive supplies, access and utilization, health system opportunities and challenges amidst Covid-19 pandemics. Of the 471 respondents, the mean age of respondents was 29.63± 3.29years, with (34.2%) within 26-30 years age group. Majorly self-employed/business (74.9%), (91.1%) Yorubas ethnicity. Only 49.2% accessed contraceptive services during restrictions; due to overwhelming fear of Covid-19 by (31.7%), and disruption of services (31.1%). Others mentioned cost, restriction in movement, and difficulty in seeing caregivers. With 65.4% of the total respondents currently obtained a method with easy in restrictions. The Chi-square test, on the relationship between respondents’ access to and utilization of contraceptive services with systemic factors shows a significant relationship with p =0.004 during the pandemic. It becomes highly imperative that the family planning program be redesigned to improve the health system as part of the preparedness measures to address gaps due to the Covid-19 restrictions.

References:

[1] Zulu JM, et al, 2015. Innovation in health service delivery: integrating community health assistants into the health system at the district level in Zambia. BMC Health Serv Res. 2015;15(1):1.

[2] Schneider H, Lehmann U, 2016. From Community Health Workers to Community Health Systems: Time to Widen the Horizon? Health Syst Reform;2(2):112–8.

[3] Vinit Sharma et al., 2020Why the Promotion of Family Planning Makes More Sense Now Than Ever Before? First Published August 5, 2020, https://doi.org/10.1177/0972063420935545.

[4] Purdy C, 2020. Opinion: How will Covid-19 affect global access to contraceptives—and what can we do about it? Devex, https://www.devex.com/news/sponsored/opinion-how-will-covid-19-affect-global-access-to-contraceptives-and-what-can-we-do-about-it-96745.

[5] Marie Stopes International,2020. Stories from the frontline: in the shadow of the Covid-19 pandemic, https://www.mariestopes.org/covid-19/stories-from-the-frontline.

[6] International Planned Parenthood Federation, 2020. Covid-19 pandemic cuts access to sexual and reproductive healthcare for women around the world, 2020, https://www.ippf.org/news/covid-19-pandemic-cuts-access-sexual-and-reproductive-healthcare-women-around-world.

[7] Falcone R E, Detty A. 2015. “The Next Pandemic: Hospital Response.” Emergency Medical Reports 36 (26): 1–16.

[8] International Federation of Gyanecology and Obsteric, 2020. Covid-19 Contraception and Family Planning: Contraceptive and Family Planning services and supplies are CORE components of essential health services, and access to these services is a fundamental human right.

[9] Guanjian Li, Dongdong Tang et al., 2020: Impact of the Covid-19 Pandemic on Partner Relationships and Sexual and Reproductive Health: Cross-Sectional, Online Survey Study, Published on 6.8.2020 in Vol 22, No 8 (2020).

[10] Kavita Nanda, et al, 2020. Contraception in the Era of Covid-19, Glob Health Sci Pract. 2020 Jun 30; 8(2): 166–168. Published online 2020 Jun 30. Doi: 10.9745/GHSP-D-20-00119 PMCID: PMC7326510, PMID: 32312738.

[11] Weinberger M, Hayes B, et al., 2020: Doing things differently: what it would take to ensure continued access to contraception during Covid-19. Glob Health Sci Pract, 8, pp. 169-175.

[12] Modupe Taiwo, et al, 2020. Gendered Impact of Covid-19 on the Decision-Making Power of Adolescents in Northern Nigeria, Save the Children Nigeria.

[13] Kantorová V, et al.,2020 Estimating progress towards meeting women’s contraceptive needs in 185 countries: A Bayesian hierarchical modelling study. PloS Med 17(2): e1003026. https://journals.plos.org/plosmedicine/articleid=10.1371/journal.pmed.1003026.

[14] United Nations, Department of Economic and Social Affairs, Population Division, 2019. Family Planning and the 2030 Agenda for Sustainable Development. New York: United Nations.

[15] WHO, 2007. Maternal mortality in 2005; Estimates Developed by WHO, UNICEF, UNFPA, and The World Bank, WHO, Geneva 2007.

[16] Lule E, et al., 2007. Fertility regulation behavior and their costs: contraception and unintended pregnancies in Africa and Eastern Europe and Central Asia. Washington: World Bank; 2007.

[17] Kayode Afolabi, 2020. Sustaining FP & Sexual Reproductive Reproductive Health Services Delivery amidst Covid-19 Pandemic, Director/Head RH Division, Federal Ministry of Health.

[18] Aishat Bukola Usman, Olubunmi Ayinde, et al, 2020. Epidemiology of Corona Virus Disease 2019 (Covid-19) Outbreak Cases in Oyo State, Southwest Nigeria March -April 2020. DOI:10.21203/rs.3.rs-29502/v1.

[19] National Population Commission (NPC) [Nigeria] and ICF. 2019. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA A: NPC and ICF.

[20] Ezugwu EC, Nkwo PO, Agu PU, Ugwu EO, Asogwa AO, 2014. Contraceptive use among HIV-positive women in Enugu, southeast Nigeria. Int J Gynaecol Obstet 2014; 126:14-7.

[21] USAID, 2020. Monitoring Covid-19’s Effects on Family Planning: What Should We Measure?

[22] FP2020, Measurement, no date, http://progress.familyplanning2020.org/measurement.

[23] Michelle Weinberger et al, 2020: Doing Things Differently: What It Would Take to Ensure Continued Access to Contraception During Covid-19. Global Health: Science and Practice, 8(2):169-175; https://doi.org/10.9745/GHSP-D-20-00171.

[24] Sorpreso ICE, et al, 2015. Sexually vulnerable women: could long-lasting reversible contraception be the solution? Rev Bras Ginecol E Obstet.; 37:395–396.

[25] Taylor Riley et al., 2020. Estimates of the Potential Impact of the Covid-19 Pandemic on Sexual and Reproductive Health in Low- and Middle-Income Countries, International Perspectives on Sexual and Reproductive Health, A journal of peer-reviewed research, volume 46, page 73-76.