JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic affected the provision of sexual and reproductive health services, including disruptions to family planning and contraceptive services. The World Health Organization conducted a multi-country study in India, Nigeria and Tanzania to determine the impact of the pandemic on the health system's capacity to provide contraception services. In this manuscript, we present findings of health facility assessment on availability and readiness to provide contraceptive services, and a comparison of trends in contraceptive uptake before and during the pandemic.

Objective:

The objectives of the health facility assessment were to (i) determine the status, availability and health facility readiness to provide contraceptive services in regions/localities most affected during the COVID-19 pandemic and (ii) assess the trends in the provision and uptake of contraceptive services in the facilities over the past 12 months.

Methods:

This mixed method study was conducted by the Indian Council of Medical Research-National Institute of Research in Reproductive and Child Health (India), the University of Ilorin Teaching Hospital (Nigeria), and the Ifakara Health Institute (Tanzania). Eleven primary health facilities in India, six in Nigeria and thirty-three in Tanzania were evaluated for the readiness of health facilities to provide contraceptive services using a facility assessment questionnaire. The most knowledgeable senior health care provider or administrator on contraceptive service provision in each health facility was selected to complete the questionnaire. Data was collected from May to August 2022. The study received ethical and scientific approval from the WHO Ethics Review Committee and Research Project Review Panel, and national regulatory bodies. In this paper, we compare the findings of the health facility assessment from the three countries.

Results:

Health facilities in all the three countries experienced shortages of various contraceptives. The disruptions in the use of essential health services, including sexual and reproductive health, contraceptive and abortion services, had a similar pattern in all countries but were most marked in Nigeria and least in Tanzania. There was a decline in clients visiting health facilities in India (30%) and Nigeria (11%) in 2020 compared to 2019, with a gradual recovery in the number of clients. Tanzania did not show a significant decline in number of clients, except for a slight dip (1%) in 2020. Readiness measures such as telemedicine, task shifting, community outreach, triaging, and patient redirection were implemented to minimize service disruption.

Conclusions:

This study offers crucial insights into the challenges posed by the COVID-19 pandemic on contraceptive services and the measures taken to alleviate them. The findings can help countries to better prepare to prevent the disruption of family planning and contraceptive services in future pandemics or emergencies.