Continuity of Essential Sexual and Reproductive Health Services During Covid-19 Pandemic in the Who African Region

Otieno, George; Ouedraogo, Léopold; Nkurunziza, Triphonie; Asmani, Chilanga; Elamin, Hayfa; Muriithi, Assumpta; Onyiah, Pamela Amaka; Conombo, Ghislaine; Kidula, Nancy; Tall, Fatim; Sekpon, Ameyo; Adegboyega, Ayotunde Adenola

doi:10.21203/rs.3.rs-316744/v1

Cited by 7 publications

(26 citation statements)

References 21 publications

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“…Evidence of the disruptions to AGYW healthcare access during the COVID-19 pandemic and lockdowns, and the national health system crisis brought about by the pandemic, highlight how critical it is for interventions, programs and health systems to be flexible enough to respond and adapt in order to remain resilient in the face of multiple stressors, and for service providers to adopt sustainable and innovative strategies and platforms to ensure the continued delivery of SRH and psychosocial services to AGYW in South Africa (14,19,41). It is important to develop innovative ways to ensure AGYW's access to health, social protection and educational interventions during situations like the pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…It is important to develop innovative ways to ensure AGYW's access to health, social protection and educational interventions during situations like the pandemic. Without continuity of SRH and psychosocial support services during emergencies such as the COVID-19 pandemic, any gains achieved in SRH indicators will be reversed, leading to rising HIV infection, teenage pregnancies and other negative health outcomes, and thus further exacerbating the vulnerability of AGYW (19). The AGYW intervention provides a model for assessing health system resilience, and the ability of actors within this system to adapt and respond to a crisis situation.…”

Section: Discussionmentioning

confidence: 99%

“…"Alert Level 1" indicating a low virus transmission with "high health system readiness"; "Alert Level 5" indicating a high virus transmission with "low health system readiness". 1 Several waves of COVID-19, and the ensuing lockdowns and government imposed restrictions, have significantly disrupted existing health services and interventions, with interruptions in supply chains, diversion of resources, patient and provider fears of infection, transport challenges, closure of facilities, staff shortages, paring down of services, and stock outs of medicines and commodities (17)(18)(19). In terms of SRH services, contraceptive access was hampered, fewer people were tested for HIV and consequently fewer people were initiated on HIV treatment, and access to counseling, maternal and child health services were limited (17,19).…”

Section: Covid-19 Pandemic Contextmentioning

confidence: 99%

“…The South African government's monitoring data shows that the number of women and girls receiving contraceptives was lower in 2020 than in the previous year, and emerging evidence points toward increased HIV infection rates amongst AGYW since the start of the pandemic (20,21). Disruptions in the provision of sexual and reproductive health (SRH) services to South African AGYW caused by COVID-19 are likely to have exacerbated existing challenges and barriers to access faced by this population, resulting in increased adolescent pregnancies and HIV-infections (19). In recognition that continuous provision of health services, including SRH services, is vital in order to support and improve AGYW health, South African health service providers and implementing organizations have attempted to adapt to the pandemic context through various means, including increasing the services available remotely (telemedicine), and expanding medicine dispensary and commodity provision options (17).…”

Section: Covid-19 Pandemic Contextmentioning

confidence: 99%

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Adaptation and Resilience: Lessons Learned From Implementing a Combination Health and Education Intervention for Adolescent Girls and Young Women in South Africa During the COVID-19 Pandemic

Duby

Bunce²,

Fowler³

et al. 2022

Front.Health Serv.

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The COVID-19 pandemic has been associated with reduced access to health services and worsening health outcomes for HIV and sexual and reproductive health (SRH). Through the analysis of data from an evaluation study of a combination intervention for adolescent girls and young women (AGYW) in South Africa, we sought to examine the way in which implementation and service provision were impacted by the COVID-19 pandemic and related restrictions, describing the adaptation implementers made to respond to this context. The intervention was implemented from 2019 in South African districts identified as high priority, given the high rates of HIV and teenage pregnancy amongst AGYW. The South African government introduced the first COVID-19 lockdown in March 2020. We conducted in-depth interviews with 38 intervention implementers in the period from November 2020 to March 2021. Respondents described various ways in which the COVID-19 pandemic and related restrictions had limited their ability to implement the intervention and provide services as planned. As a result, AGYW intervention beneficiary access to SRH and psychosocial services was disrupted. Implementers described several ways in which they attempted to adapt to the pandemic context, such as offering services remotely or door-to-door. Despite attempts to respond to the context and adapt services, overall COVID-19 negatively affected implementation and service provision, and heightened issues around community acceptability of the programs. Our findings can help to inform efforts to reduce health service disruption, increase health system resilience, and ensure continuous SRH service provision to AGYW in times of pandemics and other crises.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Covid-19 Pandemic Contextmentioning

confidence: 99%

Section: Covid-19 Pandemic Contextmentioning

confidence: 99%

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Adaptation and Resilience: Lessons Learned From Implementing a Combination Health and Education Intervention for Adolescent Girls and Young Women in South Africa During the COVID-19 Pandemic

Duby

Bunce²,

Fowler³

et al. 2022

Front.Health Serv.

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“…The WHO African Region found that health ministries’ financing for national procurement was stable in 2020 as funding had been allocated and orders were already placed prepandemic. 25 …”

Section: Review Findingsmentioning

confidence: 99%

Disruptions to the procurement of medical abortion medicines during COVID-19: a scoping review

et al. 2022

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ObjectivesThis scoping review aimed to systematically search, retrieve and map the extent and characteristics of available literature on the evidenced disruptions to medical abortion (MA) medicine procurement caused by the COVID-19 outbreak.DesignScoping review using Arksey and O’Malley’s methodology and Levacet al’s methodological enhancement with adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews.Data sourcesPubMed, Embase, PMC, Science Direct, the Cochrane Library and Google Scholar were searched from January 2020 to April 2022.Eligibility criteriaWe included articles in English that: (1) contained information on MA medicines; (2) included descriptions of procurement disruptions, including those with examples, characteristics and/or statistics; (3) documented events during the COVID-19 pandemic; and (4) presented primary data.Data extraction and synthesisTwo reviewers independently screened search results, performed a full-text review of preliminarily included articles and completed data extraction in a standard Excel spreadsheet. Extracted data from was compared for validation and synthesised qualitatively.ResultsThe two articles included are unpublished grey literature demonstrating evidence of short-lived disruptions in sexual and reproductive health commodity procurement, including MA medicines, in sub-Saharan Africa during the early months of the pandemic. Findings from the two included grey literature articles show that in sub-Saharan contexts, emergency preparedness, stockpiling, adaptations and flexibility of key actors, including donors, alleviated COVID-19 disruptions allowing for resumption of services within weeks.ConclusionThere is a need for increased empirical evidence of MA procurement challenges to understand which barriers to MA procurement may persist and impact continuity of supply while others can fuel resilience and preparedness efforts at the country and subregional levels. The lack of evidence from social marketing organisations and their networks is a significant gap as these actors constitute a vital artery in the distribution of MA commodities in low-income and middle-income countries.

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Adaptations to comprehensive abortion care during the COVID-19 pandemic: case studies of provision in Bolivia, Mali, Nepal, and the occupied Palestinian territory

Sorhaindo,

Castle,

Flomen

et al. 2023

Sexual and Reproductive Health Matters

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The COVID-19 pandemic impacted comprehensive abortion care provision. To maintain access to services while keeping individuals safe from infection, many organisations adapted their programmes. We conducted a programme evaluation to examine service adaptations implemented in Bolivia, Mali, Nepal, and the occupied Palestinian territory. Our programme evaluation used a case study approach to explore four programme adaptations through 14 group and individual interviews among 16 service providers, facility managers and representatives from supporting organisations. Data collection took place between October 2021 and January 2022. We identified adaptations to comprehensive abortion care services in relation to provision, health information systems and counselling, and referrals. Four overarching strategies emerged: (1) the use of digital technologies, (2) home and community outreach, (3) health worker optimisation, and (4) further consideration of groups in vulnerable situations. In Bolivia, the use of a messaging application increased access to confidential gender-based violence support and comprehensive abortion care. In Mali, the adoption of digital approaches created timely and complete data reporting and trained members of the community served as “interlocutors” between the communities and providers. In Nepal, an interim law expanded medical abortion provision to pharmacies, and home visits complemented facility-based services. In the occupied Palestinian territory, the use of a hotline and social media expanded access to quick and reliable information, counselling, referrals, and post-abortion care. Adaptations to comprehensive abortion care service delivery to mitigate disruptions to services during the COVID-19 pandemic may continue to benefit service quality of care, access to care, routine monitoring, as well as inclusivity and communication in the longer term.

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Continuity of Essential Sexual and Reproductive Health Services During Covid-19 Pandemic in the Who African Region

Cited by 7 publications

References 21 publications

Adaptation and Resilience: Lessons Learned From Implementing a Combination Health and Education Intervention for Adolescent Girls and Young Women in South Africa During the COVID-19 Pandemic

Adaptation and Resilience: Lessons Learned From Implementing a Combination Health and Education Intervention for Adolescent Girls and Young Women in South Africa During the COVID-19 Pandemic

Disruptions to the procurement of medical abortion medicines during COVID-19: a scoping review

Adaptations to comprehensive abortion care during the COVID-19 pandemic: case studies of provision in Bolivia, Mali, Nepal, and the occupied Palestinian territory

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