Page 21 - IJPS-10-1

International Journal of
Population Studies COVID-19 and access to family planning in Africa

lockdown of socioeconomic activities and restrictions on services, the findings suggested a higher proportion of
local and international travel, were implemented (Devi, adolescent girls and women of reproductive age (less than
2020; Hugelius et al., 2021; Zajenkowski et al., 2020). a seven percentage point difference) had low access to
While these control measures significantly contributed family planning services before the COVID-19 outbreak
to stemming the spread of the disease, they also gave compared to during the pandemic. These results suggest
rise to numerous negative unintended consequences, that adolescent girls and women of reproductive age had
such as heightened violence against women, substance improved access to family planning services during the
abuse, increased risky sexual activities, and reduced COVID-19 period than before the pandemic. However,
access to critical health-care services, such as sexual and it is essential to consider the potential bias introduced
reproductive health-care services (Avena et al., 2021; by the length of the comparison periods. To confirm and
Roesch et al., 2020; Spagnolo et al., 2020). This scoping better understand these results, a sensitivity bias test was
review aims to furnish key evidence on the impact of conducted.
COVID-19 on access to family planning services among
adolescent girls and women of reproductive age in SSA. In this analysis, we compared the last 3 years preceding
the pandemic outbreak to the 2.3 years of the ongoing
Guided by JBI’s scoping review guidelines, we included pandemic. Coincidentally, each period comprised 13
36 articles in our review that met our inclusion criteria. articles. However, the COVID-19 period encompassed
These articles focused on nine SSA countries, spanning one qualitative and 12 quantitative designs, while the
the Western, Eastern, and Southern regions. There were 17 pre-COVID-19 period included one mixed-method,
studies from West Africa, 18 from East Africa, and 1 from one qualitative, and 11 quantitative designs. The results
Southern Africa. The majority of the studies employed revealed a stagnation in access to family planning services
quantitative methodology, with slightly over one-third of among adolescent girls and women of reproductive age.
the reviewed papers concentrating on the COVID-19 era. Despite recent efforts to enhance family planning services
The restrictions imposed during the COVID-19 period for these groups through a series of reproductive health
appeared to exert a critical influence beyond health-care interventions (Adedini et al., 2018; Babalola et al., 2019;
services access, potentially impacting the execution of Benson et al., 2018; Henry et al., 2021; Tweya et al., 2018),
primary studies. Notably, our search procedure yielded within the sub-region, nothing has changed in the period
no studies directly examining the impact of COVID-19 just before the COVID-19 period and approximately 2½
on access to family planning services among adolescent years into the pandemic. While it is possible that other
girls and women in the African sub-region. However, factors may jointly contribute to this poor access to
to align with the focus of this review, we assessed the family planning services among this group of interest, the
level of contraceptive access through various family COVID-19 pandemic likely played some role in restricting
planning methods across studies selected for this review. access to these reproductive health and other services in the
These methods included CPR, mCP use, PPFP, current region. The restriction was, in part, due to the movement
contraceptive use, LARC, and any method of contraception, restrictions imposed to curb the spread of the virus during
including modern methods. For each of these method that time.
categories, the proportion of respondents who utilized the Furthermore, a comprehensive understanding of
methods was employed to determine the level of access to how movement restrictions during the lockdown could
family planning during the periods of interest. impact access to family planning services emerges when
In comparing the 10-year pre-COVID-19 period considering the underlying reasons for the low utilization
with the 2.3 years of the COVID-19 period, the results of these services in the sub-region. In Ethiopia, for
revealed findings somewhat contrary to the hypothesis. instance, during the pre-COVID-19 period, factors such
Notably, when assessing different levels of categorizations, as limited access to counseling and educational levels were
a higher proportion of adolescent girls and women of identified as common barriers to family planning service
reproductive age had moderate access to family planning access (Aliyu et al., 2015; Apanga & Adam, 2015; Esike
services during the COVID-19 period compared to the et al., 2017; Melkie et al., 2021; Ogboghodo et al., 2017).
period preceding the pandemic outbreak. Similarly, in However, throughout the period of movement restrictions,
the comparison of these periods concerning high family adolescent girls and women of reproductive age might
planning services access, the results indicated that study not have had seamless opportunities to reach their service
subjects had approximately six more percentage points providers for both health and other types of education.
during the COVID-19 period than in the pre-COVID-19 Additionally, school-age girls might have been deprived
period. Regarding low levels of access to family planning of access to their schools. If school served as the primary

Volume 10 Issue 1 (2024) 15 https://doi.org/10.36922/ijps.365