PDF(Pubmed)
Abstract：
The COVID-19 pandemic has disproportionate effects on people living in low- and middle-income countries (LMICs), exacerbating weak health systems. We conducted a scoping review to identify, map, and synthesise studies in LMICs that measured the impact of COVID-19 on demand for, provision of, and access to contraceptive and abortion-related services, and reproductive outcomes of these impacts. Using a pre-established protocol, we searched bibliographic databases (December 2019-February 2021) and key grey literature sources (December 2019-April 2021). Of 71 studies included, the majority (61%) were not peer-reviewed, and 42% were based in Africa, 35% in Asia, 17% were multi-region, and 6% were in Latin America and the Caribbean. Most studies were based on data through June 2020. The magnitude of contraceptive service-related impacts varied widely across 55 studies (24 of which also included information on abortion). Nearly all studies assessing changes over time to contraceptive service provision noted declines of varying magnitude, but severe disruptions were relatively uncommon or of limited duration. Twenty-six studies addressed the impacts of COVID-19 on abortion and postabortion care (PAC). Overall, studies found increases in demand, reductions in provision and increases in barriers to accessing these services. The use of abortion services declined, but the use of PAC was more mixed with some studies finding increases compared to pre-COVID-19 levels. The impacts of COVID-19 varied substantially, including the country context, health service, and population studied. Continued monitoring is needed to assess impacts on these key health services, as the COVID-19 pandemic evolves.
摘要：
COVID-19大流行对生活在低收入和中等收入国家(LMICs)的人们产生了不成比例的影响，加剧薄弱的卫生系统。我们进行了范围审查以确定，地图，以及LMIC的综合研究，测量COVID-19对需求的影响，提供,以及获得避孕和堕胎相关服务的机会，和这些影响的生殖结果。使用预先建立的协议，我们检索了书目数据库(2019年12月-2021年2月)和关键灰色文献来源(2019年12月-2021年4月).包括71项研究，大多数(61%)没有经过同行评审，42%的人在非洲，亚洲35%17%是多区域的，6%在拉丁美洲和加勒比地区。大多数研究基于截至2020年6月的数据。在55项研究中，避孕服务相关影响的程度差异很大（其中24项还包括堕胎信息）。几乎所有评估避孕服务提供随时间变化的研究都指出了不同程度的下降，但严重中断相对罕见或持续时间有限。26项研究探讨了COVID-19对堕胎和堕胎后护理（PAC）的影响。总的来说,研究发现需求增加，减少提供和增加获得这些服务的障碍。堕胎服务的使用有所减少,但PAC的使用更加混杂，一些研究发现，与COVID-19之前的水平相比，PAC的使用更加混杂。COVID-19的影响变化很大，包括国家背景，卫生服务,和人口研究。需要继续监测，以评估对这些关键卫生服务的影响，随着COVID-19大流行的演变。
