PDF(Pubmed)
Abstract：
Background: The COVID-19 pandemic affected global access to health services, including contraception. We sought to explore effects of the pandemic on family planning (FP) service provision and use in South Africa and Zambia, including on implant and intrauterine device (IUD) users\' desire and ability to obtain removal. Methods: Between August 2020 and April 2021, we conducted surveys with 537 women participating in an ongoing longitudinal contraceptive continuation study. We also carried out in-depth interviews with 39 of the survey participants and 36 key informants involved in FP provision. We conducted descriptive analysis of survey responses and thematic analysis of interviews. Results: Contraceptive use changed minimally in this sample with the emergence of COVID-19. Fewer than half of women (n=220) reported attempting to access FP since the start of the pandemic, the vast majority of whom were using short-acting methods. Among those who sought services, 95% obtained their preferred method. The proportion of women not using a method before and after pandemic start did not change in Zambia (31%); in South Africa, the proportion increased from 8% to 10%. Less than 7% of implant or IUD users in either country reported wanting removal. Among those who sought removal (n=22), 91% (n=10) in Zambia and 55% (n=6) in South Africa successfully obtained removal. In qualitative interviews, women with challenges accessing FP services mentioned long queues, deprioritization of contraceptive services, lack of transportation, stock-outs, and fear of contracting COVID-19 at a facility. Key informants reported stock-outs, especially of injectables, and staff shortages as barriers. Conclusions: We did not find a substantial impact of COVID-19 on contraceptive access among this sample; however, providers and others involved in service provision identified risks to continuity of care. As the COVID-19 pandemic wanes, it continues to be important to monitor people\'s ability to access their preferred contraceptive methods.
摘要：
背景：COVID-19大流行影响了全球获得卫生服务的机会，包括避孕。我们试图探索大流行对南非和赞比亚计划生育（FP）服务提供和使用的影响，包括植入和宫内节育器（IUD）用户的愿望和能力获得移除。方法：在2020年8月至2021年4月之间，我们对537名参与正在进行的纵向避孕延续研究的妇女进行了调查。我们还对参与FP提供的39名调查参与者和36名关键线人进行了深入访谈。我们对调查答复进行了描述性分析，对访谈进行了主题分析。结果：随着COVID-19的出现，该样本中避孕药具的使用变化最小。自流行病开始以来，不到一半的妇女（n=220）报告试图使用FP，其中绝大多数使用短效方法。在那些寻求服务的人中，95%获得了他们首选的方法。在赞比亚，在大流行开始之前和之后不使用一种方法的妇女比例没有变化(31%)；在南非，比例从8%上升到10%。在这两个国家中，不到7%的植入物或宫内节育器使用者报告想要移除。在寻求驱逐的人中（n=22），91%(n=10)在赞比亚和55%(n=6)在南非胜利获得去除。在定性采访中，有挑战获得FP服务的女性提到排长队，取消避孕服务的优先次序，缺乏交通,缺货，以及担心在设施感染COVID-19。关键线人报告了缺货，尤其是注射剂，和员工短缺作为障碍。结论：在该样本中，我们没有发现COVID-19对避孕方法的实质性影响；然而，提供者和其他参与提供服务的人发现了护理连续性的风险。随着COVID-19大流行的减弱，它仍然是重要的监测人们的能力，以获得他们的首选避孕方法。
