TY - JOUR
T1 - Barriers and facilitators to accessing and utilising sexual and reproductive health services during the COVID-19 pandemic in Africa
T2 - a systematic review and meta-analysis
AU - Bolarinwa, Obasanjo Afolabi
AU - Odimegwu, Clifford
AU - Ajayi, Kobi V
AU - Oni, Tosin Olajide
AU - Sah, Rajeeb Kumar
AU - Akinyemi, Akanni
N1 - Funding Information:
We acknowledge the support from the Union African for Population Studies (UAPS) and the Royal Society for Tropical Medicine and Hygiene (RSTMH) towards the overall objective of this study. Not applicable.
Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12/5
Y1 - 2024/12/5
N2 - BACKGROUND: Ensuring uninterrupted access and utilisation of sexual and reproductive health (SRH) services remains crucial for preventing adverse SRH outcomes. However, the unprecedented emergence of the 2019 coronavirus disease (COVID-19) significantly disrupted most of these services in Africa. Thus, we systematically reviewed and examined barriers and facilitators to accessing and utilising SRH services during the COVID-19 pandemic in Africa.METHODS: We systematically searched five databases for relevant articles published between January 2020 to December 2022, and the articles were screened following the JBI and PRISMA guidelines. Meta-synthesis of barriers and facilitators to accessing and utilising SRH services during the COVID-19 pandemic were reported, while a meta-analysis of the pooled prevalence of barriers to accessing and utilising SRH services during the COVID-19 pandemic in Africa was analysed using R.RESULTS: The pooled prevalence of barriers to accessing and utilising SRH services during the COVID-19 pandemic in Africa was 26%. Seven themes were developed for the identified barriers (disruption of healthcare services, fear and misinformation, limited availability of resources, place & region of residence, healthcare staff attitude/manpower, limited access to transportation, and stigma and discrimination), whilst six themes were developed for the identified facilitators (support for vulnerable populations, socio-demographic characteristics, community outreach programs, policy adaptations, telemedicine and digital health, and change in choice of sexual and reproductive commodities).CONCLUSION: This study found that the COVID-19 pandemic significantly impacted SRH service access and utilisation in Africa. We recommend that future research consider a longitudinal examination of the pandemic on African SRH services.TRIAL REGISTRATION: PROSPERO registration number: CRD42022373335.
AB - BACKGROUND: Ensuring uninterrupted access and utilisation of sexual and reproductive health (SRH) services remains crucial for preventing adverse SRH outcomes. However, the unprecedented emergence of the 2019 coronavirus disease (COVID-19) significantly disrupted most of these services in Africa. Thus, we systematically reviewed and examined barriers and facilitators to accessing and utilising SRH services during the COVID-19 pandemic in Africa.METHODS: We systematically searched five databases for relevant articles published between January 2020 to December 2022, and the articles were screened following the JBI and PRISMA guidelines. Meta-synthesis of barriers and facilitators to accessing and utilising SRH services during the COVID-19 pandemic were reported, while a meta-analysis of the pooled prevalence of barriers to accessing and utilising SRH services during the COVID-19 pandemic in Africa was analysed using R.RESULTS: The pooled prevalence of barriers to accessing and utilising SRH services during the COVID-19 pandemic in Africa was 26%. Seven themes were developed for the identified barriers (disruption of healthcare services, fear and misinformation, limited availability of resources, place & region of residence, healthcare staff attitude/manpower, limited access to transportation, and stigma and discrimination), whilst six themes were developed for the identified facilitators (support for vulnerable populations, socio-demographic characteristics, community outreach programs, policy adaptations, telemedicine and digital health, and change in choice of sexual and reproductive commodities).CONCLUSION: This study found that the COVID-19 pandemic significantly impacted SRH service access and utilisation in Africa. We recommend that future research consider a longitudinal examination of the pandemic on African SRH services.TRIAL REGISTRATION: PROSPERO registration number: CRD42022373335.
KW - Humans
KW - COVID-19/epidemiology
KW - Reproductive Health Services/statistics & numerical data
KW - Health Services Accessibility
KW - Africa/epidemiology
KW - SARS-CoV-2
KW - Female
KW - Pandemics
KW - Social Stigma
KW - Patient Acceptance of Health Care/statistics & numerical data
KW - Africa
KW - Access
KW - COVID-19
KW - Sexual and reproductive health services
KW - Barriers
KW - Utilisation
KW - Facilitators
UR - http://www.scopus.com/inward/record.url?scp=85211318228&partnerID=8YFLogxK
U2 - 10.1186/s12913-024-12028-2
DO - 10.1186/s12913-024-12028-2
M3 - Review article
C2 - 39639274
VL - 24
JO - BMC Health Services Research
JF - BMC Health Services Research
SN - 1472-6963
IS - 1
M1 - 1554
ER -
