ABSTRACT
To examine demographic, socioeconomic, and regional differences between in-person and telehealth contraception visits and telehealth visit quality in the US during the COVID-19 pandemic. In July 2020 and January 2021, we surveyed reproductive-aged women about experiences seeking contraception. We created a COVID-19 hardship score assessing pandemic-related job, income, and housing loss and a telehealth quality score assessing telehealth visit convenience, communication, and privacy. We used chi-square tests and multivariable logistic regression to examine relationships between baseline variables and in-person vs. telehealth visits and telehealth quality scores. Among 2,028 respondents who answered questions about contraception visits, 1,490 (73.4%) reported any visit, of which 530 (35.6%) were telehealth. In adjusted analyses, respondents identifying as Hispanic/Latina and mixed race/other (adjusted OR (aOR), 0.59 and 0.36, respectively), from the South, Midwest, or Northeast (aOR, 0.63, 0.64, 0.52, respectively), without insurance (aOR 0.63), and with greater COVID-19 hardship (aOR 0.52) had significantly lower odds of attending any visit (all p<0.05). Among respondents with any visit for contraception, respondents from the Midwest and South had significantly lower odds of having a telehealth versus in-person visit (aOR 0.63 and 0.54 respectively, p<0.01). Hispanic/Latina respondents and those in the Northeast had significantly lower odds of reporting high telehealth quality (≥75th percentile) (aOR 0.53 and 0.65, respectively, p<0.05). Disparities in telehealth usage for contraception among people identifying as Hispanic/Latina and people in the South and Midwest, and in telehealth quality among Hispanic/Latina people. Further research should focus on patients' desires around telehealth and increasing access to telehealthcare. [ FROM AUTHOR]
ABSTRACT
COVID-19 and its associated lockdowns and restrictions on movement may be impacting women and men’s access to and use of health care services including contraceptive, prenatal, and postnatal care. Yet we know little of its impact to date, especially in low- and middle-income countries, including India. Understanding how COVID-19 impacts the use of these services now, and as it persists, is essential for improving access and use today. Additionally, these data are necessary to understand fertility and other health-related outcomes we may see in the future. The objectives of this study are to understand a Facebook sample of respondent’s perceived barriers to contraceptive, prenatal, and postnatal care in India and how these changed over 4 months of the COVID-19 pandemic. To meet this need, we conducted four rounds of monthly online surveys with men and women (N = 9,140) recruited using Facebook ads in India between April and July 2020, a period when the national lockdown was tapered from the strictest to restricted. While about 75% of respondents reported no barriers to contraception due to COVID-19, about half of those pregnant or postpartum reported barriers to pre- and postnatal care. Barriers to care for contraception, prenatal, and postnatal care increased significantly over time. Most respondents reported some change on fertility preferences, with more respondents reporting desire to delay, rather than to have a child sooner, due to COVID-19. Overall, as the early COVID-19 pandemic persisted, barriers to reproductive and maternal health care increased in India, suggesting that as the pandemic continued there have likely been additional challenges for people seeking these services. It is essential that health care providers begin to address these barriers to ensure access to care throughout these important time periods. © 2022 The Author(s).