Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 24
Filter
1.
Sex Reprod Healthc ; 36: 100844, 2023 Jun.
Article in English | MEDLINE | ID: covidwho-2298380

ABSTRACT

OBJECTIVE: The COVID-19 pandemic presented new care delivery obstacles in the form of scheduling procedures and safe presentation to in-person visits. Contraception provision is an indispensable component of postpartum care that was not immune to these challenges. Given the barriers to care during the initial months of the pandemic, we sought to examine how postpartum contraception, sterilization, and visit attendance were affected during this period. STUDY DESIGN: We performed a retrospective chart review to examine contraception initiation, sterilization, and postpartum virtual and in-person visit attendance rates during the first six months (March 15 to September 7, 2020) of the COVID-19 pandemic compared to the rates in the same period in the year prior at a single tertiary academic care center. We abstracted data from the first prenatal visit through twelve weeks postpartum. RESULTS: With the initiation of virtual appointments, postpartum visit attendance significantly increased (94.6 % vs 88.4 %, p < 0.001) during the pandemic with no difference in overall contraception uptake (51 % vs 54.1 %, p = 0.2) or sterilization (11.0 % vs 11.5 %, p = 0.88). During the pandemic, contraception prescribed differed significantly with a trend towards patient-administered methods including pills, patches, and rings (21 % vs 16 %, p = 0.02). In both periods, there was a significantly younger mean age (p < 0.001), higher proportion of non-White and non-Asian race (p < 0.001), public insurance (p = 0.003, 0.004), and an established contraceptive plan prenatally (p < 0.001) in the group that received contraception. CONCLUSION: As virtual postpartum visits were instituted, contraception initiation and sterilization were maintained at pre-pandemic rates and visit attendance rose despite the obstacles to care presented by the COVID-19 pandemic. Provision of virtual postpartum visits may be a driver to maintain contraception and sterilization rates at a time, such as early in the COVID-19 pandemic, when patient care is at risk to be disrupted by social distancing, isolation, and avoidance of medical campuses.


Subject(s)
COVID-19 , Pandemics , Pregnancy , Female , Humans , Retrospective Studies , Contraception/methods , Postpartum Period
2.
Contraception ; 123: 110054, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-2302650

ABSTRACT

OBJECTIVES: To understand how changes to in-person health care during the COVID pandemic impacted contraceptive use in Oregon's state-funded network. STUDY DESIGN: A retrospective cohort of 245,600 visits (virtual and in-person) among 70,295 women presenting to publicly funded family planning clinics in Oregon between January 2019 and June 2021. Data were abstracted from clinic records and restricted to visits of patients identifying as female, 12-51 years old, not using sterilization as a method. Contraception was grouped by effectiveness Tier (Tier 1: intrauterine device, implants; Tier 2: progestin injectable, pill/patch/ring). Multivariable logistic regression predicted the use of contraception by stage of the COVID pandemic which corresponded to service availability (prepandemic, acute: nonemergency services halted, subacute: restricted services), patient demographics, including insurance type, and clinic and geospatial characteristics. RESULTS: Overall during the acute stage, people with visits were more likely to leave with a method of contraception odds ratios (OR) 1.39 (95% confidence interval [CI] 1.24-1.57); however, it was significantly less likely to be a Tier 1 method (OR 0.82, 95% CI 0.74-0.91) as compared to prepandemic. This finding was particularly marked in rural areas (OR 0.69 [96% CI 0.58-0.83]) and among the publicly insured (OR 0.87 [95% CI 0.80-0.94]). CONCLUSIONS: Demand for contraception increased during the acute phase of the COVID pandemic, and shifts in method mix from Tier 1 to Tier 2 methods occurred. Disparities in contraceptive access persisted for those in rural locations or with public insurance. IMPLICATIONS: Lessons learned from the COVID-19 pandemic are critical to informing our future emergency response. The need for family planning services increased during the public health emergency.


Subject(s)
COVID-19 , Contraceptive Agents , Female , Humans , Child , Adolescent , Young Adult , Adult , Middle Aged , Pandemics , Oregon , Retrospective Studies , Contraception/methods , Family Planning Services , Health Services Accessibility
3.
J Obstet Gynaecol ; 42(6): 2292-2296, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-2291543

ABSTRACT

The coronavirus 19 (COVID-19) pandemic has negatively impacted family planning services worldwide. There are no published reports from Jordan on the impact of COVID-19 pandemic on family planning methods. This was a web-based cross-sectional study between September and December 2020 with 519 participants; of these 43.5% did not use any method. The most used methods were intrauterine devices, coitus interruptus and male condoms. Furthermore, 38.2% of women changed methods due to limited access to services and non-availability of methods. While 82.1% of women preferred modern methods before the pandemic, 79.7% became more acceptant of traditional methods. Moreover, 35.3% of women got pregnant during the curfew, and 90% were unplanned with a statistically significant higher rate in women who changed their routine method, accepted traditional methods, have been married for less than 10 years and multiparous women. National health policy makers should consider the impact of large-scale pandemics on family planning services.IMPACT STATEMENTWhat is already known on this subject? Family planning services in Jordan have improved significantly over the last decade because of accessibility and availability of a wide range of contraceptive methods. Available methods are either traditional or modern. Because of the high failure rates of traditional methods, public health family planning programmes promote modern methods.What do the results of this study add? There are no published reports from Jordan on the impact of COVID-19 pandemic and curfew on family planning methods. This study aims to report on what family planning methods women used during the pandemic, reporting if women changed their preferred methods and the reasons, assess women's knowledge about the natural methods of family planning which is probably an alternative method in situations where services and accessibility to more effective methods are limited and estimate unplanned pregnancies.What are the implications of these findings for clinical practice and/or further research? National health policy makers should consider the impact of large-scale pandemics on family planning services. Additionally, the implementation of telehealth and home delivery of self-administered methods should be considered. Natural methods of contraception may be an option when access and availability to modern methods is limited.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , Contraception/methods , Contraception Behavior , Cross-Sectional Studies , Family Planning Services , Female , Humans , Jordan/epidemiology , Male , Pandemics/prevention & control , Pregnancy
4.
Int J Environ Res Public Health ; 20(3)2023 01 28.
Article in English | MEDLINE | ID: covidwho-2216032

ABSTRACT

BACKGROUND: One of the manifestations of family development is pregnancy planning, where this method is applied 0-42 days after childbirth. Post-partum contraception is an effort to avoid pregnancy by using contraceptive medicine from 42 days to 84 days after childbirth. PURPOSE: This research aims to analyze the attitudes of fertile couples who use contraceptive devices after childbirth during the COVID-19 pandemic and the factors that influence it. METHOD: This research uses a quantitative method approach. The sampling technique was random sampling with proportional sampling so that 280 respondents were obtained from 3 regencies/cities in West Java with high fertility rates and low post-partum contraceptive participation rates. Quantitative data analysis used univariate, bivariate, and multivariate methods. RESULT: The results showed that the final model of the analysis of the most determining factors for post-partum contraception during a pandemic were family support, healthcare staff support, counselling with healthcare staff, attitudes, and age at first marriage. CONCLUSION: Fertile couples with the highest amount of family support are more likely to use post-partum contraceptive devices during COVID-19. The results of this study can be used as material for consideration in making decisions about post-partum contraception, especially during the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Pregnancy , Female , Humans , Indonesia/epidemiology , COVID-19/epidemiology , Contraception/methods , Contraceptive Agents , Postpartum Period , Family Planning Services
5.
Int J Environ Res Public Health ; 19(19)2022 Oct 05.
Article in English | MEDLINE | ID: covidwho-2066048

ABSTRACT

The COVID-19 pandemic has burdened the healthcare system and influenced individuals' health-related choices. The aim of the study was to estimate the prevalence and to identify the correlates of the use of more and less effective contraceptive methods among Poles in the initial period of the COVID-19 pandemic. The cross-sectional online study was conducted among the representative sample of 642 female respondents aged 18-49. Three groups of contraception choices (only effective methods-42.2%, mixed effective and ineffective methods-26.8%, none-31.0%) were distinguished and 11 potential determinants were considered. One in ten women declared having difficulty in accessing contraception during the first months of the pandemic. A multinomial logistic regression model explained 48.7% of the variation in contraceptive method choice. Both effective and ineffective methods were more often declared by young women, and less often in case of lower education, planning children or subjective no need for contraception. In addition, factors that reduced the chance of effective contraception were poor financial situation, already having children and a relatively higher degree of religiosity. The study confirmed that a significant share of Polish women do not opt for effective methods of contraception. Their choices had strong demographic, social and cultural determinants.


Subject(s)
COVID-19 , Contraceptive Agents , COVID-19/epidemiology , Child , Contraception/methods , Cross-Sectional Studies , Family Planning Services , Female , Humans , Pandemics , Poland/epidemiology
6.
Glob Health Sci Pract ; 10(4)2022 08 30.
Article in English | MEDLINE | ID: covidwho-2025436

ABSTRACT

INTRODUCTION: We conducted an assessment in Malawi, Nepal, Niger, and Uganda to document access-related reasons for not using contraceptive methods during the COVID-19 pandemic that led to unintended pregnancies, describe use of modern contraception among women in potential need of contraception compared to before the pandemic, examine method choice, and describe barriers to contraceptive access and use. METHODS: Between December 2020 and May 2021, we conducted an opt-in phone survey with 21,692 women, followed by an outbound survey with 5,124 women who used modern nonpermanent contraceptive methods or who did not want to get pregnant within 2 years but were not using a modern contraceptive method. The surveys examined current behaviors and documented behaviors before the pandemic retrospectively. We used multivariable logistic regression models to examine factors associated with contraceptive use dynamics during COVID-19. RESULTS: Pregnant women surveyed reported that the pandemic had affected their ability to delay or avoid getting pregnant, ranging from 27% in Nepal to 44% in Uganda. The percentage of respondents to the outbound survey using modern contraception decreased during the pandemic in all countries except Niger. Fear of COVID-19 infection was associated with discontinuing modern contraception in Malawi and with not adopting a modern method among nonusers in Niger. Over 79% of surveyed users were using their preferred method. Among nonusers who tried obtaining a method, reasons for nonuse included unavailability of the preferred method or of providers and lack of money; nonusers who wanted a method but did not try to obtain one cited fear of COVID-19 infection. CONCLUSION: We found evidence of surveyed women attributing unintended pregnancies to the pandemic and examples of constraints to contraceptive access and use on the supply and demand side. The effects of the pandemic must be interpreted within the local contraceptive, health system, and epidemiological context.


Subject(s)
COVID-19 , Family Planning Services , COVID-19/epidemiology , Contraception/methods , Contraception Behavior , Contraceptive Agents , Cross-Sectional Studies , Female , Humans , Malawi/epidemiology , Nepal/epidemiology , Niger , Pandemics , Pregnancy , Retrospective Studies , Uganda/epidemiology
7.
Perspect Sex Reprod Health ; 54(3): 80-89, 2022 09.
Article in English | MEDLINE | ID: covidwho-2021458

ABSTRACT

CONTEXT: The COVID-19 pandemic increased the provision of contraception through telemedicine. This qualitative study describes provider perceptions of how telemedicine provision of contraception has impacted patient care. METHODS: We interviewed 40 obstetrics-gynecology and family medicine physicians, midwives, nurse practitioners, and support staff providing contraception via telemedicine in practices across Illinois, including Planned Parenthood of Illinois (PPIL) health centers. We analyzed interview content to identify themes around the perceived impact of telemedicine implementation on contraception access, contraceptive counseling, patient privacy, and provision of long-acting reversible contraception (LARC). RESULTS: Participants perceived that telemedicine implementation improved care by increasing contraception access, increasing focus on counseling while reducing bias, and allowing easier method switching. Participants thought disparities in telemedicine usage and limitations to the technological interface presented barriers to patient care. Participants' perceptions of how telemedicine implementation impacts patient privacy and LARC provision were mixed. Some participants found telemedicine implementation enhanced privacy, while others felt unable to ensure privacy in a virtual space. Participants found telemedicine modalities useful for counseling patients considering methods of LARC, but they sometimes presented an unnecessary extra step for those sure about receiving one at a practice offering same day insertion. CONCLUSION: Providers felt telemedicine provision of contraception positively impacted patient care. Improvements to counseling and easier access to method switching suggest that telemedicine implementation may help reduce contraceptive coercion. Our findings highlight the need to integrate LARC care with telemedicine workflows, improve patient privacy protections, and promote equitable access to all telemedicine modalities.


Subject(s)
COVID-19 , Telemedicine , Contraception/methods , Contraceptive Agents , Family Planning Services , Female , Humans , Pandemics , Patient Outcome Assessment , Pregnancy
8.
Reprod Fertil Dev ; 34(13): 855-866, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1991760

ABSTRACT

Against the backdrop of a global pandemic, the Society for Reproductive Biology (SRB) 2021 meeting reunited the Australian and New Zealand reproductive research community for the first time since 2019 and was the first virtual SRB meeting. Despite the recent global research disruptions, the conference revealed significant advancements in reproductive research, the importance of which span human health, agriculture, and conservation. A core theme was novel technologies, including the use of medical microrobots for therapeutic and sperm delivery, diagnostic hyperspectral imaging, and hydrogel condoms with potential beyond contraception. The importance of challenging the contraceptive status quo was further highlighted with innovations in gene therapies, non-hormonal female contraceptives, epigenetic semen analysis, and in applying evolutionary theory to suppress pest population reproduction. How best to support pregnancies, particularly in the context of global trends of increasing maternal age, was also discussed, with several promising therapies for improved outcomes in assisted reproductive technology, pre-eclampsia, and pre-term birth prevention. The unique insights gained via non-model species was another key focus and presented research emphasised the importance of studying diverse systems to understand fundamental aspects of reproductive biology and evolution. Finally, the meeting highlighted how to effectively translate reproductive research into policy and industry practice.


Subject(s)
Contraception , Semen , Australia , Biology , Congresses as Topic , Contraception/methods , Female , Humans , Male , New Zealand , Pregnancy
9.
Contraception ; 115: 22-26, 2022 11.
Article in English | MEDLINE | ID: covidwho-1977162

ABSTRACT

OBJECTIVE: This study assessed a broad array of socioeconomic barriers in relation to preferred contraceptive use during a time of exacerbated personal and social financial strain (the COVID-19 pandemic). STUDY DESIGN: Using statewide data collected in early 2021 through the Survey of the Health of Wisconsin, we conducted bivariate analyses exploring the relationship between socioeconomic resources and preferred contraceptive use among Wisconsin women. RESULTS: The survey garnered 1889 responses, with a response rate of 34%. The sample for the current study (N = 247) included only adult women of reproductive age who reported current contraceptive use. Nearly one-third (32.8%) of contraceptive users reported that they were not using their preferred method. We found that greater resource deprivation, including housing instability (had to relocate: p = 0.004; unable to pay rent and/or mortgage: p = 0.008), food insecurity (ran out of food: p = 0.003; worried about running out of food: p = 0.008), and greater financial stress (p < 0.001), were significantly associated with lowered likelihood of using one's preferred contraceptive method. CONCLUSIONS: Findings indicated that people lacking socioeconomic resources, including adequate food and housing, may be unable to access their preferred contraceptive method(s). Amidst competing demands on time and resources, the inability to obtain preferred contraceptive method(s) may represent system-wide barriers as well as people's lowered ability to prioritize and access care in light of socioeconomic struggles. IMPLICATIONS: Health care providers and health systems should work to address structural barriers to care and bolster community resources in ways that promote patients' reproductive autonomy. There is also a need for continued research on specific socioeconomic determinants of preferred contraceptive use and potential solutions that bolster community resources.


Subject(s)
COVID-19 , Contraceptive Agents , Adult , Contraception/methods , Female , Financial Stress , Humans , Pandemics , Wisconsin
10.
Eur J Contracept Reprod Health Care ; 27(4): 284-288, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1895694

ABSTRACT

BACKGROUND: During COVID-19, early medical abortion (EMA) at home in Scotland was largely delivered by telemedicine. Short-acting post-abortion contraception was provided with EMA medications, but long-acting reversible contraception (LARC) (implant, injectable and intrauterine device) required an in-person visit. We wished to assess LARC uptake following telemedicine abortion, and factors associated with method receipt. METHODS: A prospective observational cohort study of patients accessing abortion via NHS Lothian (October 2020 to February 2021). Patients were offered contraception at telemedicine consultation and their choice was recorded in their clinical notes. Those wishing LARC were directed to the service's rapid-access LARC clinic. We reviewed electronic patient records six weeks post-abortion to determine whether patients received their chosen method. RESULTS: 944 patients had an abortion; 768 (81.4%) had EMA, 131 (13.9%) had a medical or surgical abortion in hospital. The most popular contraceptive method was the progestogen-only pill (n = 324, 34%). 330 patients (35%) requested LARC but less than half (153/330; 46%) received this. Of patients choosing LARC, those who attended the clinic for a pre-abortion ultrasound, or had an abortion in hospital, were more likely to initiate LARC than those having full telemedicine EMA. Nulliparity, gestation over 7 weeks, and age under-26 years were also positively associated with initiating LARC. CONCLUSION: During COVID-19 there was demand for post-abortion LARC but less than half of patients received this by six weeks. Provision was enhanced when in-person clinical interactions took place. Interventions are required to facilitate timely access and initiation of LARC with telemedicine delivered abortion care.


Subject(s)
Abortion, Induced , Abortion, Spontaneous , COVID-19 , Long-Acting Reversible Contraception , Telemedicine , Contraception/methods , Female , Humans , Long-Acting Reversible Contraception/methods , Observational Studies as Topic , Pregnancy , Prospective Studies
11.
Contraception ; 113: 1-12, 2022 09.
Article in English | MEDLINE | ID: covidwho-1850912

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has posed a burden to healthcare systems around the world and has changed the way people access health services, including contraception. This document sets forth guidance from the Society of Family Planning for providing contraceptive care in the context of the COVID-19 pandemic, including when access to healthcare is restricted due to pandemic response. It also outlines the role of telehealth for providing contraceptive care beyond the pandemic. Clinicians can use synchronous telemedicine visits and other forms of telehealth to provide many aspects of contraceptive care. Both audio-video and audio-only visits are acceptable forms of telemedicine. Access to permanent contraception should be maintained, especially in the postpartum period. Combined hormonal contraceptive (CHC) users who have asymptomatic or mild COVID-19 infection may continue their contraceptive method, while those admitted to the hospital with severe infection should suspend CHC use until they are clinically recovered. CHC users who take Paxlovid for mild-moderate COVID-19 infection can consider a back-up contraceptive method for the duration of therapy, but clinically relevant drug interactions are unlikely. Future research should examine contraceptive outcomes in people who receive care via telemedicine; and access to telemedicine among historically excluded populations such as adolescents, people of color, people of low socioeconomic status, disabled people, or people who do not speak English as a primary language.


Subject(s)
COVID-19 , Telemedicine , Adolescent , Contraception/methods , Contraceptive Agents , Family Planning Services/methods , Female , Humans , Pandemics
12.
Stud Fam Plann ; 53(2): 301-314, 2022 06.
Article in English | MEDLINE | ID: covidwho-1794568

ABSTRACT

This study assessed the impact of the COVID-19 pandemic on the number of new contraceptive acceptors in Senegal overall and by method. Monthly service data from March 2019 to December 2020 were extracted for the number of new contraceptive users of IUDs, implants, injectables, and oral contraceptive pills (OCPs). Data were analyzed using descriptive statistics and interrupted time series analysis for trend analyses overall and by the contraceptive method. Following the announcement of the first COVID-19 case in Senegal in March 2020, there was an immediate significant decrease in the number of new acceptors overall, and for new users of implants and injectables. From March-December 2020, the trend in monthly new family planning acceptors increased overall, mainly driven by significant increases in new IUD and implant acceptors. Compared to the period before the onset of COVID-19, there was a statistically significant shift from shorter-acting methods (OCPs, injectables) to long-acting reversible methods (IUDs, implants). Despite the immediate adverse impact of COVID-19-related restrictions, the number of new acceptors rebounded, trends in the number of new monthly acceptors significantly increased, and there was a significant shift to longer-acting methods.


Subject(s)
COVID-19 , Contraceptive Agents, Female , Intrauterine Devices , COVID-19/epidemiology , Contraception/methods , Contraceptives, Oral , Family Planning Services , Female , Humans , Pandemics , Senegal/epidemiology
13.
Eur J Contracept Reprod Health Care ; 27(2): 115-120, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1684369

ABSTRACT

OBJECTIVE: The aim of the study was to assess the impact of the COVID-19 pandemic on sales of modern contraceptive methods in Brazil. METHODS: Monthly sales data were analysed of short-acting reversible contraceptive methods and long-acting reversible contraceptive (LARC) methods (implants and intrauterine contraception) and COVID-19 related deaths. Contraceptive methods were grouped as follows: emergency contraception (EC); oral contraception, vaginal rings and transdermal patches; injectable contraception; LARC methods including the copper intrauterine device (Cu-IUD); and LARC methods excluding the Cu-IUD. RESULTS: Contraceptive sales showed a non-significant increase in 2020 compared with the previous year; average sales ranged from 12.8 to 13.0 million units per month. Sales of injectable contraceptives increased between March and June 2020 and EC pills between June and July 2020; the variation in sales of pills, patches and rings was not significant. Sales of the levonorgestrel-releasing intrauterine system (LNG-IUS) and the etonogestrel (ENG) implant showed three patterns: a decrease in sales between February and May 2020 (coinciding with the closure of family planning services), an increase in sales after May 2020 (coinciding with the first COVID-19-related deaths), and a further increase in sales after July 2020 (corresponding to the increasing number of deaths from COVID-19). CONCLUSION: The COVID-19 pandemic has disrupted the Brazilian health care system. Since many family planning clinics were closed, sales of most modern contraceptives fell during 2020; however, the increase in sales of the LNG-IUS and ENG implant in the private sector indicates inequitable access to modern contraceptive methods.


Subject(s)
COVID-19 , Contraceptive Agents, Female , Contraceptive Devices, Female , Intrauterine Devices, Medicated , Brazil/epidemiology , Contraception/methods , Contraceptive Agents, Female/therapeutic use , Female , Humans , Levonorgestrel , Pandemics
14.
Contraception ; 108: 50-55, 2022 04.
Article in English | MEDLINE | ID: covidwho-1588017

ABSTRACT

OBJECTIVES: To assess the impact of the COVID-19 pandemic on the use of reimbursed contraceptives in France after 15 months of the pandemic, according to age-group and updating previous data only pertaining to the first lockdown (2 months). STUDY DESIGN: We conducted a national register-based study by extracting all reimbursements of oral contraceptives (OC), emergency contraception (EC), intrauterine devices (IUD), and implants from the French National Health Insurance database (SNDS), which includes and covers 99.5% of the French population, in 2018, 2019, 2020 and from January 1, 2021 to April30, 2021. We calculated the expected use of contraceptives in 2020 and 2021 in the absence of the pandemic, based on 2018 and 2019 usage and taking annual trends into account. We assessed the difference between observed and expected dispensing rates by contraceptive type and by age-group (≤18 years old, 18< age ≤25, 25< age ≤35, >35). RESULTS: Dispensing of all contraceptives decreased compared to expect dispensing numbers: -2.0% for OC, -5.3% for EC, -9.5% for LNG-IUS, -8.6% for C-IUD, and -16.4% for implant. This decrease in the dispensing of contraceptives was observed in all age-groups, but mainly concerned women under the age of 18 years (-22% for OC, -10% for EC, -37.2% for LNG-IUS, -36.4% for C-IUD, -26.4% for implant) and those aged 18 to 25 (-5.1% for OC, -11.9% for EC, -18.1% for LNG-IUS, -15.9% for C-IUD, -17.6% for implants). CONCLUSIONS: Our study showed that the dispensing of contraceptives in France was markedly impacted by the COVID-19 pandemic. Prescriptions for long-acting contraceptive use and women under the age of 25 years were the most substantially impacted. Ensuring access to contraceptive methods during health emergencies must be a public health policy priority. IMPLICATIONS: The COVID-19 pandemic strongly impacted the dispensing of contraceptives in France with varying degrees of decreased dispensing according to the type of contraceptive, the age-group and the level of pandemic-related restrictions. The impact of these restrictions on unintended pregnancy at the population level remains undetermined.


Subject(s)
COVID-19 , Contraception, Postcoital , Contraceptive Agents, Female , Adolescent , Adult , Communicable Disease Control , Contraception/methods , Female , Humans , Infant , Levonorgestrel , Pandemics , Pregnancy , SARS-CoV-2 , Young Adult
15.
PLoS One ; 16(11): e0259583, 2021.
Article in English | MEDLINE | ID: covidwho-1505858

ABSTRACT

BACKGROUND: Infectious disease outbreaks like COVID-19 and their mitigation measures can exacerbate underlying gender disparities, particularly among adolescents and young adults in densely populated urban settings. METHODS: An existing cohort of youth ages 16-26 in Nairobi, Kenya completed a phone-based survey in August-October 2020 (n = 1217), supplemented by virtual focus group discussions and interviews with youth and stakeholders, to examine economic, health, social, and safety experiences during COVID-19, and gender disparities therein. RESULTS: COVID-19 risk perception was high with a gender differential favoring young women (95.5% vs. 84.2%; p<0.001); youth described mixed concern and challenges to prevention. During COVID-19, gender symmetry was observed in constrained access to contraception among contraceptive users (40.4% men; 34.6% women) and depressive symptoms (21.8% men; 24.3% women). Gender disparities rendered young women disproportionately unable to meet basic economic needs (adjusted odds ratio [aOR] = 1.21; p<0.05) and in need of healthcare during the pandemic (aOR = 1.59; p<0.001). At a bivariate level, women had lower full decisional control to leave the house (40.0% vs. 53.2%) and less consistent access to safe, private internet (26.1% vs. 40.2%), while men disproportionately experienced police interactions (60.1%, 55.2% of which included extortion). Gender-specific concerns for women included menstrual hygiene access challenges (52.0%), increased reliance on transactional partnerships, and gender-based violence, with 17.3% reporting past-year partner violence and 3.0% non-partner sexual violence. Qualitative results contextualize the mental health impact of economic disruption and isolation, and, among young women, privacy constraints. IMPLICATIONS: Youth and young adults face gendered impacts of COVID-19, reflecting both underlying disparities and the pandemic's economic and social shock. Economic, health and technology-based supports must ensure equitable access for young women. Gender-responsive recovery efforts are necessary and must address the unique needs of youth.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Adolescent , Adult , Cohort Studies , Contraception/methods , Contraception Behavior/statistics & numerical data , Cross-Sectional Studies , Female , Humans , Hygiene , Kenya/epidemiology , Male , Menstruation/physiology , Pandemics/prevention & control , SARS-CoV-2/pathogenicity , Sexual Behavior/statistics & numerical data , Urban Population , Young Adult
16.
PLoS One ; 16(4): e0246132, 2021.
Article in English | MEDLINE | ID: covidwho-1199974

ABSTRACT

Use of modern contraception in Rwanda has risen dramatically over a short time period. To better understand contraceptive users' motivations for family planning services in Rwanda, 32 in-depth interviews with contraceptive users and eight focus groups with 88 family planning providers were conducted in Rwanda's Musanze and Nyamasheke districts. Study participants noted how family planning is critical for providing a better life for children. Family planning gives mothers independence from childcare to work in order to provide for their children's wellbeing. Family planning presented an opportunity for generational upward mobility and was perceived as a way to contribute positively to society.


Subject(s)
Contraception , Family Planning Services , Adult , Child , Child Health , Contraception/methods , Family Planning Services/methods , Female , Humans , Male , Middle Aged , Motivation , Rwanda , Sex Education
17.
Contraception ; 103(6): 377-379, 2021 06.
Article in English | MEDLINE | ID: covidwho-1157217

ABSTRACT

The COVID-19 pandemic has exposed the vulnerability of global contraception provision, exacerbating the barriers to access reproductive health services, leading to suspension of clinical services and disruption of supply chains. Critical to combatting this crisis is the expansion of healthcare to include self-care approaches to de-medicalize contraception and increase an individual's agency in determining what method they use, when they use it, and where they obtain it. Expanding the mix of self-administered contraceptives is essential for ensuring choice, access, and availability. We highlight advances in the self-care movement and actions needed to strengthen self-management approaches to maximize our chances of preventing a reproductive health crisis.


Subject(s)
COVID-19 , Contraception/methods , Contraceptive Devices/supply & distribution , Family Planning Services/supply & distribution , Health Services Accessibility , Self-Management/methods , Family Planning Services/methods , Global Health , Humans , Self Administration
18.
Eur J Contracept Reprod Health Care ; 26(4): 265-271, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1091337

ABSTRACT

PURPOSE: Australia introduced 'lockdown' measures to control COVID-19 on 22 March 2020 which continued for a period of two months. We aimed to investigate the impact this had on sexual and reproductive health (SRH). MATERIALS AND METHODS: Australians aged 18+ were eligible to participate in an online survey from 23 April to 11 May 2020. We report on the experiences of 518 female participants aged <50 years. Pregnancy intentions and contraceptive use were analysed using descriptive statistics. Odds ratios and 95% confidence intervals were calculated to investigate difficulty accessing SRH products and services. Qualitative data were analysed using conventional content analysis. RESULTS: Most participants were aged 18-24 years, and indicated they were trying to avoid pregnancy. The oral contraceptive pill was the most common single method used however nearly 20% reported they were not using contraception. Women who were employed had less trouble accessing contraception during lockdown. Participants reported delaying childbearing or deciding to remain childfree due to COVID-19. CONCLUSION: COVID-19 lockdown impacted the SRH of Australian women. Findings highlight the importance of continued access to SRH services and products during global emergencies.


Subject(s)
COVID-19 , Communicable Disease Control/methods , Contraception Behavior , Contraception , Health Services Accessibility/statistics & numerical data , Reproductive Health Services , Adult , Australia/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Contraception/methods , Contraception/statistics & numerical data , Contraception Behavior/psychology , Contraception Behavior/statistics & numerical data , Decision Making , Female , Health Services Needs and Demand , Humans , Pregnancy , Reproductive Health , Reproductive Health Services/organization & administration , Reproductive Health Services/statistics & numerical data , SARS-CoV-2 , Sexual Health
19.
Adv Ther ; 38(2): 1011-1023, 2021 02.
Article in English | MEDLINE | ID: covidwho-1033629

ABSTRACT

The rapid spread of novel coronavirus (COVID-19) has posed complex challenges to global public health. During this pandemic period, access to essential services including post-abortion care (PAC) has been disrupted. Along with the clinical management of the disease in women, protection of the healthcare workers and medical staff from nosocomial infection is important to ensure infection control. Thus, in order to implement the proper contraceptive measures and to reduce the rate of repeated abortion, the family planning group of minimally invasive gynecological branch of the Liaoning Medical Association organized a committee of experts to formulate guidance and suggestions to ensure the timely treatment and surgery of women opting for abortion, the implementation of PAC, implementation of safe contraceptive measures after surgery, and the protection of healthcare professionals and medical staff from infection. We believe these guidelines might be helpful for obstetrics and gynecology departments in China and globally, as well for women who wish to undergo abortion during these unprecedented times.


Subject(s)
Abortion, Induced , Aftercare/methods , COVID-19 , Contraception/methods , Family Planning Services/methods , Infection Control , Practice Guidelines as Topic , Telemedicine , Abortifacient Agents/therapeutic use , China , Consensus , Contraceptive Agents , Female , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics , Personal Protective Equipment , Pregnancy , SARS-CoV-2 , Self-Management , Triage
SELECTION OF CITATIONS
SEARCH DETAIL