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1.
BMJ Open ; 10(1): e033002, 2020 02 02.
Article in English | MEDLINE | ID: covidwho-1455699

ABSTRACT

INTRODUCTION: Due to a high global incidence of unintended pregnancy, finding novel ways to increase the accessibility of contraceptive products and information is critical. One proposed strategy is to use the accessibility of community pharmacies and expand the role of pharmacists to deliver these services. This protocol reports the methods of a proposed scoping review of pharmacy-based initiatives for preventing unintended pregnancy. We intend to identify the range of interventions employed by pharmacists worldwide and their outcomes and aim to infer the value of task sharing for reducing certain access and equity barriers to contraception. METHODS AND ANALYSIS: This protocol was developed with guidance from the Joanna Briggs Institute Methodology for Scoping Reviews. Reporting is compliant with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocols. The scoping review will be reported according to the PRISMA Extension for Scoping Reviews. Seven electronic databases (PubMed, Ovid Medline, Embase, Cochrane Library, Scopus and Cumulative Index to Nursing and Allied Health Literature) were systematically searched for relevant literature published in English from 2000, on 22 August 2019. Two authors will individually screen articles for eligibility in Covidence and data will be charted and reported using a tool developed for the purpose of this review. ETHICS AND DISSEMINATION: Findings will be disseminated in publications and presentations with relevant stakeholders. Ethical approval is not required as we will be using data from publicly available literature sources. We will map available evidence across the breadth of studies that have been conducted and identify the effectiveness and acceptability of interventions.


Subject(s)
Pharmaceutical Services/organization & administration , Pharmacies/organization & administration , Pharmacists/statistics & numerical data , Pregnancy, Unplanned , Female , Humans , Pregnancy
3.
Contraception ; 103(6): 380-385, 2021 06.
Article in English | MEDLINE | ID: covidwho-1082588

ABSTRACT

OBJECTIVE: To understand how the COVID-19 pandemic affected women of reproductive age, specifically their economic conditions, desire for pregnancy, and access to contraceptive services during the pandemic. STUDY DESIGNS: A total of 554 women respondents age 18 to 49 and reside in the United States were recruited using social media between May 16, 2020 and June 16, 2020. Logistic regression models assessed predictors of reporting pandemic-related changes in economic conditions, desire for pregnancy, and contraceptive access. RESULTS: Compared to White/Caucasian respondents, Hispanics/Latinx and Black/African Americans have 4 times the odds of experiencing inability to afford food, transportation, and/or housing (p < 0.01) during the pandemic; Hispanics/Latinx have twice the odds of experiencing food insecurity (p < 0.05). Inability to afford food, transportation, and/or housing was associated with drop in desire to be pregnant (p < 0.01). Despite the 25% of participants who reported a drop in desire for pregnancy, 1 in 6 reported difficulty accessing contraceptives, particularly those who experienced reduced income (p < 0.01). CONCLUSIONS: In our sample, the pandemic unevenly affected people from different socioeconomic groups. Many simultaneously experienced reduced income, difficulties in accessing contraception, and a greater desire to avoid a pregnancy. This combination of factors increases the chance that people will experience unintended pregnancies. IMPLICATIONS: The pandemic caused economic hardship and an increased desire to postpone or prevent pregnancy at the same time that it created new barriers to contraceptive services. This pattern may lead to a potential net effect of an increase in unintended pregnancy, particularly among people who had difficulty affording food, transportation, and/or housing during the pandemic.


Subject(s)
COVID-19/economics , Family Planning Services/supply & distribution , Health Services Accessibility/statistics & numerical data , Intention , Poverty , Pregnancy, Unplanned , Pregnancy/psychology , Adolescent , Adult , COVID-19/epidemiology , Contraceptive Agents/supply & distribution , Economics , Family Planning Services/economics , Female , Health Services Accessibility/economics , Humans , Logistic Models , Middle Aged , Pandemics , Poverty/economics , Poverty/ethnology , Poverty/psychology , Pregnancy/ethnology , United States/epidemiology , Young Adult
4.
Pan Afr Med J ; 37(Suppl 1): 41, 2020.
Article in English | MEDLINE | ID: covidwho-1069974

ABSTRACT

Adolescent sexual and reproductive health is an essential aspect that may be forgotten in the COVID-19 pandemic. Valuable insights gained from previous humanitarian crises indicate undesirable short and long-term adolescent maternal consequences in low resource settings. Young girls are at a higher risk of dropping out of school and being forced into early child marriages and high-risk jobs that predispose them to sexual exploitation and sexual and gender-based violence. Economic recessions, supply chain disruptions and reallocation of resources may limit access and utilisation of services and commodities. The COVID-19 pandemic thus indirectly exposes adolescent girls to multiplied risks of unintended pregnancies, sexually transmitted infections including HIV and Human Papilloma Virus. Sexual and gender-based violence, including female genital mutilation cases may increase as intervention programmes to avert these are disrupted, and the resultant psychosocial and socioeconomic consequences may be devastating. Thus, a pro-active approach is required to come up with frameworks to ensure the minimum initial service package for reproductive health. A multi-sectoral collaborative intersection of relevant stakeholders in adolescent sexual and reproductive health is therefore urgently desired.


Subject(s)
COVID-19 , Reproductive Health Services/organization & administration , Reproductive Health , Sexual Health , Adolescent , Cooperative Behavior , Developing Countries , Female , Humans , Pregnancy , Pregnancy in Adolescence/prevention & control , Pregnancy, Unplanned , Sexual Behavior , Sexually Transmitted Diseases/prevention & control
5.
Afr J Reprod Health ; 24(s1): 56-63, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-903315

ABSTRACT

South Africa, similar to many other countries in the African continent is still experiencing challenges in its efforts to provide sexual and reproductive health (SRH) care to women and adolescent girls, and it has become clear that the COVID-19 pandemic is the latest threat to universal access to SRH. In the face of this threat, the Sustainable Developmental Goals that call on the global community to -leave no one behind‖ may become a blurred vision unless we adopt a wider lens away from the tunnel vision that currently plagues health systems around the globe. This paper therefore exposes how SRH may become collateral damage in the face of the present COVID-19 pandemic. Previous disease outbreaks diverted attention from critical SRH services, including antenatal care, safe abortions, contraception, HIV/AIDS and sexually transmitted infections. Governments, policy makers, health system gatekeepers and civil society organisations should not allow the COVID-19 phobia to bar women and adolescent girls from accessing SRH services. In fact, the global and South African response to the COVID-19 pandemic must protect everyone's rights, particularly in the health care context. Gender considerations and a human rights approach must be embedded in ensuring the accessibility and availability of SRH services.


Subject(s)
COVID-19/epidemiology , Health Services Accessibility/organization & administration , Reproductive Health Services/organization & administration , Sexual Health , Abortion, Induced/standards , Contraception/methods , Female , Human Rights , Humans , Maternal Mortality/trends , Pregnancy , Pregnancy, Unplanned , Prenatal Care/organization & administration , SARS-CoV-2 , South Africa/epidemiology
6.
Afr J Reprod Health ; 24(s1): 49-55, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-903314

ABSTRACT

The outbreak of COVID-19 threatens continued access to non-urgent healthcare including sexual and reproductive health (SRH) services. With the epicentre of the outbreak projected to shift to sub-Saharan Africa (SSA) after making significant impact in China, Europe, USA, and South America, it is necessary for countries in this region to begin to plan for how to tackle a rapid surge in cases. Health facilities are already being primed for increased presentation of COVID-19 cases. As countries prepare, they also need to consider how non-urgent services will not be interrupted. Estimates of a potential disruption in access to long and short acting contraceptives for up to 12 months will result in an additional 15 million unintended pregnancies and additional 28,000 maternal deaths. Thus, effort must be made to ensure that the gains made in SRH outcomes over several years are not lost. The potential of utilizing telemedicine to continue to offer healthcare services to the population for non-urgent care needs to be considered. It will not only provide for continued access to important services that can be delivered remotely but will reduce the risks of COVID-19 infection for both the client and the health workers.


Subject(s)
COVID-19/epidemiology , Reproductive Health Services/organization & administration , Sexual Health , Telemedicine/organization & administration , Africa South of the Sahara/epidemiology , Contraception/methods , Female , Health Services Accessibility , Humans , Maternal Mortality/trends , Pregnancy , Pregnancy, Unplanned , SARS-CoV-2
7.
Eur J Contracept Reprod Health Care ; 25(6): 445-448, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-843340

ABSTRACT

OBJECTIVES: The aims of the study were to investigate the effects of social distancing during the COVID-19 pandemic on the use of hormonal contraceptives, their discontinuation and the risk of unplanned pregnancy. METHODS: The study enrolled 317 women listed in the database of the Department of General Surgery and Medical-Surgical Specialties, University of Catania, Italy, family planning clinic who were known to be using hormonal contraceptives. The women were contacted by telephone and asked whether they would like to participate in the study. If they agreed, they were then emailed a questionnaire about their social behaviour and sexual activity during the pandemic, according to their cohabiting status, i.e., whether they were continuing to use their hormonal contraception and whether they had had an unplanned pregnancy. RESULTS: The questionnaire was completed by 175 (81.8%) women who were using short-acting reversible contraception (SARC) and by 90 (87.4%) women who were using long-acting reversible contraception (LARC). All married and cohabiting women were continuing to use their contraceptive method. None had had an unplanned pregnancy. On the other hand, 51 (50.5%) non-cohabiting or single women had discontinued their SARC method while social distancing, for non-method-related reasons; however, 47 (46.5%) non-cohabiting or single women had continued their sexual activity, infringing social distancing rules, and 14.9% had had an unplanned pregnancy, for which they had sought a termination. CONCLUSION: Several non-cohabiting women using SARC had discontinued their contraceptive method during the pandemic but had continued to engage in sexual activity and had had an unplanned pregnancy. Clinicians should counsel women about what they should do in regard to contraception in the event of new, future social distancing measures.


Subject(s)
Contraception Behavior , Contraceptive Agents, Hormonal/therapeutic use , Coronavirus Infections , Medication Adherence/statistics & numerical data , Pandemics , Pneumonia, Viral , Sexual Behavior , Social Isolation/psychology , Adult , Betacoronavirus , COVID-19 , Communicable Disease Control/methods , Contraception Behavior/psychology , Contraception Behavior/trends , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Female , Humans , Italy/epidemiology , Needs Assessment , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Pregnancy , Pregnancy, Unplanned , Reproductive Health/statistics & numerical data , SARS-CoV-2
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