Impact of COVID-19 Lockdowns on Rates of Adolescent Pregnancies: A Systematic Review (preprint)

Background: Education is known to protect adolescent girls from unplanned pregnancy. School closures were component of COVID-19 “lockdown measures”. The impact of these measures on adolescent pregnancy worldwideis unknown.  Methods: We performed a systematic review to find evidence of the impact of “lockdowns” and school closures on adolescent pregnancy events during the COVID-19 pandemic. Databases including Pubmed, EMBASE, CINAHL, WHO Index Medicus, and Literatura Latinoamericana y Caribe en Ciencias de la Salud (LILACS) were searched. Studies that provided data on pregnancy rates in girls aged 10-19 before, during, and after the onset of the COVID-19 pandemic (defined as March 2020) were eligible for inclusion. Extracted data included study design, study location, age of participants, exposure period, and percentage or pregnancy rate data. Findings: On August 21st, 2023, 3049 studies were screened, with 79 eligible for full-text review. Ten studies were included in the final review: Seven performed in Africa (Uganda, Kenya, South Africa, and Ethiopia), and three in the Americas (USA and Brazil). Adolescent pregnancy increased in six out of the seven African studies while a decrease or no change was noted in USA and Brazil.All studies were at a high risk of bias. Interpretation:   Adolescent pregnancy rates during the COVID-19 pandemic may have substantially increased in sub-Saharan Africa. Data scarcity and low-quality evidence are significant limitations. The dynamic relationship between lockdown measures and adolescent pregnancies warrants ongoing multifaceted research and adaptive policies to safeguard adolescent sexual and reproductive health during health crisis. Systematic Review Registration: PROSPERO registration number CRD42022308354.

Online Education for Undergraduate Health Professional Education during the COVID-19 Pandemic: Attitudes, Barriers, and Ethical Issues (preprint)

Background: The online teaching demand has increased tremendously to promote the implementation of online teaching-leaning system to meet the need of students during the outbreaks of emerging infectious disease. This study aims to explore whether the pandemic of COVID-19, which requires universities to rapidly offer online learning, will affect attitudes about online education for undergraduate health sciences students. Also, it investigates the barriers for using online tools. Method: A cross-sectional survey using online social media was used to recruit eligible participants. The data for this study were focused on students’ experiences utilizing an online education method offered by the Jordanian government universities. This study is utilizing newly developed measuring tools that are expected to enable students to evaluate online teaching in terms of their own learning progress. Results: A total of 1,210 participants agreed to complete the online survey questionnaire. The mean score preparedness and attitude toward online education was average. The majority of students agreed that online courses helped assign reading and homework time better than on-campus approach (75.0%) and felt comfortable to actively communicate with my classmates and instructors online. Zoom and eLearning were the most common online platforms utilized by students. The geographic locations, lack of past experience on using online tools, and lack of past experience on using online tools were identified by students as the main barrier to online educations. Conclusions: Although the pandemic of COVID-19 appeared as uncommon catalyst for promoting eLearning, further research is needed to assess whether learners are ready and willing to make greater use of online education to obtain high quality teaching and learning opportunities, which could totally change educators’ and students’ attitudes and impression, and subsequently the general themes of online education.