Impact of the COVID-19 Pandemic on Sexual and Reproductive Health Services in Burkina Faso, Ethiopia, Kenya, Malawi and Uganda

Evidence shows that public health emergencies typically exert tremendous pressure, with severe consequences on SSA’s fragile healthcare system (Tessema et al, 2021). The COVID-19 pandemic has only served to confirm this notion. Governments have focused on overcoming the COVID-19 challenge in the face of several competing needs and priorities in health and other sectors (Mbatha & Tendai, 2020; Hillier, Tom, Rithika & Larsen, 2020). Certain services have been deprioritized, while broad and sometimes non-specific interventions have been implemented, such as travel bans, lockdowns, and curfews among others (Haider et al, 2020). Similarly, SSA governments put forth national guidelines and policies for the continuity of essential health services and information, even though some failed to recognize or prioritize critical SRH services (World Health Organization, 2020; PAI, 2020). Some COVID-19 SRH guidelines proposed innovative interventions to circumvent pandemic barriers even though some of the suggested measures had not been widely tested, particularly in the context of limited resources, and this exacerbated inequality (Barach et al, 2020).

The COVID-19 mitigation measures and disruptions from the pandemic have diminished the availability of, access to, and utilization of SRH services (Mbatha & Tendai, 2020), as well as the quality of available services (Tang et al, 2020). Groups typically excluded from SRH services faced additional barriers during the pandemic (Plan International UK, 2020). Vulnerable individuals who had suboptimal access to health services even before the pandemic now faced the greatest risks of abuse, exclusion, and devastating health outcomes from both the pandemic and the response of governments to the emergency (Mbatha & Tendai, 2020; Tang et al, 2020; Plan International UK, 2020).

So far, large-scale data describing the effects of the pandemic on SRH services are lacking in SSA (Riley, Sully, Ahmed & Biddlecom, 2020). Existing research suggests linkages between public health emergencies and increased risks of sexual and gender-based violence, unintended pregnancies, unsafe abortions (Banke-Thomas & Yaya, 2021), and the exclusion of minority communities – for example, members of the lesbian, gay, bisexual and transgender (LGBT) community and people with disabilities (Ella, 2020). Existing estimates show that modest disruptions of SRH services create a huge unmet need for modern contraceptives, and result in unintended pregnancies, poor health outcomes, and the deaths of newborns, infants, and mothers; they also exacerbate chronic inequalities (Riley et al, 2020). In this report, we describe results from cross-sectional surveys conducted in five SSA countries to examine and document the overall impact of the COVID-19 pandemic on the access, availability, and utilization of SRH services. The findings are useful for informing and guiding response and mitigation strategies for the present and future pandemics in SSA, and for strengthening advocacy to establish resilient health systems.

While substantial variations exist among the five countries in terms of the timing and magnitude of the spread of Covid, at the time of this survey and reporting, all of them had reported large numbers of confirmed cases and Covid-related deaths. The numbers continue to change, and the widespread infections and case fatalities are constantly changing depending on the experience of the different waves of disease.

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