The novel coronavirus (COVID-19) and unintended pregnancy during the quarantine period

Interruptions in contraception and unintended pregnancy during the COVID-19 pandemic: A protocol for systematic review and meta-analysis

BACKGROUND

The COVID-19 pandemic has impacted access to and use of maternal, newborn, and child health services. Due to lockdowns and travel restrictions implemented during the first wave of the pandemic, the provision of essential maternal health services such as family planning was critically affected. Unlike most healthcare, contraception-related services are impractical for virtual care provision as women need to attend the clinic in person. Therefore, most women across the world might have been left with an unmet need for contraception during the lockdown period. Interruptions in contraception services have led to an increased number of unintended pregnancies. With the emergence of several pocket studies, it is essential to pool the available evidence reporting the effects of COVID-19 on contraception to inform maternal health policy and practice.

OBJECTIVE

The aims of this review are (1) to determine the effects of the COVID-19 pandemic on access to contraceptives among sexually active women and (2) to identify the magnitude of unintended pregnancy linked to interruptions of contraceptives due to the COVID-19 pandemic.

METHODS

The protocol for this systematic review was registered in PROSPERO (CRD42021267077). Electronic databases such as MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, and Google Scholar will be searched for articles using appropriate key terms. The identified articles will be assessed against the eligibility criteria. Two reviewers (A.B. and T.B.) will independently screen titles and abstracts of all retrieved articles followed by a full-text review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The quality of the papers will be assessed by using the Risk of Bias Assessment tool for Non-Randomized Studies. Quantitative findings will be pooled using a random-effects model meta-analysis, while qualitative findings will be presented using a narrative synthesis.

ETHICS AND DISSEMINATION

Ethical approval is not required. The findings will be disseminated through conference presentations and peer-reviewed publications.

DISCUSSION

This systematic review will present current data needed to design evidence-based programmes for improving access to contraception and preventing unintended pregnancy during the COVID-19 pandemic and future emergencies.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42021267077.

Exploring the Challenges of Afghan Refugee Women Facing COVID-19: A Qualitative Study in Iran

Objective

Afghan refugee women in Iran confront many problems in dealing with COVID-19 due to their fragile conditions. Therefore, the aim of this study was to explore the challenges of Afghan refugee women in the face of COVID-19 in Iran with a qualitative approach.

Methods

The present study was conducted with a qualitative approach among Afghan refugee women in Iran. Data were collected through semi-structured face-to-face and telephone interviews and were saturated with 30 women. Both targeted and snowball sampling were used. Data were analyzed using conventional qualitative content analysis and Graneheim and Lundman method. Guba and Lincoln criteria were observed to evaluate the quality of research results.

Results

143 primary codes, 12 subcategories and five main categories were obtained from data analysis. The main categories include little knowledge and information (limited access to information resources, incomplete knowledge about COVID-19), family challenges (intensified experience of violence and conflict in the family, problems related to childbirth and pregnancy), socio-economic challenges (exacerbation of economic problems, high-risk living conditions, social isolation, limited support of social and health organizations), health issues (problems related to treatment, injustice in providing services and facilities) and problems after the death of a COVID-19 patient (burial challenges for immigrants; lack of funeral rites).

Conclusion

Afghan refugee women in Iran are very vulnerable facing COVID-19 due to their fragile conditions. Social and health institutions and organizations need to provide more support to these women so that they can protect their health and that of their families against COVID-19 and the damage caused by it.

Factors associated with access to condoms and sources of condoms during the COVID-19 pandemic in South Africa

BACKGROUND

Evidence has shown that the prescribed lockdown and physical distancing due to the novel coronavirus disease 2019 (COVID-19) have made accessing essential health care services much more difficult in low-and middle-income countries. Access to contraception is an essential service and should not be denied, even in a global crisis, because of its associated health benefits. Therefore, it is important to maintain timely access to contraception without unnecessary barriers. Hence, this study examines the factors contributing to limited access to condoms and sources of condoms during the COVID-19 pandemic in South Africa.

METHODS

This study used the National Income Dynamics Study-Coronavirus Rapid Mobile Survey (NIDS-CRAM) wave 1 survey dataset. The NIDS-CRAM is a nationally representative survey of the National Income Dynamics Survey (NIDS) conducted via telephone interview during COVID-19 in the year 2020. This is the first secondary dataset on COVID-19 conducted by NIDS during pandemic. A total of 5304 respondents were included in the study. Data were analysed using frequencies distribution percentages, chi-square test and multivariable logistic regression analysis.

RESULTS

Almost one-quarter (22.40%) of South Africans could not access condoms, and every 7 in 10 South Africans preferred public source of condoms during the COVID-19 pandemic. Those who were from other population groups [AOR = 0.37; 95% CI = 0.19-0.74] and those who were in the third wealth quintile [AOR = 0.60; 95% CI = 0.38-0.93] had lower odds of having access to condoms while those respondents who were aged 25-34 [AOR = 0.48; 95% CI = 0.27-0.83] and those with a secondary level of education and above [AOR = 0.24; 95% CI = 0.08-0.71] were less likely to prefer public source of condom.

CONCLUSIONS

This study concludes that there was limited access to condoms during the COVID-19 pandemic and that the preferred source of condoms was very skewed to public sources in South Africa. Strategic interventions such as community distribution of free condoms to avert obstruction of condom access during the COVID-19 pandemic or any future pandemics should be adopted.