1
|
Adelekan B, Ikuteyijo L, Goldson E, Abubakar Z, Adepoju O, Oyedun O, Adebayo G, Dasogot A, Mueller U, Fatusi AO. When one door closes: a qualitative exploration of women's experiences of access to sexual and reproductive health services during the COVID-19 lockdown in Nigeria. BMC Public Health 2024; 24:1124. [PMID: 38654297 DOI: 10.1186/s12889-023-15848-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 05/08/2023] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND COVID-19 pandemic widely disrupted health services provision, especially during the lockdown period, with females disproportionately affected. Very little is known about alternative healthcare sources used by women when access to conventional health services became challenging. This study examined the experiences of women and adolescent girls regarding access to sexual and reproductive health (SRH) services during the COVID-19 lockdown in Nigeria and their choices of alternative healthcare sources. METHODS The study sites were two northern states, two southern states, and the Federal Capital Territory. Qualitative data were obtained through 10 focus group discussion sessions held with married adolescents, unmarried adolescents, and older women of reproductive age. The data were transcribed verbatim and analysed using a thematic approach and with the aid of Atlas ti software. RESULTS Women reported that access to family planning services was the most affected SRH services during the COVID-19 lockdown. Several barriers to accessing SRH services during COVID-19 lockdown were reported, including restriction of vehicular movement, harassment by law enforcement officers, fear of contracting COVID-19 from health facilities, and fear of undergoing compulsory COVID-19 tests when seeking care in health facilities. In the face of constrained access to SRH services in public sector facilities during the COVID-19 lockdown, women sought care from several alternative sources, mostly locally available and informal services, including medicine vendors, traditional birth attendants, and neighbours with some health experience. Women also widely engaged in self-medication, using both orthodox drugs and non-orthodox preparations like herbs. The lockdown negatively impacted on women's SRH, with increased incidence of sexual- and gender-based violence, unplanned pregnancy resulting from lack of access to contraceptives, and early marriage involving adolescents with unplanned pregnancies. CONCLUSION COVID-19 negatively impacted access to SRH services and forced women to utilise mostly informal service outlets and home remedies as alternatives to conventional health services. There is a need to ensure the continuity of essential SRH services during future lockdowns occasioned by disease outbreaks. Also, community systems strengthening that ensures effective community-based health services, empowered community resource persons, and health-literate populations are imperative for overcoming barriers to healthcare access during future lockdowns.
Collapse
Affiliation(s)
| | - Lanre Ikuteyijo
- Department of Sociology and Anthropology, Faculty of Social Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Erika Goldson
- United Nations Population Fund (UNFPA) Country Office, Abuja, Nigeria
| | - Zubaida Abubakar
- United Nations Population Fund (UNFPA) Country Office, Abuja, Nigeria
| | | | - Olaitan Oyedun
- Academy for Health Development (AHEAD), Ile-Ife, Nigeria
| | | | - Andat Dasogot
- United Nations Population Fund (UNFPA) Country Office, Abuja, Nigeria
| | - Ulla Mueller
- United Nations Population Fund (UNFPA) Country Office, Abuja, Nigeria
| | - Adesegun O Fatusi
- Academy for Health Development (AHEAD), Ile-Ife, Nigeria.
- Centre for Adolescent Health and Development, School of Public Health, University of Medical Sciences, Ondo, Nigeria.
- Department of Community Health, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
| |
Collapse
|
2
|
Meherali S, Bhaumik S, Idrees S, Kennedy M, Lassi ZS. Digital Knowledge Translation Tools for Disseminating Sexual and Reproductive Health Information to Adolescents: Protocol for an Evidence Gap Map Review. JMIR Res Protoc 2024; 13:e55081. [PMID: 38349722 PMCID: PMC10900081 DOI: 10.2196/55081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Digital or eHealth knowledge translation (KT) interventions have been identified as useful public health tools, particularly to advance sexual and reproductive health (SRH) among adolescents. Existing literature reviews on digital health interventions for adolescents' SRH demonstrate limitations, including shortcomings in reporting and comprehensiveness that limit the utility and trustworthiness of findings. However, there is a lack of evidence synthesis on the effectiveness of available digital or mobile health KT tools to promote SRH interventions for adolescents. OBJECTIVE We aim to identify, map, and describe existing empirical evidence on the digital KT tools developed to improve adolescent SRH outcomes globally. METHODS This study will be conducted using an evidence gap map (EGM) approach to address the objectives, including reviewing relevant literature and a landscape analysis of the outcomes of interest. The following electronic databases will be searched for retrieval of literature: MEDLINE (1946-present), Embase (1974-present), and Global Health (1910-present) via OVID; CINAHL (1936-present) via EBSCOhost; Scopus (1976-present); and Cochrane Library (1993-present) via Wiley. We will include only those studies that focused on adolescents aged 10-19 years and addressed SRH outcomes. We will include experimental studies (randomized or cluster randomized and nonrandomized controlled trials, including quasi-randomized, controlled before-after, and interruptive time series) and observational studies, that is, including prospective cohort and case-control studies. The experimental and observational studies will only be included in the presence of control or comparison arms. Studies with a historical control arm will be excluded. The systematic review software, Covidence (Ventas Health Innovation), will be used to screen and select the studies. Further, 2 independent reviewers will complete the first and second levels of screening of studies and any conflicts arising will be resolved by consensus between the 2 reviewers or by involving the third reviewer. We will conduct the quality assessment of all included studies using the Risk of Bias tool for randomized controlled trials and nonrandomized controlled trials, and AMSTAR2 for systematic reviews. RESULTS Papers screening, data extraction, and synthesis will be completed by March 2024. We will use EPPI-Mapper (The International Public Policy Observatory) software to generate an online evidence map and to produce the tables and figures for the descriptive report. This EGM review will identify areas with high-quality, evidence-based digital KT tools (for immediate scale and spread) and areas where few or no KT tools exist (for targeted KT tool development and research or policy prioritization). CONCLUSIONS This protocol focused on mapping eHealth KT tools that have been used in the literature to address SRH among adolescents. This will be the first EGM exercise to map digital KT tools to promote adolescents' SRH and will incorporate a range of published sources. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55081.
Collapse
Affiliation(s)
- Salima Meherali
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Soumyadeep Bhaumik
- Meta-research and Evidence Synthesis Unit, Health Systems Science, George Institute for Global Health, Sydney, Australia
| | - Sobia Idrees
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Megan Kennedy
- Health Science Library, University of Alberta, Edmonton, AB, Canada
| | - Zohra S Lassi
- Robinson Research Institute, Helen Mayo North, Adelaide, Australia
| |
Collapse
|
3
|
Karp C, Williams K, Wood SN, OlaOlorun FM, Akilimali P, Guiella G, Gichangi P, Mosso R, Makumbi F, Anglewicz PA, Moreau C. Family planning service disruptions in the first two years of the COVID-19 pandemic: Evidence from health facilities in seven low- and middle-income countries. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002435. [PMID: 38180911 PMCID: PMC10769091 DOI: 10.1371/journal.pgph.0002435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/16/2023] [Indexed: 01/07/2024]
Abstract
Many speculated that COVID-19 would severely restrict the delivery of essential health services, including family planning (FP), but evidence of this impact is limited, partly due to data limitations. We use cross-sectional data collected from regional and national samples of health facilities (n = 2,610) offering FP across seven low- and middle-income countries (LMICs) between 2019 and 2021, with longitudinal data from four geographies, to examine reported disruptions to the FP service environment during COVID-19, assess how these disruptions varied according to health system characteristics, and evaluate how disruptions evolved throughout the first two years of the pandemic, relative to a pre-pandemic period. Findings show significant variation in the impact of COVID-19 on facility-based FP services across LMICs, with the largest disruptions to services occurring in Rajasthan, India, where COVID-19 cases were highest among geographies sampled, while in most sub-Saharan African settings there were limited disruptions impacting FP service availability, method provision, and contraceptive supplies. Facility-reported disruptions to care were not reflected in observed changes to the number of FP clients or types of stockouts experienced in the first two years of the pandemic. Public and higher-level facilities were generally less likely to experience COVID-19-related disruptions to FP services, suggesting policy mitigation measures-particularly those implemented among government-operated health facilities-may have been critical to ensuring sustained delivery of reproductive healthcare during the pandemic.
Collapse
Affiliation(s)
- Celia Karp
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Kelsey Williams
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Shannon N. Wood
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Funmilola M. OlaOlorun
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Pierre Akilimali
- Patrick Kayembe Research Center, Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Georges Guiella
- Institut Supérieur des Sciences de la Population (ISSP/University Joseph Ki-Zerbo), Ouagadougou, Burkina Faso
| | - Peter Gichangi
- International Centre for Reproductive Health-Kenya, Nairobi, Kenya
- Department of Primary Care, Technical University of Mombasa, Ghent University, Ghent, Belgium
| | - Rosine Mosso
- École Nationale Supérieure de Statistique et d’Economie Appliquee (ENSEA) of Abidjan, Abidjan, Côte d’Ivoire
| | | | - Philip A. Anglewicz
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Caroline Moreau
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Soins et Santé Primaire, CESP Centre for Research in Epidemiology and Population Health U1018, Inserm, Villejuif, France
| |
Collapse
|
4
|
Gharacheh M, Khalili N, Ebrahimi Kalan M, Heidarzadeh M, Ranjbar F. Pregnancy-Related Complications During the COVID-19 Pandemic in Iran. ARCHIVES OF IRANIAN MEDICINE 2024; 27:30-35. [PMID: 38431958 PMCID: PMC10915933 DOI: 10.34172/aim.2024.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 10/24/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND The COVID-19 pandemic has profoundly affected healthcare systems worldwide, with significant collateral damage to vulnerable populations, including the perinatal population. This study sought to compare pregnancy-related complications before and during the COVID-19 pandemic in Iran. METHODS This retrospective data analysis was performed from February 20 to August 20, 2019 (prior to the onset of the COVID-19 pandemic) and from February 20 to August 20, 2020 (during the pandemic), encompassing the initial wave of the pandemic and the subsequent lockdown. To collect data, we utilized the medical records of 168,358 women obtained from the Iranian Maternal and Neonatal Network, which is a comprehensive electronic health record database management system specifically designed to store information pertaining to maternal and neonatal health. RESULTS A total of 168,358 medical records were analyzed, with 87388 (51.9%) and 80970 (48.1%) before and during the pandemic, respectively. The occurrence of pregnancy complications was found to be significantly more frequent during the pandemic compared to the pre-pandemic period. Notably, there was a higher likelihood of experiencing preeclampsia (odds ratio [OR]=1.14, 95% confidence interval [CI]: 1.07‒1.22, P=0.0001) and gestational diabetes (OR=1.14, 95% CI: 1.09‒1.19, P=0.0001) during the pandemic. Furthermore, cesarean section (CS) became more prevalent during the pandemic in comparison to vaginal delivery (OR=1.19, 95% CI: 1.17‒-1.22, P=0.0001). CONCLUSION Our findings demonstrated a significant association between the COVID-19 pandemic and an escalation in adverse pregnancy outcomes, notably preeclampsia, gestational diabetes, and CS deliveries. However, further research is warranted to gain a richer understanding of the intricate interplay between the COVID-19 pandemic and pregnancy complications. This is particularly crucial in light of the evolving landscape of new coronavirus variants.
Collapse
Affiliation(s)
- Maryam Gharacheh
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Narjes Khalili
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Heidarzadeh
- Department of Pediatrics, School of Medicine, Children Medical Research and Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fahimeh Ranjbar
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Dogan NN, Salihoglu O. How Did the COVID-19 Pandemic Affect Maternal and Neonatal Health? Am J Perinatol 2023. [PMID: 38101441 DOI: 10.1055/s-0043-1777717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of the coronavirus disease 2019 (COVID-19) pandemic on the proportional growth of the fetus, maternal health, and neonatal outcomes. STUDY DESIGN The study group (Group 1) included pregnant women with a history of COVID-19. Pregnant women who were hospitalized during the same period without COVID-19 were the control group (Group 2). Maternal and neonatal outcomes were compared between the groups. RESULTS A total of 230 pregnant women and their infants were assessed. Group 1 (n = 74) had significantly higher rates of diabetes mellitus and hypertension than Group 2 (n = 156; p = 0.015 and 0.014, respectively). Premature birth and cesarean section rates were also significantly higher in Group 1 than in Group 2 (p = 0.001 and 0.040, respectively). While the rate of iatrogenic preterm birth was significantly higher in Group 1, the rate of spontaneous preterm birth was significantly higher in Group 2 (p = 0.049). Infants born to COVID-19-positive mothers had lower median gestational age, birth weight, and Apgar scores (p < 0.01). There was no significant difference between the groups in terms of the results of cord blood gas analysis (p > 0.05). The rate of admission to the neonatal intensive care unit (NICU) and need for mechanical ventilation was significantly higher in infants of COVID-19-positive mothers (p < 0.05 for both). The length of stay in the NICU was also significantly longer for the infants of COVID-19-positive mothers (p < 0.05). Birth weights decreased due to increased cases of iatrogenic preterm births (p < 0.05). However, ponderal indices (PIs) of newborns of pregnant COVID-19 mothers did not differ at birth (p > 0.05). CONCLUSION COVID-19 is associated with low Apgar scores, increased risk of premature birth complications, and maternal comorbidities, with no effect on the PI and proportionate growth of the infant at birth. KEY POINTS · No difference in ponderal indices.. · No difference in postnatal cardiovascular adaptation.. · COVID-19 is frequent in pregnant women with comorbidities like diabetes mellitus and hypertension..
Collapse
Affiliation(s)
- Nazan N Dogan
- Division of Neonatology, Department of Pediatrics, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training Research Center, Istanbul, Turkey
| | - Ozgul Salihoglu
- Division of Neonatology, Department of Pediatrics, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training Research Center, Istanbul, Turkey
| |
Collapse
|
6
|
Bhuptani PH, Hunter J, Goodwin C, Millman C, Orchowski LM. Characterizing Intimate Partner Violence in the United States During the COVID-19 Pandemic: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:3220-3235. [PMID: 36321779 DOI: 10.1177/15248380221126187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Intimate partner violence (IPV) is a significant global health concern. Numerous research studies document increases in IPV since the onset of the COVID-19 pandemic in March 2020. Despite this widespread recognition, research around the nature of this violence is still growing. This systematic review summarizes the existing literature documenting the prevalence and characteristics of IPV during the COVID-19 pandemic. Inclusion criteria are as follows: reported original data empirical study, assessed for IPV among adult population in the United States, and was published in English between December 2019 and March 2022. A total of 53 articles were then independently reviewed and sorted into four thematic subcategories: victimization, perpetration, articles addressing victimization and perpetration, and provider perspectives. Studies document consistent increases in the prevalence of IPV victimization and perpetration. Providers within agencies providing support to individuals impacted by IPV also documented increased strain on the agencies.
Collapse
Affiliation(s)
- Prachi H Bhuptani
- Rhode Island Hospital, Providence, USA
- Brown University, Providence, RI, USA
| | | | | | | | | |
Collapse
|
7
|
Krishna E, Karthikeyan V, Ahmad S, Ranjan A, Hasan Km A, Pandey S, Kumar P, Singh CM. Acceptance of Annual Booster Doses of COVID-19 Vaccines Among Indian Healthcare Professionals: A Pan-India Cross-Sectional Survey. Cureus 2023; 15:e49363. [PMID: 38146559 PMCID: PMC10749219 DOI: 10.7759/cureus.49363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2023] [Indexed: 12/27/2023] Open
Abstract
Introduction The emergence of coronavirus disease 2019 (COVID-19) posed significant challenges to global health, leading to the declaration of a pandemic by the World Health Organization. Vaccination efforts have effectively reduced severe outcomes and mortality, but breakthrough infections and new variants are of concern. In response, annual booster doses of COVID-19 vaccines are being considered to maintain immunity. Healthcare professionals, as frontline workers, play a pivotal role in vaccination campaigns. This study explores their attitudes toward and willingness to accept annual COVID-19 booster doses in India. Methods A pan-India cross-sectional survey was conducted among healthcare professionals, including faculty, resident doctors, interns, and nursing staff, across Indian medical and nursing colleges. Convenience sampling was used to collect responses via an online questionnaire. The questionnaire assessed demographics, vaccine status, attitudes toward COVID-19 vaccination, and willingness to accept annual booster doses. Multivariate analysis was performed to identify predictors of booster dose acceptance. Results A total of 535 participants responded from 28 states and 8 union territories of India. Most were 34.2 years (± 11.1 SD), and 372 (69.5%) had taken Covishield (Serum Institute of India, Pune, India) as their primary vaccine. While 525 (98.1%) had taken the first dose and 518 (96.8%) of them had taken the second dose, only 333 (62.2%) had received a booster. Around 318 (60%) of healthcare professionals were willing to accept an annual booster dose. The mean attitude score toward annual booster doses was 75.4 (range: 28-111). Healthcare professionals' trust in government recommendations and medical experts significantly influenced their willingness to accept annual booster doses. Conclusion This study provides insights into the attitudes of healthcare professionals in India toward annual COVID-19 booster doses. At the same time, a significant proportion showed a willingness to accept boosters.
Collapse
Affiliation(s)
- Ekta Krishna
- Community and Family Medicine, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Venkatesh Karthikeyan
- Community and Family Medicine, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Shamshad Ahmad
- Community and Family Medicine, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Alok Ranjan
- Community and Family Medicine, All India Institute of Medical Sciences, Patna, Patna, IND
| | | | - Sanjay Pandey
- Community and Family Medicine, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Pragya Kumar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Patna, IND
| | - C M Singh
- Community and Family Medicine, All India Institute of Medical Sciences, Patna, Patna, IND
| |
Collapse
|
8
|
Tian T, Fu L, Lu Z, Wu X, Luo G, Wang B, Zhou X, Lin YF, Zhang Z, Liu L, Xi M, Zhen C, Dai J, Zou H. Changes in human papillomavirus prevalence, incidence, and clearance among men who have sex with men in Xinjiang, China after implementation of nonpharmaceutical interventions to control COVID-19: An interrupted time series analysis. Int J Infect Dis 2023; 134:261-268. [PMID: 37453487 DOI: 10.1016/j.ijid.2023.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/05/2023] [Accepted: 07/08/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVES This study aimed to assess the effects of COVID-19 nonpharmaceutical interventions (NPIs) on the human papillomavirus (HPV) epidemic among men who have sex with men (MSM) in Xinjiang, China. METHODS In our cohort study, we enrolled and followed HIV-negative MSM in Xinjiang, China, between 2016 and 2022. Anal swab samples were collected to test for HPV DNA. We used interrupted time series analysis to characterize the temporal trends in HPV prevalence, incidence, and clearance before (September 01, 2016, to July 16, 2020) and during the implementation of COVID-19 NPIs in Xinjiang (July 17, 2020, to March 31, 2022). We used binomial segmented regression models to estimate the impact of COVID-19 NPIs on HPV prevalence, incidence, and clearance. RESULTS We recruited 1296 MSM who contributed to a total of 5374 HPV tests in our study. COVID-19 NPIs were associated with a 37.9% decrease in the prevalence (prevalence ratio, 0.621; 95% confidence interval, 0.465-0.830), 52.2% decrease in the incidence (risk ratio, 0.478; 0.377-0.606), and 40.4% increase in the clearance (risk ratio, 1.404; 1.212-1.627) of HPV of any genotype after the implementation of COVID-19 NPIs in Xinjiang. CONCLUSION COVID-19 NPIs may lead to lower transmission and higher clearance of HPV among MSM. Future studies are needed to clarify the longer-term impact of COVID-19 on the transmission and natural history of HPV among MSM.
Collapse
Affiliation(s)
- Tian Tian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Zhen Lu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xinsheng Wu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Ganfeng Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xinyi Zhou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yi-Fan Lin
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Zewen Zhang
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Lirong Liu
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Miaomiao Xi
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Chen Zhen
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Jianghong Dai
- School of Public Health, Xinjiang Medical University, Urumqi, China.
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, China; School of Public Health, Southwest Medical University, Luzhou, China; Kirby Institute, University of New South Wales, Sydney, Australia.
| |
Collapse
|
9
|
Adelekan B, Goldson E, Ntoimo LFC, Adonri O, Aliyu Y, Onoja M, Araoyinbo I, Anakhuekha E, Mueller U, Ekwere EO, Inedu M, Moruf O, Swomen G, Igboin B, Okonofua FE. Clients' perspectives on the utilization of reproductive, maternal, neonatal, and child health services in primary health centers during COVID-19 pandemic in 10 States of Nigeria: A cross-sectional study. PLoS One 2023; 18:e0288714. [PMID: 37471429 PMCID: PMC10359015 DOI: 10.1371/journal.pone.0288714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/04/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Reports from various parts of the world suggest that the COVID-19 pandemic may have severe adverse effects on the delivery and uptake of reproductive health, maternal, neonatal, and child health (RMNCH) services. The objective of the study was to explore women's experiences with utilization of RMNCH services during the COVID-19 pandemic in Nigeria, and to elicit their perceptions on ways to sustain effective service delivery during the pandemic. METHODS A cross-sectional survey of 2930 women using primary health care facilities for antenatal, delivery, postnatal, and child care services before and after the onset of the pandemic in 10 States of Nigeria were interviewed with a semi-structured questionnaire. Data were collected on women's socio-demographic characteristics and pregnancy histories, the services they sought before and after the pandemic, the challenges they faced in accessing the services, their use of alternative sources of health care, and their recommendations on ways to sustain RMNCH service delivery during the pandemic. The data were analyzed with descriptive statistics, and multivariable logistic regression using SPSS 20.0. All the statistical analyses were two-tailed with a 95% confidence interval, and the p-value was set at 0.05. RESULTS The logistic regression results showed that women were at least 56% more likely to report that they used family planning, antenatal, and delivery services before the pandemic than after the pandemic started, but 38% less likely to report use of postnatal services. The experience of difficulty accessing RMNCH services was 23% more likely after the pandemic started than before the pandemic. Three categories of recommendations made by the respondents on measures to sustain RMNCH delivery during the pandemic included 1) facility improvement, and staff recruitment and re-training; 2) free and readily accessible PHC services, and 3) the provision of social safety nets including transportation and palliatives. CONCLUSION We conclude that the COVID-19 pandemic limited women's access to antenatal, delivery, and childcare services offered in PHCs in Nigeria. Addressing the recommendations and the concerns raised by women will help to sustain the delivery of RMNCH services during the COVID-19 pandemic and future epidemics or health emergencies in Nigeria.
Collapse
Affiliation(s)
| | | | - Lorretta Favour C. Ntoimo
- Department of Demography and Social Statistics, Federal University Oye-Ekiti, Oye-Ekiti, Nigeria
- Women’s Health and Action Research Centre, Benin City, Nigeria
| | | | | | | | | | | | | | | | | | - Olayinka Moruf
- Planned Parenthood Federation of Nigeria, Abuja, Nigeria
| | - George Swomen
- Planned Parenthood Federation of Nigeria, Abuja, Nigeria
| | - Brian Igboin
- Women’s Health and Action Research Centre, Benin City, Nigeria
| | - Friday E. Okonofua
- Women’s Health and Action Research Centre, Benin City, Nigeria
- Centre of Excellence in Reproductive Health Innovation (CERHI), University of Benin, Benin City, Nigeria
- Department of Obstetrics and Gynecology, University of Benin, Benin City, Nigeria
| |
Collapse
|
10
|
Navarrete J, Hughes CA, Yuksel N, Schindel TJ, Yamamura S, Terajima T, Sriboonruang T, Patikorn C, Anantachoti P. Community Pharmacists' Experiences and Attitudes towards the Provision of Sexual and Reproductive Health Services: An International Survey. Healthcare (Basel) 2023; 11:healthcare11111530. [PMID: 37297670 DOI: 10.3390/healthcare11111530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Access to comprehensive sexual and reproductive health (SRH) services remains a challenge worldwide. Describing community pharmacists' SRH services in countries with different scopes of practice will aid in understanding how pharmacists view their roles and how to support them in providing needed services. A cross-sectional web-based survey was administered to pharmacists working in community pharmacies in Japan, Thailand, and Canada. The survey covered 7 SRH categories: pregnancy tests, ovulation tests, contraception, emergency contraception, sexually transmitted and blood-borne infections, maternal and perinatal health, and general sexual health. Descriptive statistics were used to analyze the data. A total of 922 eligible responses were included in the analysis (Japan = 534, Thailand = 85, and Canada = 303). Most Thai and Canadian participants reported dispensing hormonal contraceptives (Thailand = 99%, Canada = 98%) and emergency contraceptive pills (Thailand = 98%, Canada = 97%). Most Japanese participants provided patient education on barrier contraceptives for men (56%) and information on the safety of medications in pregnancy (74%) and breastfeeding (76%). The majority of participants expressed interest in additional training and expanding their roles in SRH. Sharing international experiences can guide challenges faced by the evolution of pharmacists' practice in SRH. Providing pharmacists support could help their readiness for this role.
Collapse
Affiliation(s)
- Javiera Navarrete
- Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, University of Alberta, Edmonton, AB T6G 2H1, Canada
| | - Christine A Hughes
- Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, University of Alberta, Edmonton, AB T6G 2H1, Canada
| | - Nese Yuksel
- Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, University of Alberta, Edmonton, AB T6G 2H1, Canada
| | - Theresa J Schindel
- Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, University of Alberta, Edmonton, AB T6G 2H1, Canada
| | - Shigeo Yamamura
- Faculty of Pharmaceutical Sciences, Josai International University, Chiba 283-8555, Japan
| | - Tomoko Terajima
- Faculty of Pharmaceutical Sciences, Shonan University of Medical Sciences, Kanagawa 244-0806, Japan
| | - Tatta Sriboonruang
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand
| | - Chanthawat Patikorn
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand
| | - Puree Anantachoti
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand
| |
Collapse
|
11
|
Berdychevsky L, Cavanaugh D, Dariotis JK. Psychological, Socio-Demographic, and Logistical Factors Associated With Changes in Sex Life After Over a Year Into the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:263-283. [PMID: 38601008 PMCID: PMC10903566 DOI: 10.1080/19317611.2023.2193568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/31/2022] [Accepted: 11/24/2022] [Indexed: 04/12/2024]
Abstract
This study examined changes in sex life about a year into the COVID-19 pandemic for both partnered and non-partnered individuals and identified the determinants of these changes. The results of an online survey (N = 675) reflect a significant decrease in the frequency of intimate and sexual behaviors and declines in sexual desire, quality, intimacy, diversity, and satisfaction. This study also showed that socio-demographic characteristics, psychological factors, and the logistical impacts of the pandemic explain trends in people's sex lives during the pandemic. This study contributes to understanding the long(er)-term nature, scope, and determinants of changes in sex life during the pandemic.
Collapse
Affiliation(s)
- Liza Berdychevsky
- Department of Recreation, Sport and Tourism; The Family Resiliency Center; Center for Social and Behavioral Science; Center on Health, Aging, and Disability; Health Care Engineering Systems Center; Discovery Partners Institute, The University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Damien Cavanaugh
- Department of Recreation, Sport and Tourism, The University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Jacinda K. Dariotis
- Department of Human Development and Family Studies, The Family Resiliency Center, The Beckman Institute, The University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| |
Collapse
|
12
|
Meherali S, Munro S, Puinean G, Salami B, Wong JPH, Vandermorris A, Benoit JRA, Flicker S, Okeke-Ihejirika P, Stroulia E, Norman WV, Scott SD. Co-designing a Sexual Health App With Immigrant Adolescents: Protocol for a Qualitative Community-Based Participatory Action Research Study. JMIR Res Protoc 2023; 12:e45389. [PMID: 36947124 PMCID: PMC10131995 DOI: 10.2196/45389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Canada is one of the world's most ethnically diverse countries, with over 7 million individuals out of a population of 38 million being born in a foreign country. Immigrant adolescents (aged 10 to 19 years) make up a substantial proportion of newcomers to Canada. Religious and cultural practices can influence adolescents' sexual attitudes and behaviors, as well as the uptake of sexual and reproductive health (SRH) services among this population. Adolescence is a time to establish lifelong healthy behaviors. Research indicates an alarming gap in adolescents' SRH knowledge, yet there is limited research on the SRH needs of immigrant adolescents in Canada. OBJECTIVE The purpose of this study is to actively engage with immigrant adolescents to develop, implement, and evaluate a mobile health (mHealth) intervention (ie, mobile app). The interactive mobile app will aim to deliver accurate and evidence-based SRH information to adolescents. METHODS We will use community-based participatory action research to guide our study. This research project will be conducted in 4 stages based on user-centered co-design principles. In Stage 1 (Empathize), we will recruit and convene 3 adolescent advisory groups in Edmonton, Toronto, and Vancouver. Members will be engaged as coresearchers and receive training in qualitative and quantitative methodologies, sexual health, and the social determinants of health. In Stage 2 (Define and Ideate), we will explore SRH information and service needs through focus group discussions with immigrant adolescents. In Stage 3 (Prototype), we will collaborate with mobile developers to build and iteratively design the app with support from the adolescent advisory groups. Finally, in Stage 4 (Test), we will return to focus group settings to share the app prototype, gather feedback on usability, and refine and release the app. RESULTS Recruitment and data collection will be completed by February 2023, and mobile app development will begin in March 2023. The mHealth app will be our core output and is expected to be released in the spring of 2024. CONCLUSIONS Our study will advance the limited knowledge base on SRH and the information needs of immigrant adolescents in Canada as well as the science underpinning participatory action research methods with immigrant adolescents. This study will address gaps by exploring SRH priorities, health information needs, and innovative strategies to improve the SRH of immigrant adolescents. Engaging adolescents throughout the study will increase their involvement in SRH care decision-making, expand efficiencies in SRH care utilization, and ultimately improve adolescents' SRH outcomes. The app we develop will be transferable to all adolescent groups, is scalable in international contexts, and simultaneously leverages significant economies of scale. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/45389.
Collapse
Affiliation(s)
| | - Sarah Munro
- University of British Columbia, Vancouver, BC, Canada
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Hensel DJ, Rosenberg M, Luetke M, Fu TC, Herbenick D. The Impact of Household Context on Self-Perceived Changes in Solo and Partnered Sexual Behaviors During the COVID-19 Pandemic: Findings from a U.S. Probability Survey. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:655-667. [PMID: 36376743 PMCID: PMC9662764 DOI: 10.1007/s10508-022-02459-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/26/2022] [Accepted: 10/16/2022] [Indexed: 05/16/2023]
Abstract
To understand how household context factors impacted self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the COVID- 19 pandemic, we conducted an online, nationally representative, cross-sectional survey of U.S. adults (N = 1010; aged 18-94 years; 62% response rate) from April 10-20, 2020. We used weighted descriptive statistics with Wilcoxon rank sign tests to understand the population prevalence and significance of self-reported changes (five-point scale: much less to much more) in 10 solo and partnered sexual behaviors. Ordinal regression was used to assess the impact of household predictor variables-including number of children at home, number of adults in home, partnership status (unpartnered, partnered and not living together, partnered and living together) and employment status (not working, employed not as essential worker, employed as essential worker). All models were adjusted for gender, age, sexual orientation, race/ethnicity, and residence location (urban, suburban, rural).All solo and partnered sexual behaviors showed some amount of significant change-increased activity for some and decreased for others-for U.S. adults during the pandemic. Not living with a partner was broadly associated with decreased affectionate partnered sexual behaviors; unpartnered adults reported increased sexting. Individuals not employed reported increased oral sex and increased consumption of sexually explicit materials as compared to non-essential workers. Number of children at home and household size were not significantly linked to self-reported behavior change. Ongoing sexual health-focused research should continue to focus on understanding how adults manage opportunities and constraints to their sexual lives in the context of a still-going pandemic. While many aspects of social life look more "normal" (e.g., many people have returned to their in-person offices and children are largely back in school), new and more-infectious strains of COVID-19 have proven that the pandemic may still yet impact daily living. Lessons learned from COVID need to include sexual health planning both for any future strains of COVID, as well as for future public health emergencies.
Collapse
Affiliation(s)
- Devon J Hensel
- Department of Pediatrics, Division of Adolescent Medicine, Indiana University School of Medicine, 410 West 10th Street Room 1001, Indianapolis, IN, 46202, USA.
- Department of Sociology, Indiana University Purdue University-Indianapolis, Indianapolis, IN, USA.
- Center for Sexual Health Promotion, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.
| | - Molly Rosenberg
- Center for Sexual Health Promotion, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
- Institute for Social Research and Data Innovation/Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA
| | - Maya Luetke
- Institute for Social Research and Data Innovation/Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA
| | - Tsung-Chieh Fu
- Center for Sexual Health Promotion, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Debby Herbenick
- Center for Sexual Health Promotion, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| |
Collapse
|
14
|
Musinguzi M, Kumakech E, Auma AG, Akello RA, Kigongo E, Tumwesigye R, Opio B, Kabunga A, Omech B. Prevalence and correlates of teenage pregnancy among in-school teenagers during the COVID-19 pandemic in Hoima district western Uganda-A cross sectional community-based study. PLoS One 2022; 17:e0278772. [PMID: 36525426 PMCID: PMC9757589 DOI: 10.1371/journal.pone.0278772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic related restrictions and lockdown measures had compromised the routine delivery and access of sexual and reproductive health and rights services to the population including the teenage girls. However, the teenage pregnancy rates during COVID-19 pandemic period were poorly documented. This study aimed at determining the prevalence and the factors associated with teenage pregnancy among in-school teenage girls during the COVID-19 pandemic period in Hoima District Uganda. METHODS This was a descriptive cross-sectional study that employed quantitative research methods. A total of 314 in-school teenage girls aged 13-19 years were selected using a multi-stage sampling techniques. Interviewer-administered questionnaires were used to collect the data from the participant's homes during the period December 2021-January 2022. Data analysis was done using univariate, bi-variate, and multivariate. RESULTS The prevalence of teenage pregnancy among the in-school teenage girls in Hoima district Uganda was 30.6% [96/314]. Higher teenage pregnancy rates were prevalent among the unmarried teenage girls [aOR: 9.6; 95%CI: 4.64-19.87; p = 0.000], teenage girls studying from boarding schools [aOR 2.83, 95%CI 1.36-5.86, p = 0.005], contraceptive non-users [aOR: 2.54; 95%CI: 1.12-5.4; p = 0.015] and teenage girls involved in sex trade [aOR 3.16, 95%CI 1.5-6.7, p = 0.003]. The factors associated with the reduced likelihood for teenage pregnancy included being an adult teenage girl aged 18-19 years [aOR: 0.15; 95%CI: 0.07-0.32; p = 0.000] and not receiving sex education during the period [aOR 0.36, 95%CI 0.13-0.62, p = 0.024]. CONCLUSION The results indicated that 3 out of 10 in-school teenage girls from Hoima district Uganda got pregnant during the COVID-19 pandemic period of 2021. Teenage pregnancy was prevalent among teenage girls who don't use modern contraceptive methods and those involved in sex trade. Teenage pregnancy was however, less prevalent among adult teenage girls aged 18-19 years. The findings point to the need for health stakeholders to innovate creative policies, contingency plans and programmes aimed at delaying age for sexual activities, increasing contraceptive use and minimizing pregnancy risk from sex trade among in-school teenage girls during COVID-19 pandemics.
Collapse
Affiliation(s)
| | - Edward Kumakech
- Department of Nursing and Midwifery, Lira University, Lira, Uganda
- * E-mail:
| | - Anne Grace Auma
- Department of Nursing and Midwifery, Lira University, Lira, Uganda
| | | | - Eustes Kigongo
- Department of Public Health, Lira University, Lira, Uganda
| | | | - Bosco Opio
- Department of Public Health, Lira University, Lira, Uganda
| | - Amir Kabunga
- Department of Psychiatry, Lira University, Lira, Uganda
| | - Bernard Omech
- Department of Public Health, Lira University, Lira, Uganda
| |
Collapse
|
15
|
Christian CS, Rossouw L. Scoping review of the impact of coronavirus disease 2019 on unplanned pregnancy. Afr J Prim Health Care Fam Med 2022; 14:e1-e8. [PMID: 36546497 PMCID: PMC9772756 DOI: 10.4102/phcfm.v14i1.3601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/09/2022] [Accepted: 10/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Increased pressure on the healthcare system because of coronavirus disease 2019 (COVID-19) along with national lockdown policies had consequences on the sexual and reproductive health of women. While the pandemic has resulted in changes in pregnancy intentions, child-bearing and fertility, the direction of this relationship is unclear and is likely to be impacted by each country's socio-economic status and stage of fertility transition. Understanding the fertility trajectory and the pandemic is important in understanding population structures and ageing, which have consequences for health policies, budgeting and economic activity. AIM This study aimed to conduct a scoping review of the impact of COVID-19 on unplanned pregnancy. METHODS A rapid review of available literature using Google Scholar, PubMed and Medical Literature Analysis and Retrieval System Online (MEDLINE), SocINDEX, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete and Academic Search Ultimate. Articles in English from 2020 to 2021 were included. RESULTS Fifteen articles were included. These were mostly cross-sectional, primary data-collection surveys exploring the relationship between COVID-19 and child-bearing intentions. CONCLUSION Access to contraceptives, socio-economic status and uncertainty about the health impact of COVID-19 on pregnancy were major themes that emerged when considering child-bearing intentions. Evidence of changes in the number of unplanned pregnancies and abortions was not insignificant but should be explored further. Although the studies covered a range of countries, more studies are needed focusing on low- and middle-income countries where the socio-economic impact of child-bearing intention is greater. There is a need for causal analysis using country-level data and for longer studies using more robust methodologies. The pandemic will continue to influence birth rates.Contribution: This article revealed gaps in the current literature on the measurement of the quantitative and causal impact of the COVID-19 pandemic on fertility and child-bearing. Findings from our study may assist in setting the trajectory for future research.
Collapse
Affiliation(s)
- Carmen S. Christian
- Department of Economics, Faculty of Economic and Management Sciences, University of the Western Cape, Bellville, South Africa
| | - Laura Rossouw
- School of Economics and Finance, Faculty of Commerce, Law and Management, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
16
|
Mackworth-Young CRS, Mavodza C, Nyamwanza R, Tshuma M, Nzombe P, Dziva Chikwari C, Tembo M, Dauya E, Apollo T, Ferrand RA, Bernays S. "Other risks don't stop": adapting a youth sexual and reproductive health intervention in Zimbabwe during COVID-19. Sex Reprod Health Matters 2022; 30:2029338. [PMID: 35192449 PMCID: PMC8865116 DOI: 10.1080/26410397.2022.2029338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
COVID-19 threatens hard-won gains in sexual and reproductive health (SRH) through compromising the ability of services to meet needs. Youth are particularly threatened due to existing barriers to their access to services. CHIEDZA is a community-based integrated SRH intervention for youth being trialled in Zimbabwe. CHIEDZA closed in March 2020, in response to national lockdown, and reopened in May 2020, categorised as an essential service. We aimed to understand the impact of CHIEDZA's closure and its reopening, with adaptations to reduce COVID-19 transmission, on provider and youth experiences. Qualitative methods included interviews with service providers (n = 22) and youth (n = 26), and observations of CHIEDZA sites (n = 10) and intervention team meetings (n = 7). Analysis was iterative and inductive. The sudden closure of CHIEDZA impeded youth access to SRH services. The reopening of CHIEDZA was welcomed, but the necessary adaptations impacted the intervention and engagement with it. Adaptations restricted time with healthcare providers, heightening the tension between numbers of youths accessing the service and quality of service provision. The removal of social activities, which had particularly appealed to young men, impacted youth engagement and access to services, particularly for males. This paper demonstrates how a community-based youth-centred SRH intervention has been affected by and adapted to COVID-19. We demonstrate how critical ongoing service provision is, but how adaptations negatively impact service provision and youth engagement. The impact of adaptations additionally emphasises how time with non-judgemental providers, social activities, and integrated services are core components of youth-friendly services, not added extras.
Collapse
Affiliation(s)
- Constance R S Mackworth-Young
- Assistant Professor, Biomedical Research and Training Institute, Harare, Zimbabwe; Assistant Professor, Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Constancia Mavodza
- Research Fellow, Biomedical Research and Training Institute, Harare, Zimbabwe; PhD Candidate, Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Maureen Tshuma
- Research Assistant, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Portia Nzombe
- Research Assistant, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Chido Dziva Chikwari
- Study Coordinator, Biomedical Research and Training Institute, Harare, Zimbabwe; Assistant Professor, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Mandikudza Tembo
- Research Fellow, Biomedical Research and Training Institute, Harare, Zimbabwe; PhD Candidate, MRC Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ethel Dauya
- Study Coordinator, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Tsitsi Apollo
- Deputy Director, AIDS and TB Unit, Ministry of Health and Child Care, Central Avenue, Harare, Zimbabwe
| | - Rashida A Ferrand
- Professor - International Health, Biomedical Research and Training Institute, Harare, Zimbabwe; Professor - International Health, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Sarah Bernays
- Associate Professor, Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK; Senior Lecturer in Global Health, School of Public Health, University of Sydney, Australia. Correspondence:
| |
Collapse
|
17
|
Tres J, Damaso EL, de Nadai MN. Impact of COVID-19 on the prescription of contraceptives in a city in São Paulo. Rev Assoc Med Bras (1992) 2022; 68:1765-1768. [PMID: 36449808 PMCID: PMC9779952 DOI: 10.1590/1806-9282.20220999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/31/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE In the beginning of the pandemic, measures, such as social distancing, lockdown strategies, and restrictions on mobility, as well as the fear of transiting through health facilities, raised concerns about the impact of COVID-19 on women's ability to continue using contraceptives. METHODS This is a retrospective cohort study, which evaluated reports of medication distribution spreadsheets in Bauru - SP, from January 2019 to June 2021. RESULTS Our study showed that the municipal dispensation of contraceptives in the SUS was markedly impacted by the COVID-19 pandemic, suffering reductions that can impact on an increase in unplanned pregnancy rates. It is possible to note a significant decrease in the distribution of combined oral contraceptives (44.18%), combined injectable contraceptives (47.58% reduction), and medroxyprogesterone acetate (13.98%). This fact may be associated with the reduction in offers of face-to-face consultations in gynecology, due to the social isolation necessary at the time of the pandemic. CONCLUSION Ensuring access to contraceptives during health emergencies should be a public health policy priority. Thus, it is essential to draw up strategic plans to encourage full access to reproductive planning services even in times of health emergency, so that the occurrence of unplanned pregnancies can be adequately prevented.
Collapse
Affiliation(s)
- Julia Tres
- Universidade de São Paulo, Faculdade de Odontologia de Bauru – Bauru (SP), Brazil
| | - Enio Luis Damaso
- Universidade de São Paulo, Faculdade de Odontologia de Bauru – Bauru (SP), Brazil
| | - Mariane Nunes de Nadai
- Universidade de São Paulo, Faculdade de Odontologia de Bauru – Bauru (SP), Brazil.,Corresponding author:
| |
Collapse
|
18
|
Watare SH, Alemu MA, Tayachew A, Yohannes N, Gizachew L, Kebede A, Tessema A, Kassa W, Biru M, Teferi M, Wendrad N, Eshetu K, Teka G, Yimer H, Ebrahim F, Mulugeta D, Mirkuze A, Abdela S, Emmanuel M, Hassen A, Wosen M, Hussen M, Fufa Y, Tolera G, Assefa Z, Abayneh A, Abate E. An investigation of a hundred COVID-19 cases and close contacts in Ethiopia, May to June, 2020: A prospective case-ascertained study. PLoS One 2022; 17:e0275596. [PMID: 36240226 PMCID: PMC9565438 DOI: 10.1371/journal.pone.0275596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022] Open
Abstract
Background Corona Virus Disease 2019 is a novel respiratory disease commonly transmitted through respiratory droplets. The disease has currently expanded all over the world with differing epidemiologic trajectories. This investigation was conducted to determine the basic clinical and epidemiological characteristics of the disease in Ethiopia. Methods A prospective case-ascertained study of laboratory-confirmed COVID-19 cases and their close contacts were conducted. The study included 100 COVID-19 laboratory-confirmed cases reported from May 15, 2020 to June 15, 2020 and 300 close contacts. Epidemiological and clinical information were collected using the WHO standard data collection tool developed first-few cases and contacts investigation. Nasopharyngeal and Oropharyngeal samples were collected by using polystyrene tipped swab and transported to the laboratory by viral transport media maintaining an optimal temperature. Clinical and epidemiological parameters were calculated in terms of ratios, proportions, and rates with 95% CI. Result A total of 400 participants were investigated, 100 confirmed COVID-19 cases and 300 close contacts of the cases. The symptomatic proportion of cases was 23% (23) (95% CI: 15.2%-32.5%), the proportion of cases required hospitalization were 8% (8) (95%CI: 3.5%-15.2%) and 2% (95%CI: 0.24% - 7.04%) required mechanical ventilation. The secondary infection rate, secondary clinical attack rate, median incubation period and median serial interval were 42% (126) (95% CI: 36.4%-47.8%), 11.7% (35) (95% CI: 8.3%-15.9%), 7 days (IQR: 4–13.8) and 11 days (IQR: 8–11.8) respectively. The basic reproduction number (RO) was 1.26 (95% CI: 1.0–1.5). Conclusion The proportion of asymptomatic infection, as well as secondary infection rate among close contacts, are higher compared to other studies. The long serial interval and low basic reproduction number might contribute to the observed slow progression of the pandemic, which gives a wide window of opportunities and time to control the spread. Testing, prevention, and control measures should be intensified.
Collapse
Affiliation(s)
| | | | - Adamu Tayachew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Adisu Kebede
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Wubayehu Kassa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mengistu Biru
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Kirubel Eshetu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Gizaw Teka
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Faiqa Ebrahim
- World Health Organization Country Office, Addis Ababa, Ethiopia
| | | | | | - Saro Abdela
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Musa Emmanuel
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | - Mesfin Wosen
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mukemil Hussen
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yaregal Fufa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Zewdu Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Ebba Abate
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| |
Collapse
|
19
|
Sexual and reproductive health services during outbreaks, epidemics, and pandemics in sub-Saharan Africa: a literature scoping review. Syst Rev 2022; 11:161. [PMID: 35945580 PMCID: PMC9361234 DOI: 10.1186/s13643-022-02035-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic could worsen adolescent sexual and reproductive health (ASRH). We sought evidence on the indirect impacts of previous infectious disease epidemics and the current COVID-19 pandemic on the uptake of ASRH in sub-Saharan Africa (SSA) to design relevant digital solutions. METHODS We undertook a literature scoping review to synthesize evidence on the indirect impacts of COVID-19 on ASRH in SSA per the Arksey and O'Malley framework and PRISMA reporting guidelines. We conducted the search on PubMed, Embase, Google Scholar, and ResearchGate in June and November 2020. We included all peer-reviewed, English-language primary studies on the indirect impacts of infectious disease epidemics on the uptake of sexual and reproductive health (SRH) in SSA. RESULTS We included 21 of 42 identified studies. Sixteen studies (76.2%) quantitatively assessed utilization and access to SRH during epidemics. Five studies (2 [9.6%] qualitative and 3 [14.3%] mixed methods) explored factors affecting SRH services. All studies focused on adult populations, most often on labor and delivery (n = 13 [61.9%]) and family planning (n = 8 [38.1%]) outcomes. Although we sought out to assess all outbreaks, epidemics, and pandemics, the only relevant studies took place during the West African Ebola pandemic (n = 17 [80.9%]) and COVID-19 pandemic (n = 4 [19.0%]). One study (4.8%) highlighted adolescent-specific outcomes and condom use. Most studies found declined access to and utilization of facility delivery, antenatal care, family planning, and HIV care. One study noted an increase in adolescent pregnancies. However, other studies noted similar, or even increasing trends in access to and utilization of other SRH services (family planning visits; HIV diagnosis; ART initiation) during epidemics. Barriers to SRH uptake included factors such as a reduced ability to pay for care due to lost income, travel restrictions, and fear of infection. Supply-side barriers included lack of open facilities, workers, commodities, and services. Community-based peer delivery systems, telemedicine, and transport services improved SRH uptake. CONCLUSION Access to SRH services during epidemics among adolescents and young people in SSA is understudied. We found that no studies focused on SRH outcomes of abortion, emergency contraception, sexually transmitted infections, or cervical cancer. To improve access to and utilization of SRH during pandemics, we recommend the following; in terms of research, key standardized SRH indicators should be included in routine data collection, routine data should be disaggregated by age, gender, and geography to understand gaps in ASRH service delivery, and additional rigorous epidemiological and social-behavioral studies should be conducted. On implementation, community-based peer delivery systems and telemedicine, internet-based, and other technological solutions may better reach adolescent and young people in SSA.
Collapse
|
20
|
Ramón Michel A, Ariza Navarrete S, Chávez S. Abortion as an Essential Health Service in Latin America During the COVID-19 Pandemic. Front Glob Womens Health 2022; 3:898754. [PMID: 35979197 PMCID: PMC9376594 DOI: 10.3389/fgwh.2022.898754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background The rapid increase in demand for health services as a result of the COVID-19 outbreak has created significant challenges for health systems. National and international health authorities have declared reproductive health services as essential, particularly those related to prevention, care during pregnancy, delivery and postpartum, as well as abortion services. This research was conducted by a regional team in cooperation with nine local organizations that are members of the Latin American Consortium against Unsafe Abortion (Consorcio Latinoamericano Contra el Aborto Inseguro, CLACAI). Objectives Our research aimed to examine the provision of reproductive healthcare services, with a focus on abortion, in nine countries during the first few months of the pandemic (March to September 2020). Methods Our research design developed a set of quantitative and qualitative indicators to monitor the availability and accessibility of abortion services during the COVID-19 pandemic. Researchers collected the quantitative data by reviewing regulations and other documents, government and civil society reports, and official statistics; the qualitative data was acquired through interviews with key actors, and non-representative surveys completed by healthcare professional and end users of reproductive services. Results Although six of the nine countries we researched deemed reproductive health services essential, only two of these six countries considered abortion services to be essential, and all nine countries reported difficulties in accessing abortion services. Restrictive abortion laws remained in place in the majority of countries (seven), and as a result access to abortion services became even more limited than it had been before the pandemic. At the same time, good practices to facilitate access to abortion services in healthcare facilities, updated regulatory frameworks, and collaboration between civil society and government agencies were identified and should continue to be promoted even after the pandemic crisis has subsided. Conclusions The pandemic catalyzed what was already happening in each country, and as such abortion services have become more accessible in countries like Argentina, where the so-called green wave has been generating social, legal and policy changes, whereas in countries such as Ecuador, where abortion is legally restricted and opposed to by the government, access to safe abortion became even more difficult than it was before the pandemic. However, the general trend has been a lack of adequate adaptation in order to guarantee quality in abortion care. That said, there have also been some interesting and positive service provision initiatives, such as telemedicine, implemented in at least two countries, which, if maintained long-term, could improve access to safe abortion.
Collapse
Affiliation(s)
- Agustina Ramón Michel
- Centro de Estudios de Estado y Sociedad, Health Area, Latin American Consortium Against Unsafe Abortion, Palermo University, Buenos Aires, Argentina
- *Correspondence: Agustina Ramón Michel
| | - Sonia Ariza Navarrete
- Centro de Estudios de Estado y Sociedad, Latin American Consortium Against Unsafe Abortion, Lisboa, Portugal
| | - Susana Chávez
- Latin American Consortium against Unsafe Abortion, Centro de Promoción y Defensa de los Derechos Sexuales y Reproductivos, Lisboa, Portugal
| |
Collapse
|
21
|
Kartono R, Salahudin, Sihidi IT. Covid-19 stigmatization: A systematic literature review. J Public Health Res 2022; 11:22799036221115780. [PMID: 36090024 PMCID: PMC9459472 DOI: 10.1177/22799036221115780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 07/09/2022] [Indexed: 12/02/2022] Open
Abstract
Covid-19 has severe implications for the emergence of negative stigmatization of
specific individuals and community groups. Due to labeling and discrimination,
mental attacks cause psychological distress so seriously that it requires proper
handling. Therefore, this study aims to conduct a systematic literature review
on articles on COVID-19 stigmatization. This paper used descriptive analysis
that 248 articles are from the Scopus database obtained by keyword Covid-19
stigmatization in the 2020–2021 time span were then processed and visualized
using the Vosviewer software. The results reveal the three most dominant
concepts studied: anxiety, isolation, and knowledge. The Covid-19 stigma arises
due to low public knowledge, widespread Covid-19 disinformation, and lack of
trust in the government. This research contributes to a description of the root
causes and adverse effects of stigmatization during Covid-19 to help formulate
recommendations for preventive and treatment actions that can be taken.
Meanwhile, the limitation of this research is that the articles reviewed are
only sourced from Scopus, so they do not have comparative data. Therefore,
future studies require using a comparative analysis approach that uses a Web of
Science (WoS) database.
Collapse
Affiliation(s)
- Rinikso Kartono
- Department of Social Welfare, Universitas Muhammadiyah Malang, Indonesia
| | - Salahudin
- Department of Government Studies, Universitas Muhammadiyah Malang, Indonesia
| | | |
Collapse
|
22
|
Gómez Ponce de Leon R, Bahamondes MV, Hellwig F, Barros A, Bahamondes L, Tobar F, da Silveira MF, Ali M, Gómez-Sánchez PI, Bremner J, Smith M, Serruya SJ. Potential of LARC to recover loss in satisfied demand for modern contraception after the COVID-19 pandemic: a case scenario analysis of Brazil and Mexico. Rev Panam Salud Publica 2022; 46:e41. [PMID: 35677216 PMCID: PMC9168421 DOI: 10.26633/rpsp.2022.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives. To estimate inequalities in demand for family planning satisfied with modern methods among women in Latin America and the Caribbean, with an emphasis on Brazil and Mexico, and to calculate the scenario for recovery of modern contraceptive coverage by expanding access to long-acting contraceptives (LARC) after the COVID-19 pandemic. Methods. National health surveys from 2006 to 2018 were used to estimate the demand for family planning satisfied with modern methods and how it was affected by the COVID-19 pandemic. The scenario included three variables: coverage, health outcomes, and costs. Considering coverage, United Nations Population Fund data were used to estimate the impact of COVID-19 on access to contraception in Latin America and the Caribbean. Health outcomes were assessed with the Impact 2 tool. Direct investment was used to evaluate cost-effectiveness. Results. Substantial inequalities were found in the use of modern contraceptive methods before the pandemic. We showed the potential cost-effectiveness of avoiding maternal deaths by introducing LARCs. Conclusions. In the scenario predicted for Brazil and Mexico, the costs of modern family planning and averted disability-adjusted life years are modest. Governments in Latin America and the Caribbean should consider promoting LARCs as a highly efficient and cost-effective intervention.
Collapse
Affiliation(s)
- Rodolfo Gómez Ponce de Leon
- Latin American Center of Perinatology Women and Reproductive Health (CLAP/WR) of the Pan American Health Organization/World Health Organization Montevideo Uruguay Latin American Center of Perinatology, Women and Reproductive Health (CLAP/WR) of the Pan American Health Organization/World Health Organization, Montevideo, Uruguay
| | - Maria Valeria Bahamondes
- Latin American Center of Perinatology Women and Reproductive Health (CLAP/WR) of the Pan American Health Organization/World Health Organization Montevideo Uruguay Latin American Center of Perinatology, Women and Reproductive Health (CLAP/WR) of the Pan American Health Organization/World Health Organization, Montevideo, Uruguay
| | - Franciele Hellwig
- Universidade Federal de Pelotas PelotasRS Brazil Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Aluísio Barros
- Universidade Federal de Pelotas PelotasRS Brazil Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Luis Bahamondes
- Universidade Estadual de Campinas CampinasSP Brazil Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Federico Tobar
- United Nations Population Fund Panama City Panama United Nations Population Fund, Panama City, Panama
| | | | - Moazzam Ali
- World Health Organization Geneva Switzerland World Health Organization, Geneva, Switzerland
| | - Pio Iván Gómez-Sánchez
- Universidad Nacional de Colombia Bogotá Colombia Universidad Nacional de Colombia, Bogotá, Colombia
| | - Jason Bremner
- United Nations Foundation Washington, D.C. United States of America United Nations Foundation, Washington, D.C., United States of America
| | - Martyn Smith
- United Nations Foundation Washington, D.C. United States of America United Nations Foundation, Washington, D.C., United States of America
| | - Suzanne J Serruya
- Latin American Center of Perinatology Women and Reproductive Health (CLAP/WR) of the Pan American Health Organization/World Health Organization Montevideo Uruguay Latin American Center of Perinatology, Women and Reproductive Health (CLAP/WR) of the Pan American Health Organization/World Health Organization, Montevideo, Uruguay
| |
Collapse
|
23
|
Kaya Senol D, Polat F. Effects of the pandemic on women's reproductive health protective attitudes: a Turkish sample. Reprod Health 2022; 19:106. [PMID: 35501810 PMCID: PMC9059458 DOI: 10.1186/s12978-022-01412-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/11/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This descriptive, cross-sectional study was performed to examine the effects of the COVID-19 pandemic on women's reproductive health protective attitudes. METHODS The study sample included 306 women and data were collected through a web-based, online questionnaire. The data were collected using the Personal Information Form, Determination of Married Women's Reproductive Health Protective Attitudes Scale. Descriptive statistics, independent samples t-test, ANOVA test were used to assess the data. RESULTS The mean scores for Determination of Married Women's Reproductive Health Protective Attitudes Scale significantly differed in terms of education, employment status, income, health insurance and perceived health status (p < 0.05). A total of 69.3% of women had their first pregnancy at the agerange of 21-34 years, 17.6% of the women had four or more pregnancies, 55.6% of the women gave birth 1-3 times, 13.4% of the women gave birth at home and 57.8% of the women did not use modern family planning methods. A total of 23.2% of women experienced a problem with their reproductive organs during the pandemic, 70.6% of them did not present to a health center for their problems and 74.5% of these women did not present to a health center to avoid the risk of COVID-19 transmission. A total of 40.2% of women used the methods they already know at home to relieve their problems and 16.0% of the women used them edications previously prescribed by their doctors. CONCLUSION The pandemic negatively affects there productive health of women. In the COVID-19 pandemic, health policies should be planned in accordance with the continuation of reproductive health and sexual health services.
Collapse
Affiliation(s)
- Derya Kaya Senol
- Department of Midwifery, Faculty of Health Sciences, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Filiz Polat
- Department of Midwifery, Faculty of Health Sciences, Osmaniye Korkut Ata University, Osmaniye, Turkey
| |
Collapse
|
24
|
Wake AD, Kandula UR. The global prevalence and its associated factors toward domestic violence against women and children during COVID-19 pandemic-"The shadow pandemic": A review of cross-sectional studies. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221095536. [PMID: 35441537 PMCID: PMC9024155 DOI: 10.1177/17455057221095536] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Globally, domestic violence affects women across their life span. Domestic violence against women and children during COVID-19 is a critical and substantial public health issue. This review article was aimed to determine the prevalence and its associated factors toward domestic violence against women and children during COVID-19. Several studies showed that the prevalence of domestic violence against women and children has been alarmingly enlarged during this COVID-19. Domestic violence is a significant and essential problem that is occurring all over the world for many years now, but this condition has been augmented during the lockdown situation because of this pandemic. Women and children of the worldwide are facing twin health emergencies that are COVID-19 and domestic violence. The pandemic was found as a threat to commit domestic violence against women and children. This is because, even though the measurements taken to avoid COVID-19 spread are supportive strategies and also the only opportunity to do so, reducing the risk of COVID-19 was found to raise the risk of domestic violence against women and children. Factors associated with domestic violence against women and children were; being housewives, age < 30 years, marriage, husband's age being between 31 and 40 years, physical victimization, and sexual victimization were factors associated with domestic violence. Depression, spending more time in close contact, job losses, financial insecurity, lockdowns, addiction (alcohol or drugs), control of wealth in the family, technology, and quarantine were factors considered as risk factors for domestic violence. This review will serve as a "call to action" to address this crisis effectively by coming together since this crisis is the global aspect. This is a shadow pandemic growing during this COVID-19 crisis and a global collective effort is needed to prevent it. The life of women and children moves from their needs to their rights during this pandemic. It is essential to undertake urgent actions to intervene in it.
Collapse
Affiliation(s)
- Addisu Dabi Wake
- Addisu Dabi Wake, Nursing Department, College of Health Sciences, Arsi University, P.O. Box: 193/04, Asella, Ethiopia.
| | | |
Collapse
|
25
|
Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031749. [PMID: 35162772 PMCID: PMC8834942 DOI: 10.3390/ijerph19031749] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 02/01/2023]
Abstract
The COVID-19 pandemic and the measures adopted are having a profound impact on a major goal of public healthcare systems: universal access to health services. The objective is to synthesize the available knowledge on access to health care for non-COVID-19 conditions and to identify knowledge gaps. A scoping review was conducted searching different databases (Medline, Google Scholar, etc.) for original articles published between December 2019 and September 2021. A total of 53 articles were selected and analyzed using the Aday and Andersen framework as a guide. Of these, 37 analyzed changes in levels of use of health services, 15 focused on the influencing factors and barriers to access, and 1 studied both aspects. Most focused on specific diseases and the early stages of the pandemic, based on a review of records. Analyses of the impact on primary care services' use, unmet needs or inequalities in access were scarce. A generalized reduction in the use of health services was described. The most frequent access barrier described for non-COVID-19 conditions related to the services was a lack of resources, while barriers related to the population were predisposing (fear of contagion, stigma, or anticipating barriers) and enabling characteristics (worse socioeconomic status and an increase in technological barriers). In conclusion, our results show a general reduction in services' use in the early stages of the pandemic, as well as new barriers to access and the exacerbation of existing ones. In view of these results, more studies are required on the subsequent stages of the pandemic, to shed more light on the factors that have influenced access and the pandemic's impact on equity of access.
Collapse
|
26
|
Larki M, Sharifi F, Manouchehri E, Latifnejad Roudsari R. Responding to the Essential Sexual and Reproductive Health Needs for Women During the COVID-19 Pandemic: A Literature Review. Malays J Med Sci 2022; 28:8-19. [PMID: 35002486 PMCID: PMC8715882 DOI: 10.21315/mjms2021.28.6.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 06/24/2021] [Indexed: 11/09/2022] Open
Abstract
The pandemic and its consequences have been shown to have a negative impact on the availability and accessibility of the basic services, including sexual and reproductive health (SRH) needs. The aim of this study was to investigate the responses to the essential SRH needs for women during the COVID-19 pandemic. This narrative review was conducted based on the Scale for Assessing Narrative Review Articles (SANRA), in order to present key activities for responding to the important SRH needs of women in the current COVID-19 pandemic. The literature search was performed through English databases of Cochrane Library, PubMed, Scopus and ScienceDirect, as well as Persian databases including Magiran and Scientific Information Database (SID). In addition, the World Health Organization (WHO), the Joint United Nations Programme on HIV and AIDS (UNAIDS) and the reports of Center for Disease Control and Prevention (CDC) were searched. The search was carried out from December 2019 up to 10 January 2021. Essential reproductive healthcare services for women during the COVID-19 pandemic were divided into six categories including access to contraception, safe abortion and post-abortion care, sexual health and sexually transmitted disease (STD) prevention, cervical cancer screening and prevention, maternity services and also addressing violence against women and girls. These essential needs should be considered as a priority by governments as well as public and private stakeholders. It seems that the implementation of the shifted strategies, active participation of public and private stakeholders, consideration of human rights and ethical issues, ensuring access to vulnerable populations, regular contact with individuals and the increased cooperation of individuals for responding to the SRH needs during the COVID-19 outbreak, are necessary.
Collapse
Affiliation(s)
- Mona Larki
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farangis Sharifi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Manouchehri
- Department of Midwifery, Faculty of Nursing and Midwifery, Mashad Medical Sciences, Islamic Azad University, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
27
|
Chengo R, Esho T, Kuria S, Kimani S, Indalo D, Kamanzi L, Mouhamed B, Wabwire A, Camara K, Kapsandui T, Kagurusi P, Nankanja M, Oele G, Osur J. A Situation Assessment of Community Health Workers' Preparedness in Supporting Health System Response to COVID-19 in Kenya, Senegal, and Uganda. J Prim Care Community Health 2022; 13:21501319211073415. [PMID: 35356847 PMCID: PMC8977686 DOI: 10.1177/21501319211073415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Coronavirus disease (COVID-19) caused socio-economic disruptions across the
globe. The pandemic disrupted the health system (HS) calling for
reengineering in response to high infection rates, deaths, and resultant
containment measures. To deal with COVID-19 and promote resilience,
community health workers (CHWs) were engaged across countries. Objective: Assess the preparedness of CHWs in supporting health system response in
prevention and management of COVID-19 in Kenya, Senegal, and Uganda. Methods: A mixed methods design study involving national and subnational jurisdictions
in the 3 countries. Key informant interviews were conducted with policy
actors (16) and health care workers (24) while in-depth interviews involved
CHWs (14) and community members (312) subjected to survey interviews. Results: Most (>50%) households survived on <USD 100/month during COVID-19
announced in March 2020 through national TV (57%), FM (42%), and radio
station (27%). Community members interactions with CHWs increased during the
pandemic through home visits as health educators, basic counseling providers
and distributors of pandemic information tools, personal protective
equipments, and social support commodities. The CHWs faced challenges during
pandemic prevention and management including lack of: protective gear,
salary, refresher courses, and identification tools; limited supervision and
training; hostile reception during home visits; misconception and
politicking about the pandemic. To effectively support prevention and manage
of COVID-19, priority needs for CHWs were identified namely: provision of
resources, protective gear, transport reimbursement, stipends,
identification cards, and tools for recording and reporting; empowerment
with adequate skills, trainings on provision of psychosocial support, first
aid, and sensitization on policies. Conclusion: COVID-19 linked disruptions to optimal functioning of HS necessitated
engagement of CHWs in the pandemic prevention and management. Findings
underscore the important role CHWs play in supporting HS during crisis like
COVID-19 to mitigate disruptions and stabilize the system for effective
response. The CHWs can improve resilience of social and HS during unplanned
disruptions for optimal functioning and attainment of universal health care.
Policy makers should develop structured mechanisms for engaging CHWs while
committing resources to address challenges that affect seamless synergy
between health and CHWs Systems.
Collapse
|
28
|
Community pharmacists’ provision of sexual and reproductive health services: a cross sectional study in Alberta, Canada. J Am Pharm Assoc (2003) 2022; 62:1214-1223. [DOI: 10.1016/j.japh.2022.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/20/2022] [Accepted: 01/20/2022] [Indexed: 11/18/2022]
|
29
|
Gryksa K, Neumann ID. Consequences of pandemic-associated social restrictions: Role of social support and the oxytocin system. Psychoneuroendocrinology 2022; 135:105601. [PMID: 34837776 PMCID: PMC8605825 DOI: 10.1016/j.psyneuen.2021.105601] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 12/15/2022]
Abstract
During pandemics, governments take drastic actions to prevent the spreading of the disease, as seen during the present COVID-19 crisis. Sanctions of lockdown, social distancing and quarantine urge people to exclusively work and teach at home and to restrict social contacts to a minimum; lonely people get into further isolation, while families` nerves are strained to the extreme. Overall, this results in a dramatic and chronic increase in the level of psychosocial stress over several months mainly caused by i) social isolation and ii) psychosocial stress associated with overcrowding, social tension in families, and domestic violence. Moreover, pandemic-associated social restrictions are accompanied by loss of an essential stress buffer and important parameter for general mental and physical health: social support. Chronic psychosocial stress and, in particular, social isolation and lack of social support affect not only mental health, but also the brain oxytocin system and the immune system. Hence, pandemic-associated social restrictions are expected to increase the risk of developing psychopathologies, such as depression, anxiety-related and posttraumatic stress disorders, on the one hand, but also to induce a general inflammatory state and to impair the course of infectious disorders on the other. Due to its pro-social and stress-buffering effects, resulting in an anti-inflammatory state in case of disease, the role of the neuropeptide oxytocin will be discussed and critically considered as an emerging treatment option in cases of pandemic-induced psychosocial stress, viral infection and during recovery. In this review, we aim to critically focus on possible short- and long-term consequences of social restrictions on mental health and the immune system, while discussion oxytocin as a possible treatment option.
Collapse
Affiliation(s)
- Katharina Gryksa
- Department of Behavioural and Molecular Neurobiology, University of Regensburg, Regensburg, Germany.
| | | |
Collapse
|
30
|
DEMİR R, TAŞPINAR A. Koronavirüs Pandemisinin Kadının Yaşamına ve Sağlığına Yansımaları. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2021. [DOI: 10.18863/pgy.882529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
|
31
|
Mukherjee TI, Khan AG, Dasgupta A, Samari G. Reproductive justice in the time of COVID-19: a systematic review of the indirect impacts of COVID-19 on sexual and reproductive health. Reprod Health 2021; 18:252. [PMID: 34930318 PMCID: PMC8686348 DOI: 10.1186/s12978-021-01286-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 11/06/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Despite gendered dimensions of COVID-19 becoming increasingly apparent, the impact of COVID-19 and other respiratory epidemics on women and girls' sexual and reproductive health (SRH) have yet to be synthesized. This review uses a reproductive justice framework to systematically review empirical evidence of the indirect impacts of respiratory epidemics on SRH. METHODS We searched MEDLINE and CINAHL for original, peer-reviewed articles related to respiratory epidemics and women and girls' SRH through May 31, 2021. Studies focusing on various SRH outcomes were included, however those exclusively examining pregnancy, perinatal-related outcomes, and gender-based violence were excluded due to previously published systematic reviews on these topics. The review consisted of title and abstract screening, full-text screening, and data abstraction. RESULTS Twenty-four studies met all eligibility criteria. These studies emphasized that COVID-19 resulted in service disruptions that effected access to abortion, contraceptives, HIV/STI testing, and changes in sexual behaviors, menstruation, and pregnancy intentions. CONCLUSIONS These findings highlight the need to enact policies that ensure equitable, timely access to quality SRH services for women and girls, despite quarantine and distancing policies. Research gaps include understanding how COVID-19 disruptions in SRH service provision, access and/or utilization have impacted underserved populations and those with intersectional identities, who faced SRH inequities notwithstanding an epidemic. More robust research is also needed to understand the indirect impact of COVID-19 and epidemic control measures on a wider range of SRH outcomes (e.g., menstrual disorders, fertility services, gynecologic oncology) in the long-term.
Collapse
Affiliation(s)
- Trena I Mukherjee
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Angubeen G Khan
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Anindita Dasgupta
- Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Goleen Samari
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
32
|
Banke-Thomas A, Yaya S. Looking ahead in the COVID-19 pandemic: emerging lessons learned for sexual and reproductive health services in low- and middle-income countries. Reprod Health 2021; 18:248. [PMID: 34906177 PMCID: PMC8670615 DOI: 10.1186/s12978-021-01307-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 pandemic has caused widespread disruption to essential health service provision globally, including in low- and middle-income countries (LMICs). Recognising the criticality of sexual and reproductive health (SRH) services, we review the actual reported impact of the COVID-19 pandemic on SRH service provision and evidence of adaptations that have been implemented to date. Across LMICs, the available data suggests that there was a reduction in access to SRH services, including family planning (FP) counselling and contraception access, and safe abortion during the early phase of the pandemic, especially when movement restrictions were in place. However, services were quickly restored, or alternatives to service provision (adaptations) were explored in many LMICs. Cases of gender-based violence (GBV) increased, with one in two women reporting that they have or know a woman who has experienced violence since the beginning of the pandemic. As per available evidence, many adaptations that have been implemented to date have been digitised, focused on getting SRH services closer to women. Through the pandemic, several LMIC governments have provided guidelines to support SRH service delivery. In addition, non-governmental organisations working in SRH programming have played significant roles in ensuring SRH services have been sustained by implementing several interventions at different levels of scale and to varying success. Most adaptations have focused on FP, with limited attention placed on GBV. Many adaptations have been implemented based on guidance and best practices and, in many cases, leveraged evidence-based interventions. However, some adaptations appear to have simply been the sensible thing to do. Where evaluations have been carried out, many have highlighted increased outputs and efficiency following the implementation of various adaptations. However, there is limited published evidence on their effectiveness, cost, value for money, acceptability, feasibility, and sustainability. In addition, the pandemic has been viewed as a homogenous event without recognising its troughs and waves or disentangling effects of response measures such as lockdowns from the pandemic itself. As the pandemic continues, neglected SRH services like those targeting GBV need to be urgently scaled up, and those being implemented with any adaptations should be rigorously tested.
Collapse
Affiliation(s)
- Aduragbemi Banke-Thomas
- School of Human Sciences, University of Greenwich, London, UK.
- LSE Health, London School of Economics and Political Science, London, UK.
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, UK
| |
Collapse
|
33
|
Suen YT, Chidgey A. Disruption of HIV Service Provision and Response in Hong Kong During COVID-19: Issues of Privacy and Space. J Int Assoc Provid AIDS Care 2021; 20:23259582211059588. [PMID: 34841949 PMCID: PMC8640322 DOI: 10.1177/23259582211059588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The impact of the COVID-19 pandemic on sexual and reproductive health and rights is a significant public health issue. HIV/AIDS related services have been severely disrupted during the pandemic in different aspects. This paper highlights how privacy concerns affected HIV service provision during COVID-19 in Hong Kong, by sharing the experience of AIDS Concern Hong Kong. Based on our experience of working with our local MSM clients, temporary closure of center-based testing, venue-based testing in gay saunas, and mobile testing, meant that MSM could not easily go to a safe space to get anonymous and gay-friendly testing. To mitigate this, AIDS Concern Hong Kong put effort into promoting and making self-testing available during periods of testing center closure. We also made sure that people can choose to have test kits delivered to an anonymous pick-up station.
Collapse
Affiliation(s)
- Yiu Tung Suen
- 26451Chinese University of Hong Kong, Shatin, Hong Kong
| | | |
Collapse
|
34
|
McClarty L, Lazarus L, Pavlova D, Reza-Paul S, Balakireva O, Kimani J, Tarasova T, Lorway R, Becker ML, McKinnon LR. Socioeconomic Burdens of the COVID-19 Pandemic on LMIC Populations with Increased HIV Vulnerabilities. Curr HIV/AIDS Rep 2021; 19:76-85. [PMID: 34822064 PMCID: PMC8614077 DOI: 10.1007/s11904-021-00591-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/25/2022]
Abstract
Purpose of Review To review the impact of the COVID-19 pandemic and its public health response on key populations at risk of HIV infection, with a focus on sex workers. Recent Findings Since last year several groups have documented how the COVID-19 pandemic has impacted the livelihoods and health of sex workers. We focus on case studies from Kenya, Ukraine, and India and place these in the broader global context of sex worker communities, drawing on common themes that span geographies. Summary COVID-19-associated lockdowns have significantly disrupted sex work, leading to economic and health challenges for sex workers, ranging from HIV-related services to mental health and exposure to violence. Several adaptations have been undertaken by sex workers and frontline workers, including migration, a move to mobile services, and struggling to find economic supports. Strengthening community-based responses for future pandemics and other shocks is critical to safeguard the health of marginalized populations.
Collapse
Affiliation(s)
- Leigh McClarty
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Lisa Lazarus
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Daria Pavlova
- Ukrainian Institute for Social Research After Oleksandr Yaremenko, Kyiv, Ukraine
| | - Sushena Reza-Paul
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Ashodaya Samithi, Mysuru, India
| | - Olga Balakireva
- Ukrainian Institute for Social Research After Oleksandr Yaremenko, Kyiv, Ukraine
- Institute for Economics and Forecasting, Ukrainian National Academy of Sciences, Kyiv, Ukraine
| | - Joshua Kimani
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 504-745 Bannatyne Ave, Winnipeg, MB, R3E 0J9, Canada
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, University of Nairobi, Nairobi, Kenya
| | - Tetiana Tarasova
- Ukrainian Institute for Social Research After Oleksandr Yaremenko, Kyiv, Ukraine
| | - Robert Lorway
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Marissa L Becker
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 504-745 Bannatyne Ave, Winnipeg, MB, R3E 0J9, Canada
| | - Lyle R McKinnon
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 504-745 Bannatyne Ave, Winnipeg, MB, R3E 0J9, Canada.
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, University of Nairobi, Nairobi, Kenya.
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.
| |
Collapse
|
35
|
Gilbert M, Chang HJ, Ablona A, Salway T, Ogilvie GS, Wong J, Haag D, Pedersen HN, Bannar-Martin S, Campeau L, Ford G, Worthington C, Grace D, Grennan T. Accessing needed sexual health services during the COVID-19 pandemic in British Columbia, Canada: a survey of sexual health service clients. Sex Transm Infect 2021; 98:360-365. [PMID: 34740976 PMCID: PMC8577923 DOI: 10.1136/sextrans-2021-055013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/24/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives We assessed COVID-19 pandemic impacts on accessing needed sexual health services, and acceptability of alternative service delivery models, among sexual health service clients in British Columbia (BC), Canada. Methods We administered an online survey on 21 July–4 August 2020 to clients using a provincial STI clinic or internet-based testing service, GetCheckedOnline, in the year prior to March 2020. We used logistic regression to identify factors associated with having unmet sexual health needs (ie, not accessing needed services) during March–July 2020 and the likelihood of using various alternative service models, if available. Results Of 1198 survey respondents, 706 (59%) reported needing any sexual health service since March 2020; of these 706, 365 (52%) did not access needed services and 458 (66%) had avoided or delayed accessing services. GetCheckedOnline users (univariate OR (uOR)=0.62; 95% CI 0.43 to 0.88) or clients with more urgent needs (eg, treatment for new STI, uOR 0.40 (95% CI 0.21 to 0.7)) had lower odds of unmet sexual health needs. The most common factors reported for avoiding or delaying access were public messaging against seeking non-urgent healthcare (234/662, 35%), concern about getting COVID-19 while at (214/662, 32%) or travelling to (147/662, 22%) a clinic or lab and closure of usual place of accessing services (178/662, 27%). All factors were positively associated with having unmet sexual health needs, with public messaging showing the strongest effect (adjusted OR=4.27 (95% CI 2.88 to 6.42)). Likelihood of using alternative sexual health service models was high overall, with the most appealing options being home self-collection kits (634/706, 90%), receiving test kits or antibiotics at home (592/700, 85%) and express testing (565/706, 80%). Conclusions Of BC sexual health service clients needing services during March–July 2020, many had unmet needs. Offering alternative service delivery methods may help to improve access during and beyond the COVID-19 pandemic.
Collapse
Affiliation(s)
- Mark Gilbert
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada .,School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Hsiu-Ju Chang
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Aidan Ablona
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Gina Suzanne Ogilvie
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.,Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Jason Wong
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Devon Haag
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Heather Nicole Pedersen
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Laurence Campeau
- Vancouver Island Health Authority, Victoria, British Columbia, Canada
| | - Geoffrey Ford
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Catherine Worthington
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Troy Grennan
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.,Division of Infectious Diseases, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
36
|
Walsh AR, Sullivan S, Stephenson R. Are Male Couples Changing Their Sexual Agreements and Behaviors During the COVID-19 Pandemic? AIDS Behav 2021; 25:3798-3803. [PMID: 33860408 PMCID: PMC8048335 DOI: 10.1007/s10461-021-03256-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 01/09/2023]
Abstract
Sexual agreements are an important element of HIV prevention for many partnered gay, bisexual, and other men who have sex with men (GBMSM). This study describes sexual agreement and sexual behavior changes during the 2020 pandemic among a sample of 215 coupled US GBMSM. Overall, reported behavior shifted towards monogamy. Fifteen percent of respondents developed/ended/changed their agreement during the pandemic; the pandemic factored into 85% of reported changes. Individuals reported fewer outside sexual partners compared to the 3 months pre-pandemic. More research is needed to investigate shifting behavior and associated risk in order to adapt HIV services during the pandemic.
Collapse
Affiliation(s)
- Alison R Walsh
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA.
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, 400 N Ingalls St., Ann Arbor, MI, 48109, USA.
| | - Stephen Sullivan
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Rob Stephenson
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, 400 N Ingalls St., Ann Arbor, MI, 48109, USA
| |
Collapse
|
37
|
Gleason N, Banik S, Braverman J, Coleman E. The Impact of the COVID-19 Pandemic on Sexual Behaviors: Findings From a National Survey in the United States. J Sex Med 2021; 18:1851-1862. [PMID: 34535369 PMCID: PMC8417519 DOI: 10.1016/j.jsxm.2021.08.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Studies from the first months of the coronavirus disease 2019 (COVID-19) pandemic and the resulting lockdown and social distancing measures have shown that there have been decreases in sexual frequency and relationship satisfaction. AIM To evaluate the ongoing impact of the COVID-19 pandemic on sexual behavior, relationship satisfaction, and intimate partner violence in the United States using a large national convenience sample. METHODS About 1,051 participants across the United States were recruited in October 2020 to complete a cross-sectional online survey. OUTCOMES Participants were asked to retrospectively report their sexual behavior frequency, relationship satisfaction, and intimate partner violence during the pandemic and prior to the pandemic RESULTS: There was a small but significant decrease in some retrospectively-reported partnered sexual activities, and men reported a small increase in masturbation and pornography use. There was no evidence for a change in relationship satisfaction or intimate partner violence, but both men and women reported a small decrease in sexual pleasure, and women reported a small decrease in sexual desire. The sexual behaviors with greatest reduction were casual sex, hookups, and number of partners, and the most diminished as aspect of sexual functioning was sexual enjoyment. Depression symptoms, relationship status, and perceived importance of social distancing emerged as predictors of these reductions. Less than half of individuals who engaged with casual sex partners before the start of the pandemic ceased this behavior completely after the start of the pandemic. Individuals waited on average 6-7 weeks before reengaging in casual sex. CLINICAL IMPLICATIONS These results inform public health response to the effects of the pandemic and add to our understanding of how the pandemic has continued to impact sexual behavior. STRENGTHS AND LIMITATIONS This is the first known study to evaluate sexual behavior several months into the COVID-19 pandemic using a large national sample. However, the results of this study are limited by its convenience sampling method and cross-sectional design. CONCLUSION These results indicate that the changes in sexual behavior observed in the early months of the pandemic have continued, with small but significant decreases in many partnered sexual behaviors and a small increase in men's solitary sexual behaviors. Gleason N, Banik S, Braverman J, et al. The Impact of the COVID-19 Pandemic on Sexual Behaviors: Findings From a National Survey in the United States. J Sex Med 2021;18:1851-1862.
Collapse
Affiliation(s)
- Neil Gleason
- Department of Psychology, University of Washington, Seattle, WA, USA.
| | - Swagata Banik
- Center for Health Disparities Research & Education, Baldwin Wallace University, Berea, OH, USA
| | | | - Eli Coleman
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| |
Collapse
|
38
|
Kuitunen I, Ponkilainen V. COVID-19-related nationwide lockdown did not reduce the reported diagnoses of Chlamydia trachomatis and Neisseria gonorrhoeae in Finland. Sex Transm Infect 2021; 97:550. [PMID: 33397798 PMCID: PMC7783371 DOI: 10.1136/sextrans-2020-054881] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/13/2020] [Accepted: 12/22/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Ilari Kuitunen
- Mikkeli Central Hospital, Mikkeli, Finland
- School of Medicine, University of Eastern Finland, Kuopio, Finland
| | | |
Collapse
|
39
|
Amerio A, Lugo A, Bosetti C, Fanucchi T, Gorini G, Pacifici R, Odone A, Gallus S. Italians do it … less. COVID-19 lockdown impact on sexual activity: Evidence from a large representative sample of Italian adults. J Epidemiol 2021; 31:648-652. [PMID: 34629362 PMCID: PMC8593579 DOI: 10.2188/jea.je20210055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background To explore how sexual activity was impacted by coronavirus disease 2019 (COVID-19) lockdown measures in the general adult population. Methods A cross-sectional survey was conducted among 6,003 Italian adults aged 18–74 years who were representative of the Italian general population. Study subjects were recruited at the time of the nationwide stay-at-home order (from April 27 to May 3, 2020). We identified characteristics associated with decreased frequency of sex during lockdown, differentiating between cohabiting and non-cohabiting subjects. Results Over one-third (35.3%) of Italians reported to have changed their sexual activity during lockdown (8.4% increased and 26.9% decreased). When focusing on cohabitants (N = 3,949, 65.8%), decreased sexual activity (20.7%) was more frequently reported by men (22.3%; compared to women, multivariable odds ratio 1.23; 95% confidence interval, 1.05–1.44), younger subjects (P for trend <0.001), more educated subjects (P for trend = 0.004), subjects living in smaller houses (P for trend = 0.003), and those reporting longer time spent outdoors before the lockdown (P for trend <0.001). Conclusions COVID-19 lockdown drastically altered people’s day-to-day life and is likely to have impacted lifestyle habits and behavioral risk factors, including sexual attitudes and practice. This is the first national population-level study exploring changes in sexual life in this COVID-19 era. As we report sexual practice to have been affected by lockdown restrictions, we suggest that the mental health, social, and other determinants of these changes are to be explored beyond imposed social distancing.
Collapse
Affiliation(s)
- Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa.,IRCCS Ospedale Policlinico San Martino
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri
| | - Tiziana Fanucchi
- SOD Alcologia & Centro Alcologico Regionale Toscano, Azienda Ospedaliero-Universitaria Careggi
| | - Giuseppe Gorini
- Oncologic Network, Prevention and Research Institute (ISPRO)
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia.,IRCCS San Raffaele Scientific Institute
| | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri
| |
Collapse
|
40
|
Quiros-Roldan E, Izzo I, Carriero C, Degli Antoni M, Storti S, Tiecco G, Gardini G, Focà E, Castelli F. Decrease in new diagnosis of HIV/AIDS in the two years period 2019-2020: impact of COVID-19 pandemic. J Public Health Res 2021; 11. [PMID: 34558252 PMCID: PMC8883525 DOI: 10.4081/jphr.2021.2256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
The emergence SARS-CoV-2 in late 2019 and early 2020 has caused a pandemic of unprecedented proportions. Management of COVID-19 became emergent public health priorities, and the impact on other public health initiatives, such as expanded HIV screening and linkage to care, remain largely unknown. In this Single-Center retrospective observational study, we describe the characteristics and circumstance of the new HIV cases during 2020 compared to 2019. We observed a decrease of HIV diagnosis during this period. Interestingly, median age at HIV diagnosis decreased of one decade and percentage of female patients was higher. In addition, more patients received diagnosis during hospitalization and more AIDS-defining conditions, such as Pneumocystis pneumonia, were detected. We express our concern that HIV new diagnoses will increase as a result of people’s inability to get tested or treated in this period. More efforts are needed to improve local screening programs both during and after COVID-19 pandemic. Significance for public health Our experience highlights the importance of a resilient healthcare system ready to implement new strategies in order to guarantee the continuum of HIV care even in the context of emergency. Notwithstanding our efforts, we observed a decrease of HIV diagnosis during this period compared to 2019. We express our concern that HIV new diagnoses will increase as a result of people's inability to get tested or treated in this period. Our City, by signing the Paris Declaration on Fast-Track Cities in 2019 made the commitment to accelerate HIV responses to achieve end of AIDS epidemic by 2030. COVID-19 pandemic has slowed down this process around the world and in our city and in order not to lose ground, more efforts are needed to improve local screening programs both during and after COVID-19 pandemic.
Collapse
Affiliation(s)
- Eugenia Quiros-Roldan
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia.
| | - Ilaria Izzo
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia.
| | - Canio Carriero
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia.
| | - Melania Degli Antoni
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia.
| | - Samuele Storti
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia.
| | - Giorgio Tiecco
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia.
| | - Giulia Gardini
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia.
| | - Emanuele Focà
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia.
| | - Francesco Castelli
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia.
| |
Collapse
|
41
|
Harries J, Daskilewicz K, Bessenaar T, Gerdts C. Understanding abortion seeking care outside of formal health care settings in Cape Town, South Africa: a qualitative study. Reprod Health 2021; 18:190. [PMID: 34556120 PMCID: PMC8460179 DOI: 10.1186/s12978-021-01243-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/13/2021] [Indexed: 11/26/2022] Open
Abstract
Background Although abortion was legalized in South Africa in 1996, barriers to safe, legal abortion services remain, and women continue to seek abortions outside of the formal healthcare sector. This study explored the decision-making processes that women undertake when faced with an unintended pregnancy, the sources of information used to make their decisions and the factors that contribute to their seeking of informal sector abortion in Cape Town, South Africa. Methods We conducted 15 semi-structured in-depth interviews in English with women who had accessed an abortion outside of the formal health care sector. Women were recruited with the assistance of a community-based key informant. Data was analyzed using a thematic analysis approach. Results Participants were aware that abortions were legal and accessible in public clinics, however they were concerned that others would find out about their unintended pregnancy and abortion if they went to legal providers. Women were also concerned about judgment and mistreatment from providers during their care. Rather than seek care in the formal sector, women looked past concerns around the safety and effectiveness of informal sector abortions and often relied on their social networks for referrals to informal providers. Conclusions The findings highlight the decision-making processes employed by women when seeking abortion services in a setting where abortion is legal and demonstrate the role of institutional and societal barriers to safe abortion access. Abortion service delivery models should adapt to women’s needs to enhance the preferences and priorities of those seeking abortion care-including those who prefer facility-based care as well as those who might prefer self-managed medical abortions. Although abortion was legalized in South Africa in 1996, barriers to safe, legal abortion services remain, and women continue to seek abortions outside of the formal healthcare sector. This study explored the decision-making processes that women undertake when faced with an unintended pregnancy, who they discuss and seek help from, and the factors that influence their decision to seek an abortion outside of the formal health care sector. We interviewed 15 women who had obtained an abortion outside of the health care sector in Cape Town, South Africa. Women were aware that abortions were legal and available in public clinics, but they were concerned about negative and judgmental attitudes from health care providers even though some women were aware of the possible health safety issues related to seeking an abortion outside of the clinic setting. Abortion services should adapt to women’s needs and offer them options of facility-based care but also self-managed medical abortions under the guidance of health care providers.
Collapse
Affiliation(s)
- Jane Harries
- Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
| | - Kristen Daskilewicz
- Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Caitlin Gerdts
- Ibis Reproductive Health, 1736 Franklin St, Oakland, CA, USA
| |
Collapse
|
42
|
Impact of COVID-19 on income, prevention attitudes, and access to healthcare among male clients in a Sexually Transmitted Infections clinic. Braz J Infect Dis 2021; 25:101617. [PMID: 34508673 PMCID: PMC8426212 DOI: 10.1016/j.bjid.2021.101617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 08/01/2021] [Accepted: 08/12/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Mobility restrictions and overloaded health services during the COVID-19 pandemic compromised services dedicated to the prevention and care of HIV and other sexually transmitted infections (STI). In this study, we present client's responses to standardized questionnaires applied during the COVID-19 pandemic period as part of the strategy to measure impacts on social and sexual vulnerability, access to STI prevention services, and access to STI care. METHODS The questionnaires included variables on sociodemographics, behavior, risk perception, prevention attitudes, barriers to service-based HIV rapid test, reasons for taking an HIV self-test, and access to health services for STI diagnosis and treatment. We explored demographic variables associated with income reduction, reduced access to HIV/STI testing/treatment and increased vulnerability to HIV/STI. RESULTS 847 participants responded to the study questionnaire between May 2020 and January 2021. Most were young, cisgender male, and 63% self-reported as men who have sex with men. Income reductions were reported by 50%, with 30% reporting a decline over 50% of total income. An increase in heavy episodic drinking (>5 doses) was reported by 18%; 7% reported more sexual partners and 6% reported using condoms less often. Difficulties in obtaining HIV tests, tests for other STI and treatment for STI were reported by 5%, 6% and 6%, respectively. Lower schooling was significantly associated with income reduction (p = 0.004) and with reduced access to HIV/STI testing or STI treatment (p = 0.024); employment status was associated with income reduction (p < 0.001) and increased vulnerability to HIV/STI (p = 0.027). Having access to an expedite test result, avoiding physical attendance in health units during the pandemic, and undertaking the test with privacy with a trusted person were reported as motivators for HIV self-test. CONCLUSIONS Our findings are relevant to promote service improvements tailored to subgroups more likely to struggle with detrimental effects during and after the COVID-19 pandemic.
Collapse
|
43
|
Stephenson R, Walsh AR, Chavanduka TMD, Sallabank G, Horvath KJ, Castel AD, Bonar EE, Hightow-Weidman L, Bauermeister JA, Sullivan PS. Widespread closure of HIV prevention and care services places youth at higher risk during the COVID-19 pandemic. PLoS One 2021; 16:e0249740. [PMID: 34506488 PMCID: PMC8432816 DOI: 10.1371/journal.pone.0249740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/23/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Central to measuring the impact of the COVID-19 pandemic on HIV is understanding the role of loss of access to essential HIV prevention and care services created by clinic and community-based organization closures. In this paper, we use a comprehensive list of HIV prevention services in four corridors of the US heavily impacted by HIV, developed as part of a large RCT, to illustrate the potential impact of service closure on LGBTQ+ youth. METHODS We identified and mapped LGBTQ+ friendly services offering at least one of the following HIV-related services: HIV testing; STI testing; PrEP/PEP; HIV treatment and care; and other HIV-related services in 109 counties across four major interstate corridors heavily affected by HIV US Census regions: Pacific (San Francisco, CA to San Diego, CA); South-Atlantic (Washington, DC to Atlanta, GA); East-North-Central (Chicago, IL to Detroit, MI); and East-South-Central (Memphis, TN to New Orleans, LA). RESULTS There were a total of 831 LGBTQ+ youth-friendly HIV service providers across the 109 counties. There was a range of LGBTQ+ youth-friendly HIV-service provider availability across counties (range: 0-14.33 per 10,000 youth aged 13-24 (IQR: 2.13), median: 1.09); 9 (8.26%) analyzed counties did not have any LGBTQ+ youth-friendly HIV service providers. The Pearson correlation coefficient for the correlation between county HIV prevalence and LGBTQ+ youth-friendly HIV service provider density was 0.16 (p = 0.09), suggesting only a small, non-statistically significant linear relationship between a county's available LGBTQ+ youth-friendly HIV service providers and their HIV burden. CONCLUSIONS As the COVID-19 pandemic continues, we must find novel, affordable ways to continue to provide sexual health, mental health and other support services to LGBTQ+ youth.
Collapse
Affiliation(s)
- Rob Stephenson
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, United States of America
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States of America
| | - Alison R. Walsh
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, United States of America
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States of America
| | - Tanaka M. D. Chavanduka
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States of America
| | - Gregory Sallabank
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States of America
| | - Keith J. Horvath
- Department of Psychology, San Diego State University, San Diego, CA, United States of America
| | - Amanda D. Castel
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Erin E. Bonar
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States of America
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States of America
| | - Lisa Hightow-Weidman
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Jose A. Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Patrick S. Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| |
Collapse
|
44
|
Sentís A, Prats-Uribe A, López-Corbeto E, Montoro-Fernandez M, Nomah DK, de Olalla PG, Mercuriali L, Borrell N, Guadalupe-Fernández V, Reyes-Urueña J, Casabona J. The impact of the COVID-19 pandemic on Sexually Transmitted Infections surveillance data: incidence drop or artefact? BMC Public Health 2021; 21:1637. [PMID: 34493244 PMCID: PMC8423330 DOI: 10.1186/s12889-021-11630-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 08/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Before the COVID-19 pandemic, Sexually transmitted infections (STIs) were increasing in Europe, and Spain and Catalonia were not an exception. Catalonia has been one of the regions with the highest number of COVID-19 confirmed cases in Spain. The objective of this study was to estimate the magnitude of the decline, due to the COVID-19 pandemic, in the number of STI confirmed cases in Catalonia during the lockdown and de-escalation phases. METHODS Interrupted time series analysis was performed to estimate the magnitude of decline in the number of STI reported confirmed cases - chlamydia, gonorrhoea, syphilis, and lymphogranuloma venereum- in Catalonia since lockdown with historical data, from March 13th to August 1st 2020, comparing the observed with the expected values. RESULTS We found that since the start of COVID-19 pandemic the number of STI reported cases was 51% less than expected, reaching an average of 56% during lockdown (50% and 45% during de-escalation and new normality) with a maximum decrease of 72% for chlamydia and minimum of 22% for syphilis. Our results indicate that fewer STIs were reported in females, people living in more deprived areas, people with no previous STI episodes during the last three years, and in the HIV negative. CONCLUSIONS The STI notification sharp decline was maintained almost five months after lockdown started, well into the new normality. This fact can hardly be explained without significant underdiagnosis and underreporting. There is an urgent need to strengthen STI/HIV diagnostic programs and services, as well as surveillance, as the pandemic could be concealing the real size of the already described re-emergence of STIs in most of the European countries.
Collapse
Affiliation(s)
- Alexis Sentís
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalonia (CEEISCAT). Department of Health. Generalitat of Catalonia, Badalona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
- Epiconcept, Epidemiology Department, Paris, France
| | - Albert Prats-Uribe
- Centre for Statistics in Medicine, Botnar Research Centre, NDORMS, University of Oxford, Oxford, UK
| | - Evelin López-Corbeto
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalonia (CEEISCAT). Department of Health. Generalitat of Catalonia, Badalona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Marcos Montoro-Fernandez
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalonia (CEEISCAT). Department of Health. Generalitat of Catalonia, Badalona, Spain
| | - Daniel Kwakye Nomah
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalonia (CEEISCAT). Department of Health. Generalitat of Catalonia, Badalona, Spain
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autónoma de Barcelona, Badalona, Spain
| | - Patrícia Garcia de Olalla
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Epidemiological Service of Public Health Agency of Barcelona, Barcelona, Spain
| | - Lilas Mercuriali
- Epidemiological Service of Public Health Agency of Barcelona, Barcelona, Spain
| | - Núria Borrell
- Epidemiological Surveillance and Response to Public Health Emergencies Service in Tarragona Camp, Agency of Public Health of Catalonia, Generalitat of Catalonia, Tarragona, Spain
| | - Víctor Guadalupe-Fernández
- Epidemiological Surveillance and Response to Public Health Emergencies Service in Central Catalonia, Agency of Public Health of Catalonia, Generalitat of Catalonia, Manresa, Spain
| | - Juliana Reyes-Urueña
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalonia (CEEISCAT). Department of Health. Generalitat of Catalonia, Badalona, Spain.
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
| | - Jordi Casabona
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalonia (CEEISCAT). Department of Health. Generalitat of Catalonia, Badalona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autónoma de Barcelona, Badalona, Spain
| |
Collapse
|
45
|
Filho ESF, Machado RB. Contraceptive counseling during the pandemic: practical guidelines. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:579-584. [PMID: 34461669 PMCID: PMC10302448 DOI: 10.1055/s-0041-1735185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
46
|
Ranjbar F, Allahqoli L, Ahmadi S, Mousavi R, Gharacheh M, Eshraghi N, Alkatout I. Changes in pregnancy outcomes during the COVID-19 lockdown in Iran. BMC Pregnancy Childbirth 2021; 21:577. [PMID: 34420514 PMCID: PMC8380188 DOI: 10.1186/s12884-021-04050-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/12/2021] [Indexed: 12/14/2022] Open
Abstract
Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.
Collapse
Affiliation(s)
- Fahimeh Ranjbar
- Reproductive Health, Nursing Care Research Centre, Iran University of Medical Sciences, P.O. Box 19395-4798, Rashid Yasemi St., Valiasr Ave., Tehran, Iran
| | - Leila Allahqoli
- Reproductive Health, Nursing Care Research Centre, Iran University of Medical Sciences, P.O. Box 19395-4798, Rashid Yasemi St., Valiasr Ave., Tehran, Iran
| | - Soheila Ahmadi
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Robab Mousavi
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Gharacheh
- Reproductive Health, Nursing Care Research Centre, Iran University of Medical Sciences, P.O. Box 19395-4798, Rashid Yasemi St., Valiasr Ave., Tehran, Iran.
| | - Nooshin Eshraghi
- Department of Perinatology, Shahid Akbarabadi hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy. Campus Kiel, University Hospitals Schleswig-Holstein, Kiel, Germany
| |
Collapse
|
47
|
Adelekan B, Goldson E, Abubakar Z, Mueller U, Alayande A, Ojogun T, Ntoimo L, Williams B, Muhammed I, Okonofua F. Effect of COVID-19 pandemic on provision of sexual and reproductive health services in primary health facilities in Nigeria: a cross-sectional study. Reprod Health 2021; 18:166. [PMID: 34348757 PMCID: PMC8334336 DOI: 10.1186/s12978-021-01217-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Nigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive, maternal, child, and adolescent health (RMCAH) services in primary health care facilities across the Nigerian States. Methods This was a cross-sectional study of 307 primary health centres (PHCs) in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and provision of RMCAH services before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using frequency and percentage, summary statistics, and Kruskal–Wallis test. Results Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. During the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients’ utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19. Conclusions The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01217-5. The onset of COVID-19 has raised concerns that it may compromise women’s access to sexual and reproductive health and rights. Although data are still emerging, some reports indicate reduced access to sexual and reproductive health services, largely due to disruptions in the demand and supply of contraceptive commodities, the diversion of staff and resources to other clinical services, and clinic closures. While these concerns have similarly been broached for Nigeria, there has been no systematic documentation of the extent of the disruptions of reproductive health services caused by COVID-19 and its effects on the provision and utilization of related services in the country This study was a cross-sectional facility-based survey conducted in 10 states, 30 Local Government Areas and 302 primary health centres in Nigeria. The objective of the study was to explore through key informant interviews with service providers in the health centres, the effects of the COVID-19 pandemic on demand and supply of sexual and reproductive health services. Field assistants administered a semi-structured interview guide to the heads of the health centres that elicited information on availability and use of the health centres before, during and after the lock-downs associated with the pandemic. The results indicate that a large proportion of the health centres opened for the provision of essential sexual and reproductive health services during the COVID-19 pandemic lockdown. However, fewer clients used the services due to difficulties in travel because of the lockdowns, stock-outs in the health centres, and the fear that they may contract the virus if they leave their houses to the health centres. Although the health centres reported some cases of COVID-19, there was limited provision for personal protective equipment to motivate the health workers to optimize services for clients. From this study, we conclude that efforts should be made to identify innovations for addressing these challenges to enable the continued provision of sexual and reproductive health services by health centres despite the COVID-19 pandemic in Nigeria’s health centres.
Collapse
Affiliation(s)
| | - Erika Goldson
- United Nations Population Fund (UNFPA) Country Office, Abuja, Nigeria
| | - Zubaida Abubakar
- United Nations Population Fund (UNFPA) Country Office, Abuja, Nigeria
| | - Ulla Mueller
- United Nations Population Fund (UNFPA) Country Office, Abuja, Nigeria
| | - Audu Alayande
- United Nations Population Fund (UNFPA) Country Office, Abuja, Nigeria
| | - Tellson Ojogun
- United Nations Population Fund (UNFPA) Country Office, Abuja, Nigeria
| | - Lorretta Ntoimo
- Women's Health and Action Research Centre (WHARC), Km 11 Benin-Lagos Expressway, Igue-Iheya, Benin City, Edo, Nigeria.,Department of Demography and Social Statistics, Federal University Oye-Ekiti, Oye, Nigeria
| | | | | | - Friday Okonofua
- Women's Health and Action Research Centre (WHARC), Km 11 Benin-Lagos Expressway, Igue-Iheya, Benin City, Edo, Nigeria. .,Department of Demography and Social Statistics, Federal University Oye-Ekiti, Oye, Nigeria. .,Centre of Excellence in Reproductive Health Innovation (CERHI), University of Benin, Benin City, Nigeria. .,Department of Obstetrics and Gynaecology, School of Medicine, University of Benin, Benin City, Nigeria.
| |
Collapse
|
48
|
Navarrete J, Yuksel N, Schindel TJ, Hughes CA. Sexual and reproductive health services provided by community pharmacists: a scoping review. BMJ Open 2021; 11:e047034. [PMID: 34312200 PMCID: PMC8314704 DOI: 10.1136/bmjopen-2020-047034] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Pharmacists are increasingly providing patient-focused services in community pharmacies, including in the area of sexual and reproductive health (SRH). Specific SRH areas have been the focus of research, but a broader perspective is needed to position pharmacists as SRH providers. This review explored research that described and evaluated professional pharmacy services across a broad range of SRH areas. DESIGN Scoping review DATA SOURCES: Medline, EMBASE, CINAHL, Web of Science, Scopus and Cochrane Library (January 2007-July 2020). STUDY SELECTION Studies reporting on the description and evaluation of professional pharmacy SRH services provided by community pharmacists. DATA EXTRACTION Two investigators screened studies for eligibility, and one investigator extracted the data. Data were analysed to primarily describe professional pharmacy services and intervention outcomes. RESULTS Forty-one studies were included. The main SRH areas and professional pharmacy services reported were sexually transmitted and bloodborne infections (63%) and screening (39%), respectively. Findings showed that pharmacists' delivery of SRH services was feasible, able to reach vulnerable and high-risk groups, and interventions were highly accepted and valued by users. However, integration into daily workflow, pharmacist remuneration, cost and reimbursement for patients, and policy regulations were some of the barriers identified to implementing SRH services. Studies were primarily in specific areas such as chlamydia screening or hormonal contraception prescribing, while studies in other areas (ie, medical abortion provision, long-acting reversible contraception prescribing and vaccine delivery in pregnant women) were lacking. CONCLUSION This scoping review highlights the expansion of pharmacists' roles beyond traditional product-focused services in a number of SRH areas. Given the potential feasibility, users' acceptability and reach, pharmacists are ideally situated to enhance SRH care access. Future research describing implementation and evaluation of professional pharmacy services in all SRH areas is needed to promote access to these services through community pharmacies and position pharmacists as SRH providers worldwide.
Collapse
Affiliation(s)
- Javiera Navarrete
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Nese Yuksel
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Theresa J Schindel
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Christine A Hughes
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
49
|
Pilecco FB, McCallum CA, Almeida MDCCD, Alves FJO, Rocha ADS, Ortelan N, Gabrielli L, Menezes GMDS. Abortion and the COVID-19 pandemic: insights for Latin America. CAD SAUDE PUBLICA 2021; 37:e00322320. [PMID: 34231763 DOI: 10.1590/0102-311x00322320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/01/2021] [Indexed: 11/22/2022] Open
Abstract
The COVID-19 pandemic may accentuate existing problems, hindering access to legal abortion, with a consequent increase in unsafe abortions. This scenario may be even worse in low- and middle-income countries, especially in Latin America, where abortion laws are already restrictive and access to services is already hampered. Our objective was to understand how different countries, with an emphasis on Latin Americans, have dealt with legal abortion services in the context of the COVID-19. Thus, we conducted a narrative review on abortion and COVID-19. The 75 articles included, plus other relevant references, indicate that the pandemic affects sexual and reproductive health services by amplifying existing problems and restricting access to reproductive rights, such as legal abortion. This impact may be even stronger in low- and middle-income countries, especially in Latin America, where access to legal abortion is normally restricted. The revision of sources in this article underlines the urgent need to maintain legal abortion services, both from women's perspective, in support of their reproductive rights, but also from that of the international commitment to achieving the Millennium Development Goals. Thereby, Latin American countries must place reproductive rights as a priority on their agendas and adapt legislation to accommodate alternative models of abortion care. Furthermore, our results underscore the need for clear information on the functioning of sexual and reproductive health services as essential for understanding the impact of the pandemic on legal abortion and to identify the groups most affected by the changes.
Collapse
Affiliation(s)
- Flávia Bulegon Pilecco
- Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.,Rede CoVida - Ciência, Informação e Solidariedade, Salvador, Brasil
| | | | | | - Flávia Jôse Oliveira Alves
- Rede CoVida - Ciência, Informação e Solidariedade, Salvador, Brasil.,Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | - Aline Dos Santos Rocha
- Rede CoVida - Ciência, Informação e Solidariedade, Salvador, Brasil.,Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brasil.,Escola de Nutrição, Universidade Federal da Bahia, Salvador, Brasil
| | - Naiá Ortelan
- Rede CoVida - Ciência, Informação e Solidariedade, Salvador, Brasil.,Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brasil
| | - Lígia Gabrielli
- Rede CoVida - Ciência, Informação e Solidariedade, Salvador, Brasil.,Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | | |
Collapse
|
50
|
Nordhues HC, Bhagra A, Stroud NN, Vencill JA, Kuhle CL. COVID-19 Gender Disparities and Mitigation Recommendations: A Narrative Review. Mayo Clin Proc 2021; 96:1907-1920. [PMID: 34218863 PMCID: PMC8057762 DOI: 10.1016/j.mayocp.2021.04.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/02/2021] [Accepted: 04/07/2021] [Indexed: 12/23/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has rapidly created widespread impacts on global health and the economy. Data suggest that women are less susceptible to severe illness. However, sex-disaggregated data are incomplete, leaving room for misinterpretation, and focusing only on biologic sex underestimates the gendered impact of the pandemic on women. This narrative review summarizes what is known about gender disparities during the COVID-19 pandemic and the economic, domestic, and health burdens along with overlapping vulnerabilities related to the pandemic. In addition, this review outlines recommended strategies that advocacy groups, community leaders, and policymakers should implement to mitigate the widening gender disparities related to COVID-19.
Collapse
Key Words
- covid-19, coronavirus disease 2019
- gbv, gender-based violence
- lgbtq+, lesbian, gay, bisexual, transgender, queer, and other marginalized sexual orientations
- mhpss, mental health and psychosocial support
- or, odds ratio
- srh, sexual and reproductive health
- thb, trafficking in human beings
Collapse
Affiliation(s)
- Hannah C Nordhues
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN. https://twitter.com/@HannahNordhues
| | - Anjali Bhagra
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Natya N Stroud
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Jennifer A Vencill
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Carol L Kuhle
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| |
Collapse
|