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. 2021 Oct;47(4):252-260.
doi: 10.1136/bmjsrh-2020-200944. Epub 2021 Feb 12.

Contraceptive dynamics during COVID-19 in sub-Saharan Africa: longitudinal evidence from Burkina Faso and Kenya

Celia Karp  1 , Shannon N Wood  2 , Georges Guiella  3 , Peter Gichangi  4 , Suzanne O Bell  2 , Philip Anglewicz  2 , Elizabeth Larson  2 , Linnea Zimmerman  2 , Caroline Moreau  2   5
Affiliations

Contraceptive dynamics during COVID-19 in sub-Saharan Africa: longitudinal evidence from Burkina Faso and Kenya

Celia Karp et al. BMJ Sex Reprod Health. 2021 Oct.

Abstract

Introduction: Evidence from health emergencies suggests COVID-19 will disrupt women's sexual and reproductive health (SRH). In sub-Saharan Africa, which experiences the highest rates of unintended pregnancy and unsafe abortion globally, COVID-19 is projected to slow recent progress toward universal access to contraceptive services.

Methods: We used longitudinal data collected from women at risk of unintended pregnancy in Burkina Faso (n=1186) and Kenya (n=2784) before (November 2019-February 2020) and during (May-July 2020) COVID-19 to quantify contraceptive dynamics during COVID-19; examine sociodemographic factors and COVID-19 experiences related to contraceptive dynamics; and assess COVID-19-related reasons for contraceptive non-use. Bivariate and multivariate logistic regressions were used to examine correlates of contraceptive dynamics amid COVID-19.

Results: Most women did not change their contraceptive status during COVID-19 (68.6% in Burkina Faso and 81.6% in Kenya) and those who did were more likely to adopt a method (25.4% and 13.1%, respectively) than to discontinue (6.0% and 5.3%, respectively). Most women who switched contraceptives were using methods as or more effective than their pre-pandemic contraception. Economic instability related to COVID-19 was associated with increased contraceptive protection in Burkina Faso but not in Kenya. Altogether, 14.4% of non-contraceptive users in Kenya and 3.8% in Burkina Faso identified COVID-19-related reasons for non-use.

Conclusions: The vast majority of women at risk of unintended pregnancy did not change their contraceptive status during COVID-19, and more women adopted than discontinued methods. A minority of women reported COVID-19-related reasons for non-use, underscoring the importance of expanding safe modes of service delivery during health crises.

Keywords: COVID-19; contraception behavior; epidemiology; family planning services; reproductive health services; surveys and questionnaires.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Changes to contraceptive use status between pre-COVID-19 and during COVID-19 by country.
Figure 2
Figure 2
Change in women’s individual contraceptive practices and method type by country and pre-COVID-19 contraceptive use.
See this image and copyright information in PMC

References

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