Keywords: COVID-19 pandemic; Contraception; Family planning; Mixed methods.

Plain language summary

The objectives of this study were to assess the impact of COVID-19 on family planning and contraception and to strengthen policies and services to be more responsive to community needs in Brazil. We used mixed quantitative and qualitative methods to assess SRH service availability and readiness, and clients’ and providers’ perceptions in three COVID-19-affected areas. Interviews were performed at baseline and 6–9 months later. We used five questionnaires for assessing infrastructure availability and readiness to provide SRH services and a qualitative survey to capture health service providers´ perspectives. The qualitative in-depth interviews (IDI) and Focus Group Discussions (FGD) with women and partners were conducted using a semi-structured interview. A thematic content analysis was then performed. The settings had different characteristics influencing the way they faced COVID-19. During the baseline interview, the population mentioned fear of seeking health support in the PHU; however, the same was still observed in one city in the end-line. Antenatal and post-partum care was offered to the population; however, contraception that was considered a priority was not. Contradictory speeches of the government leaders caused discredit to the health measures recommended by the WHO, evidencing the need for alignment among health managers at all levels. The municipal administration plus the coordinators of the health services played a key role in the fight against COVID-19. Contraception was not considered a priority during the pandemic, although participants said they should be essential in future pandemics. The PHU readiness offered antenatal and post-partum care, while other population needs were not prioritized.