Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Sep 7;22(Suppl 3):159.
doi: 10.1186/s12978-025-02123-w.

Access to contraceptive services during the COVID-19 pandemic: clients' perspective at primary health care level from India, Nigeria and Tanzania

Rita Kabra  1 , Komal Preet Allagh  2 , Tanimola Makanjuola Akande  3 , Ester Elisaria  4 , Beena Joshi  5 , Adesola Olumide  6 , Mary Ramesh  7 , Donat Shamba  7 , Deepti Tandon  8 , Ranjan Prusty  9 , Bhavya Mk  5 , Shabana Khan  5 , James Kiarie  10
Affiliations
Multicenter Study

Access to contraceptive services during the COVID-19 pandemic: clients' perspective at primary health care level from India, Nigeria and Tanzania

Rita Kabra et al. Reprod Health. .

Abstract

Background: The COVID-19 pandemic disrupted the provision of sexual and reproductive health services, including contraceptive and family planning (FP) services. The World Health Organization conducted a multi-country study in India, Nigeria and Tanzania to assess the impact of the pandemic on the health system's capacity to provide contraceptive and FP services. In this paper, we share the results of a qualitative study aimed at understanding clients' perspectives at the primary healthcare level on accessing contraceptive services in COVID-19-affected areas in the three aforementioned countries.

Methods: We conducted interviews with 644 clients seeking contraceptive services across 11, 6 and 33 primary health facilities in India, Nigeria and Tanzania. A total of 44 focus group discussions (FGDs) and 128 in-depth interviews were conducted with clients at the facility and 22 FGDs within the community. Data collection took place from May 2022 to August 2022. Ethical approval was obtained from the WHO Ethics Review Committee and national regulatory bodies. All interviews were analysed using the general approach of content analysis.

Results: Clients at primary health care facilities faced several challenges in accessing contraceptive services. These challenges were grouped into two main categories. The first was related to the unprepared health system (supply), such as a shortage of health workers, stock out of contraceptives or high cost of FP services. The second category was outside the remit of the health system and included insufficient knowledge amongst clients about the availability of FP services, socio-cultural issues like spousal and in-laws' dominance on decision making, restriction in movement due to lockdown and fear of COVID-19 infection.

Conclusions: This study highlights the obstacles clients faced in accessing contraceptives during the COVID-19 pandemic in Nigeria, India, and Tanzania. To address these barriers in future crises, ministries of health must establish functional emergency preparedness across all healthcare levels. These plans should prioritize both on the sufficient number/gender of skilled health providers and the availability of contraceptives till the last mile. Utilizing e-health can help keep communities well informed on where, how and when to avail FP services during such emergencies. Health educational programs should actively engage men to gain further support.

Keywords: Barriers; COVID-19; Contraceptives; Family planning; Primary health facilities; Qualitative study.

Plain language summary

The COVID-19 pandemic disrupted many healthcare services, including sexual and reproductive healthcare, such as contraceptive and family planning services. Our study conducted in India, Nigeria, and Tanzania aimed to understand the impact of the COVID-19 pandemic on contraceptive and family planning services. This paper presents findings on the experiences of male and female clients accessing contraceptive services at primary health facilities during the pandemic across these countries. We interviewed 424 women and 220 of their male partners seeking contraceptive services in primary health facilities in the three countries between May and August 2022.Clients at health facilities in all three countries faced many challenges in getting contraceptives. They faced problems like not enough staff at the facility, unavailability of contraceptives, fear of getting COVID-19 infection, not knowing where to find family planning services, increased cost of contraceptive services, no transportation to go to the facility or pressure from family members about decisions.Health ministries need to plan better to tackle these issues in future emergencies. They need to make sure that there are enough trained staff and that contraceptives are available everywhere. Technology like e-health can help spread information about family planning services during emergencies. Also, it's important to educate men to get their support for family planning.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
Overview of themes and sub-themes summarizing the barriers faced by clients in accessing FP and contraceptive services during the COVID-19 pandemic
See this image and copyright information in PMC

References

    1. World Health Organization. Timeline: WHO’s COVID-19 response. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interact.... Accessed date 9 Feb 2024.
    1. Polis CB, Biddlecom A, Singh S, Ushie BA, Rosman L, Saad A. Impacts of COVID-19 on contraceptive and abortion services in low- and middle-income countries: a scoping review. Sex Reprod Health Matt. 2022;30(1):2098557. https://www.tandfonline.com/doi/full/10.1080/26410397.2022.2098557. Retrieved on 9 February 2024. - DOI - PMC - PubMed
    1. VanBenschoten H, Kuganantham H, Larsson EC, Endler M, Thorson A, Gemzell-Danielsson K, et al. Impact of the COVID-19 pandemic on access to and utilisation of services for sexual and reproductive health: a scoping review. BMJ Global Health. 2022;7(10):e019171. https://gh.bmj.com/content/bmjgh/7/10/e009594.full.pdf. Retrieved on 9 February 2024. - PMC - PubMed
    1. 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(20):252. https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s.... Retrieved on 9 February 2024. - DOI - PMC - PubMed
    1. World Health Organization. Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report. 2020. https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-sur.... Retrieved on 27 February 2024.

Publication types

MeSH terms

LinkOut - more resources