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

2021 ◽  
pp. bmjsrh-2020-200944
Author(s):  
Celia Karp ◽  
Shannon N Wood ◽  
Georges Guiella ◽  
Peter Gichangi ◽  
Suzanne O Bell ◽  
...  

IntroductionEvidence 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.MethodsWe 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.ResultsMost 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.ConclusionsThe 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.

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lesley Rose Ninsiima ◽  
Isabel Kazanga Chiumia ◽  
Rawlance Ndejjo

Abstract Background Despite the global agreements on adolescents’ sexual and reproductive health and rights, access to and utilisation of these services among the youth/adolescents remain unsatisfactory in low- and middle-income countries which are a significant barrier to progress in this area. This review established factors influencing access and utilisation of youth-friendly sexual and reproductive health services (YFSRHS) among the youth in sub-Saharan Africa to inform programmatic interventions. Methodology A systematic review of studies published between January 2009 and April 2019 using PubMed, Web of Science, EMBASE, Medline, and Cochrane Library, and Google Scholar databases was conducted. Studies were screened based on the inclusion criteria of barriers and facilitators of implementation of YFSRHS, existing national policies on provision of YFSRHS, and youth’s perspectives on these services. Findings A total of 23,400 studies were identified through database search and additional 5 studies from other sources. After the full-text screening, 20 studies from 7 countries met the inclusion criteria and were included in the final review. Structural barriers were the negative attitude of health workers and their being unskilled and individual barriers included lack of knowledge among youth regarding YFSRHS. Facilitators of utilisation of the services were mostly structural in nature which included community outreaches, health education, and policy recommendations to improve implementation of the quality of health services and clinics for adolescents/youth to fit their needs and preferences. Conclusion Stakeholder interventions focusing on implementing YFSRHS should aim at intensive training of health workers and put in place quality implementation standard guidelines in clinics to offer services according to youth’s needs and preferences. In addition, educating the youth through community outreaches and health education programs for those in schools can facilitate utilisation and scale up of the service.


2017 ◽  
Vol 03 (02) ◽  
pp. E52-E59 ◽  
Author(s):  
Sikolia Wanyonyi ◽  
Charles Mariara ◽  
Sudhir Vinayak ◽  
William Stones

AbstractThe potential benefits of obstetric ultrasound have yet to be fully realized in sub-Saharan Africa (SSA), despite the region bearing the greatest burden of poor perinatal outcomes. We reviewed the literature for challenges and opportunities of universal access to obstetric ultrasound and explored what is needed to make such access an integral component of maternity care in order to address the massive burden of perinatal morbidity and mortality in SSA. Original peer-reviewed literature was searched in various electronic databases using a ‘realist’ approach. While the available data were inconclusive, they identify many opportunities for potential future research on the subject within the region that can help build a strong case to justify the provision of universal access to ultrasound as an integral component of comprehensive antenatal care.


2021 ◽  
Author(s):  
Sally Sutton ◽  
John Butterworth

While governments and development partners focus on improving community and utility-managed water supplies to ensure access for all, hundreds of millions of people are taking actions to supply their own water. In the WASH sector household investment in construction and improvement of facilities is widely employed in sanitation but in water similar efforts are ignored. Recognition of the contribution of self-supply towards universal access to water and its full potential, is hampered by a lack of data, analysis and guidance. This well-reasoned source book highlights the magnitude of the contribution of self-supply to urban and rural water provision world-wide, and the gains that are possible when governments recognise and support household-led supply development and up-grading. With limited public finances in low- (and many middle-) income countries, self-supply can fill gaps in public provision, especially amongst low-density rural populations. The book focuses on sub-Saharan Africa as the region with the greatest predicted shortfall in achieving the 2030 Sustainable Development Goal for water. Household supplies can be created, or accelerated to basic or safely managed levels, through approaches that build on the investment and actions of families, with the availability of technology options and cost-effective support from the private and public sectors. The role of self-supply needs greater recognition and a change in mindset of governments, development partners and practitioners if water services are to be extended to all and no-one is to be left behind.


2010 ◽  
Vol 21 (1) ◽  
pp. e64-e69 ◽  
Author(s):  
André R Maddison ◽  
Walter F Schlech

The United Nations millennium development goal of providing universal access to antiretroviral therapy (ART) for patients living with HIV/AIDS by 2010 is unachievable. Currently, four million people are receiving ART, of an estimated 13.7 million who need it. A major challenge to achieving this goal is the shortage of health care workers in low-income and low-resource areas of the world. Sub-Saharan African countries have 68% of the world’s burden of illness from AIDS, yet have only 3% of health care workers worldwide. The shortage of health care providers is primarily caused by a national and international ‘brain drain,’ poor distribution of health care workers within countries, and health care worker burnout.Even though the millennium development goal to provide universal access to ART will not be met by 2010, it is imperative to continue to build on the momentum created by these humanitarian goals. The present literature review was written with the purpose of attracting research and policy attention toward evidence from small-scale projects in sub-Saharan Africa, which have been successful at increasing access to ART. Specifically, a primary-care model of ART delivery, which focuses on decentralization of services, task shifting and community involvement will be discussed. To improve the health care worker shortage in sub-Saharan Africa, the conventional model of health care delivery must be replaced with an innovative model that utilizes doctors, nurses and community members more effectively.


2019 ◽  
Vol 4 (2) ◽  
pp. e001233 ◽  
Author(s):  
Jennifer Hollowell ◽  
Mari Dumbaugh ◽  
Mireille Belem ◽  
Sylvain Kousse ◽  
Tessa Swigart ◽  
...  

IntroductionEffective stimulation and responsive caregiving during the first 2 years is crucial for children’s development. By age 3–4 years, over 40% of children in sub-Saharan Africa fail to meet basic cognitive or socioemotional milestones, but there are limited data on parenting and childcare practices. This study, conducted to inform the design of a mass media intervention, explored practices, perceptions, motivators and obstacles to childhood development-related practices among parents and caregivers of children aged 0–2 years in rural Burkina Faso.MethodsWe performed two rounds of six focus groups with 41 informants in two villages, using an adapted version of the Trials of Improved Practices methodology. These first explored beliefs and practices, then introduced participants to the principles and benefits of early childhood development (ECD) and provided illustrative examples of three practices (interactive ways of talking, playing and praising) to try with their children. One week later, further discussions explored participants’ experiences and reactions. Data were analysed inductively using thematic content analysis.ResultsExisting activities with young children were predominantly instructive with limited responsive interaction and stimulation. Participants were receptive to the practices introduced, noted positive changes in their children when they adopted these practices and found engagement with children personally rewarding.ConclusionInteractive, stimulating activities with young children did not appear to be widespread in the study area, but caregivers were receptive to information about the importance of early stimulation for children’s development. ECD messages should be tailored to the local sociocultural context and consider time limitations.


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