Factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown: An online cross-sectional survey
Abstract BackgroundThe COVID-19 pandemic has caused a wide range of disruptions in health care access in many low and middle income countries. The aim of this study was to explore factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown. MethodsThis was an online cross-sectional study carried out from April 2020 to May 2020 in Uganda. An online questionnaire was used and participants aged 18years to 30 years were recruited using the snowballing approach. The statistical analysis was done using STATA version 14.2.Results Out of 724 participants, 203 (28%) reported not having information and/or education concerning sexual and reproductive health (SRH). About a quarter of the participants (26.9%, n=195) reported not having access to testing and treatment services of sexually transmitted infections during the lockdown. Lack of transport means was the commonest (68.7%) limiting factor to accessing SRH services during the lockdown followed by the long distance from home to SRH facilities (55.2%), high cost of services (42.2%) and curfew conditions (39.1%). Sexually transmitted infections were the commonest (40.4%) problems related to SRH during the lockdown followed by unwanted pregnancy (32.4%) and sexual abuse (32.4%). Limiting factors were more prevalent among the co-habiting youths [CPR: 1.3 (1.13-1.49) and APR:1.2 (1.06-1.41)] followed by unemployed [CPR: 1.3 (1.09 - 1.53) and APR:1.2 (1 - 1.42)] and non-salaried [APR:1.2 (1- 1.42)] than other participants. The bivariate and multivariate regression analyses indicate that problems were more prevalent among the co-habiting youths [CPR: 2.7 (1.88 - 3.74) and APR: 2.3 (1.6 - 3.29)] followed by the unemployed [CPR: 2 (1.27 - 3.2) and APR: 1.6 (1.03 - 2.64)] than in other categories. ConclusionThe findings of this study show that Ugandan youths had limited access to SRH information and services during the COVID-19 lockdown. Cohabiting and unemployed youths were the most affected by problems related to SRH. Lack of transport means and high cost of services were the major limiting factors to access SRH services among the youths. The findings call for concerted efforts from the Government and other stakeholders to incorporate SRH among the priority services when designing responses to any outbreak crisis.