Background/objectives
We examined the effect of the COVID-19 pandemic on Family Planning(FP) service provision and clients' FP service access in selected Primary Health Care (PHC) facilities in India, Nigeria and Tanzania. Findings from Nigeria are presented.
Materials and methods
A mixed methods study was conducted in six rural/peri-urban and urban Local Government Areas (LGAs) in Kano, Kwara and Oyo states. One PHC per LGA was purposively selected in each state. Qualitative data were obtained through in-depth interviews(IDIs) and focus group discussions(FGDs) with female clients and their partners, FGDs with community women and IDIs with two healthcare providers per PHC. Quantitative methods involved assessment of infrastructure and review of FP records (August 2019 to April 2022) in the PHCs. Quantitative data were analysed using descriptive statistics. Thematic analysis was used for qualitative data.
Results
Eighty-two IDIs and 20 FGDS were conducted. Disruptions to essential FP service provision experienced included limited FP services, changes in service delivery schedules and stockout. Disruptions were mainly attributed to COVID-19-control movement restrictions, deployment of staff to provide COVID-19 relief, insufficient commodities, and reduced clientele. Disruptions were mitigated by conducting limited outreaches to sensitize community members about modifications in service delivery, task shifting and role relegation and client referral to other facilities. Clients expressed frustrations about difficulties encountered with accessing FP during the pandemic. These were due to movement restrictions, closure of facilities, prolonged wait-times, changes in procedures for accessing care and commodity stockout, especially injectables. Record review revealed a drop in clientele which was more marked in the rural PHCs compared to the urban PHCs.
Conclusions
Family planning services were significantly affected by the COVID-19 pandemic. Measures to ensure FP services continue during epidemics should be implemented to prevent major reversals in gains in contraceptive prevalence rates made over the years.
