Barriers and facilitators to accessing and utilising sexual and reproductive health services during the COVID-19 pandemic in Africa: a systematic review and meta-analysis.

Publication date: Dec 05, 2024

Ensuring uninterrupted access and utilisation of sexual and reproductive health (SRH) services remains crucial for preventing adverse SRH outcomes. However, the unprecedented emergence of the 2019 coronavirus disease (COVID-19) significantly disrupted most of these services in Africa. Thus, we systematically reviewed and examined barriers and facilitators to accessing and utilising SRH services during the COVID-19 pandemic in Africa. We systematically searched five databases for relevant articles published between January 2020 to December 2022, and the articles were screened following the JBI and PRISMA guidelines. Meta-synthesis of barriers and facilitators to accessing and utilising SRH services during the COVID-19 pandemic were reported, while a meta-analysis of the pooled prevalence of barriers to accessing and utilising SRH services during the COVID-19 pandemic in Africa was analysed using R. The pooled prevalence of barriers to accessing and utilising SRH services during the COVID-19 pandemic in Africa was 26%. Seven themes were developed for the identified barriers (disruption of healthcare services, fear and misinformation, limited availability of resources, place & region of residence, healthcare staff attitude/manpower, limited access to transportation, and stigma and discrimination), whilst six themes were developed for the identified facilitators (support for vulnerable populations, socio-demographic characteristics, community outreach programs, policy adaptations, telemedicine and digital health, and change in choice of sexual and reproductive commodities). This study found that the COVID-19 pandemic significantly impacted SRH service access and utilisation in Africa. We recommend that future research consider a longitudinal examination of the pandemic on African SRH services. PROSPERO registration number: CRD42022373335.

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Concepts Keywords
Coronavirus Access
Crd42022373335 Africa
December Africa
Healthcare Barriers
Misinformation COVID-19
COVID-19
Facilitators
Female
Health Services Accessibility
Humans
Pandemics
Reproductive Health Services
SARS-CoV-2
Social Stigma
Utilisation

Semantics

Type Source Name
disease MESH COVID-19 pandemic
pathway KEGG Coronavirus disease
drug DRUGBANK Etoperidone
pathway REACTOME Reproduction
drug DRUGBANK Coenzyme M
disease MESH morbidity
disease MESH sexually transmitted diseases
disease MESH gender based violence
disease MESH maternal deaths
disease IDO quality
drug DRUGBANK Indoleacetic acid
drug DRUGBANK Norethindrone enanthate
drug DRUGBANK Medroxyprogesterone acetate
disease IDO facility
disease MESH sexual violence
drug DRUGBANK Trestolone
drug DRUGBANK Isoxaflutole
drug DRUGBANK Serine
drug DRUGBANK Methionine
disease IDO intervention
disease IDO process
disease IDO country
drug DRUGBANK Pentaerythritol tetranitrate
drug DRUGBANK Ilex paraguariensis leaf
disease MESH emergencies
drug DRUGBANK Tretamine
disease MESH long haul COVID 19
drug DRUGBANK L-Isoleucine
drug DRUGBANK Naproxen
disease MESH malaria
pathway KEGG Malaria
disease MESH reproductive tract infections
disease MESH Sando
disease MESH unwanted pregnancies
disease MESH Unintended pregnancy
disease IDO host
disease MESH structural violence
drug DRUGBANK Methyl isocyanate
disease MESH Health Services Accessibility
disease MESH Social Stigma

Original Article

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