Mixed methods study to determine the impact of the COVID-19 pandemic on availability, utilization, and readiness of family planning and contraceptive services at selected primary health care facilities in Africa and Asia: A study protocol (Preprint)

Abstract

The COVID-19 pandemic and the associated social restrictions may have disrupted the provision of essential services, including family planning and contraceptive services. This protocol is adapted from a generic study protocol titled ‘Health systems analysis and evaluations of the barriers to availability and readiness of sexual and reproductive health services in COVID-19 affected areas’, conducted by the WHO Department of Reproductive Health and Research.

This study aims to assess the availability and utilization of family planning and contraceptive services in primary health facilities during and after the COVID-19 pandemic, assess the risk perceptions of COVID-19 stigma, barriers to access, and quality of services from clients’ and providers’ perspectives in the COVID-19 affected areas and to assess the post-pandemic recovery of the facilities in the provision of family planning and contraceptive services.

The study will be conducted in India, Nigeria and Tanzania by the Indian Council of Medical Research -National Institute of Research in Reproductive and Child Health, the University of Ilorin Teaching hospital and the Ifakara Health Institute, respectively. In each country, study sites will be selected based on geographical location, organization of family planning and contraceptive services and epidemic status where the COVID-19 pandemic is likely to have significantly affected service delivery. This study uses a mix of quantitative and qualitative methods. In-depth interviews will be conducted with clients (women in the reproductive age group and their male partners who visit the selected health facilities for FP and contraceptive services) and health providers (the most knowledgeable person on FP and contraceptive service provision) at the selected health facilities. Focus group discussions with be conducted with clients at the selected health facilities and in the community. The in-depth interviews and focus group discussions will help to understand clients' and health service providers' perspectives of FP and contraceptive service availability and readiness in COVID-19 affected areas. A cross-sectional health facility assessment will be conducted in all the selected health facilities to determine the health facility infrastructure's ability and readiness to provide FP and contraceptive services and to capture the trends in FP and contraceptive services available during the COVID-19 pandemic. Scientific approval for this study is obtained from the WHO Research Project Review Panel, and the WHO Ethics Review Committee has given ethical approval in the three countries.

Using a standardized research protocol will ensure that the results from this study can be compared across regions and countries.

The findings from this study will provide a better understanding of the impact of the COVID-19 pandemic on family planning and contraceptive services at the facility level, which will help policymakers and health managers develop and strengthen FP policies and services to be more responsive to community needs by strengthening FP service delivery in the health facilities.