Short-term effects of the COVID-19 state of emergency on contraceptive access and utilization in Mozambique

PLoS One. 2021 Mar 25;16(3):e0249195. doi: 10.1371/journal.pone.0249195. eCollection 2021.

Abstract

The COVID-19 pandemic has increasingly disrupted the global delivery of preventive health care services, as a large number of governments have issued state of emergency orders halting service delivery. However, there is limited evidence on the realized effects of the pandemic and associated emergency orders on access to services in low-income country contexts to date. To address this gap, this paper analyzes administrative data on utilization of contraceptive health services by women referred via community health promoters in two large urban and peri-urban areas of Mozambique. We focus on the period immediately surrounding the national state of emergency declaration linked to the COVID-19 pandemic on March 31, 2020. Data reported for 109,129 women served by 132 unique promoters and 192 unique public health facilities is analyzed using logistic regression, interrupted time series analysis and hazard analysis. The results demonstrate that the imposition of the state of emergency is associated with a modest short-term drop in both service provision and utilization, followed by a relatively rapid rebound. We conclude that in this context, the accessibility of reproductive health services was not dramatically reduced during the first phase of the pandemic-related emergency.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • COVID-19 / pathology*
  • COVID-19 / virology
  • Contraceptive Agents / administration & dosage*
  • Female
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Interrupted Time Series Analysis
  • Logistic Models
  • Mozambique
  • Proportional Hazards Models
  • Referral and Consultation
  • SARS-CoV-2 / isolation & purification
  • Young Adult

Substances

  • Contraceptive Agents

Grants and funding

JL (based at IFPRI and prior to that American University) received a grant from the federal Office of Evaluation Sciences (oes.gsa.gov) linked to this project. CH received compensation from this grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.