COVID-19 and access to sexual and reproductive health services: Perspectives from adolescents and women in rural areas of Enugu State, Nigeria
The coronavirus disease 2019 (COVID-19) pandemic has a far-reaching effect on human activities and relationships, especially on sexual and reproductive health (SRH). The pandemic exposed the unpreparedness of the governments of many nations to respond to the longstanding health needs of the people. Adopting a qualitative research design, this study examined access to quality and affordable SRH in Enugu stat, Nigeria, during COVID-19 pandemic. Our findings revealed that SRH products were not easily accessible due to the prolonged lockdowns attributed to the pandemic. Adolescents and women were discouraged from procuring and accessing SRH services due to artificially induced high prices of the products and the added feeling of nosocomephobia which kept people away from medical centers. More effort is needed by government and non-governmental organizations to strengthen access to SRH products in Nigeria, especially during pandemic.
Adedini, S.A., Odimegwu, C., Imasiku, E.N., & Ononokpono, D.N. (2015). Unmet need for family planning: Implication for under-five mortality in Nigeria. Journal of Health Population and Nutrition, 33(1):187-206.
Aly, J., Haeger, K.O., Christy, A.Y., & Johnson, A.M. (2020). Contraception access during the COVID-19 pandemic. Contraception and Reproductive Medicine, 5(17):17. https://doi.org/10.1186/s40834-020-00114-9
Asante, K.O. (2013). HIV/AIDS knowledge and uptake of HIV counselling and testing among undergraduate private university students in Accra, Ghana. Reproductive Health, 10:17. https://doi.org/10.1186/1742-4755-10-17
Boserup, B., McKenney, M., & Elkbuli, A. (2020). Alarming trends in US domestic violence during the COVID-19 pandemic. American Journal of Emerging Medicine, 38(12):2753-2755. https://doi.org/10.1016/j.ajem.2020.04.077
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2):77-101. https://doi.org/10.1191/1478088706qp063oa
Brieger, W.R., Osamor, P.E., Salami, K.K., Oladepo, O., & Otusanya, S.A. (2004). Interactions between patent medicine vendors and customers in urban and rural Nigeria. Health Policy Plan, 19(3):177-182. https://doi.org/10.1093/heapol/czh021
Church, K., Gassner, J., & Elliott, M. (2020). Reproductive health under COVID-19-challenges of responding in a global crisis. Sexual and Reproductive Health Matters, 28(1):1-3. https://doi.org/10.1080/26410397.2020.1773163
Denno, D.M., Hoopes, A.J., & Chandra-Mouli, V. (2015). Effective strategies to provide adolescent sexual and reproductive health services and to increase demand and community support. Journal of Adolescent Health, 56(1 Suppl):S22-S41. https://doi.org/10.1016/j.jadohealth.2014.09.012
Cone, D., & Lamarche, A. (2021). A Crisis of Care: Sexual and Reproductive Health Competes for Attention amid Conflict and Displacement in Mali. Washington, DC: Refugees International.
Enwereji, E.E., & Enwereji, K.O. (2013). Increasing use of reproductive health services through community-based and health care financing programmes: Impact and sustainability in Abia state of Nigeria. Global Advanced Research Journal of Peace, Gender and Development, 2(4):81-85.
Esterberg, K. (2002). Qualitative Methods in Social Research. Boston: McGraw Hill.
Fagbamigbe, A.F., & Ojebuyi, B.R. (2017). Influence of spousal communication about family planning and HIV/AIDS-related issues on modern contraceptive use in Nigeria. Journal of Health Management, 19(2):320-333. https://doi.org/10.1177/0972063417699693
IntegratE Project. (2021). Women’s Perceptions on the Effects of COVID-19 on Access and Use of Private Sector Family Planning Services in Nigeria: The IntegratE Project. Available from: https://www.integrateeproject.org.ng [Last accessed on 2022 Jan 05].
International Monetary Fund. (2021). Policy Responses to COVID-19: Policy Tracker. Available from: https://www. imf.org/en/topics/imf-and-covid19/policy-response-to-covid-19#top [Last accessed on 2021 Aug 07].
International Women’s Health Coalition. (2020). Sexual and Reproductive Health during the COVID-19 Crisis. Available from: https://iwhc.org/2020/03/sexual-and-reproductive-health-during-the-covid-19-crisis [Last accessed on 2021 Sep 11].
Ipas. (2017). Abortion Law and Policy in Nigeria: Barriers to Women’s Access to Safe and Legal Care. Available from: https://www.ipas.org/en/resources/ipas%20publications/ abortion-law-and-policy-in-nigeria-barriers-to-women’s-access-to-safe-and-legal-care.aspx [Last accessed on 2021 Feb 02].
Jemisenia, J.O., Asogwa, U.S., Adejoh, A., Melugbo, D.U., & Owoeye, G. (2021). Taking the maximum risks for satisfaction: Understanding the process of condom discontinuation among national youth service corps’ members in Nigeria. International Journal of Sexual Health, 33(2):193-209. https://doi.org/10.1080/19317611.2021.1880515
Kanabe, M. (2021). World Contraception Day: Nigerians Should Carry Condoms Like Sanitary Pads, Shaving Sticks. Available from: https://www.premiumtimesng.com/news/ headlines/486741-interview-world-contraception-day-nigerians-should-carry-condoms-like-sanitary-pads-shaving-sticks-official.html [Last accessed on 2022 Jan 19].
Kassahun, E.A., Zeleke, L.B., Dessie, A.A., Gersa, B.G., Oumer, H.I., Derseh, H.A., et al. (2019). Factors associated with unintended pregnancy among women attending antenatal care in Maichew Town, Northern Ethiopia, 2017. BMC Research Notes, 12(1):381. https://doi.org/10.1186/s13104-019-4419-5
Lamina, M.A. (2015). Prevalence and determinants of unintended pregnancy among women in South-Western Nigeria. Ghana Medical Journal, 49(3):187-194. http://doi.org/10.4314/gmj.v49i3.10
Marrone, G., Abdul-Rahman, L., De Conink, Z., & Johansson, A. (2014). Predictors of contraceptive use among female adolescents in Ghana. African Journal of Reproductive Health, 18(1):102-109.
Melesse, D.Y., Mutua, M.K., Choudhury, A., Wado Y.D., Faye, C.M., Nael, S., et al. (2020). Adolescent sexual and reproductive health in sub-Saharan Africa: Who is left behind? BMJ Global Health, 5(1):e002231. https://doi.org/10.1136/bmjgh-2019-002231
Ming, L.S. (2020). Condom supply to global fund: An analysis of participation by Malaysian companies. Interdisciplinary Research and Review, 15(1):16-21.
National Health Research Ethics Committee. (2020). Promoting Highest Ethical and Scientific Standards for Health Research in Nigeria. Nigeria: Gazette of the Nigerian Federal Ministry of Health.
Nigeria Demographic and Health Survey. (2018). The 2018 Nigeria Demographic and Health Survey. Nigeria: National Population Commission (NPC).
Ninsiima, L.R., Chiumia, I.K., & Ndejjo, R. (2021). Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: A systematic review. Reproductive Health, 18(135):135. https://doi.org/10.1186/s12978-021-01183-y
Odo, A.N., Samuel, E.S., Nwagu, E.N., Nnamani, P.O., & Atama, C.S. (2018). Sexual and reproductive health services (SRHS) for adolescents in Enugu state, Nigeria: A mixed methods approach. BMC Health Services Research, 18(1):92: https://doi.org/10.1186/s12913-017-2779-x
Oshikoya, K.A., Senbanlo, I.O., & Njokanma, O.F. (2009). Self-medication for infants with colic in Lagos, Nigeria. BMC Peadiatrics, 9:9. https://doi.org/10.1186/1471-2431-9-9
Oyeyemi, A.S., Oladepo, O., Adeyemi, A.O., Titiloye, M.A., Burnett, S.M., & Apera, I. (2020). The potential role of patent and proprietary medicine vendors’ associations in improving the quality of services in Nigeria’s drug shops. BMC Health Services Research, 20(1):567. https://doi.org/10.1186/s12913-020-05379-z
Pierce, J.I. (2003). Introduction to special issues. Qualitative Sociology, 26(2):307-312.
Silva, P. (2015). The Key to Youth-Friendly Sexual and Reproductive Health Services. Available from: https:// www.iwhc.org/2015/01/key-youth-friendly-sexual-reproductivehealth-services [Last accessed on 2022 Jun 30].
Sogarwal, R., Chandra, M., & Mehra, S. (2013). Youth friendly health services and role of outreach activities to improve access to services. Open Journal of Preventive Medicine, 3(2):191-198. https://doi.org/10.4236/ojpm.2013.32026
UNFPA. (2015). Reproductive Health of Women. Available from: https://www.unfpa.org [Last accessed on 2021 Feb 02].
Walensky, R.P., & Del Rio, C. (2020). From mitigation to containment of the COVID-19 pandemic: Putting the SARS-CoV-2 genie back in the bottle. JAMA, 323(19):1889-1890. https://doi:10.1001/jama.2020.6572
World Health Organization, & Pan American Health Organization. (2000). Sexual and Reproductive Health and Research. Available from: https://www.who.int/teams/ sexual-and-reproductive-health-and-research/key-areas-of-work/sexual-health/defining-sexual-health [Last accessed on 2021 Feb 02].
Xue, J., Chen, J., Chen, C., Hu, R., & Zhu, T. (2020). The hidden pandemic of family violence during COVID-19: Unsupervised learning of tweets. Journal of Medical Internet Research, 22(11):e24361. https://doi.org/10.2196/24361