Background: To protect the gains made in sexual and reproductive health in Ethiopia over the past several decades, care for childbearing women and newborn infants needs to continue during the pandemic. The provision of safe abortion and contraceptive services remains critical. When staff and services are under extreme stress there is a real risk of increasing avoidable harm. This case study aims to determine the impact of COVID-19 on contraception and safe abortion care services at a tertiary facility in Ethiopia.
Materials and Methods: We collected data on safe abortion and contraception services from service delivery units from March through May 2020. For comparison, and due to seasonal variation in caseload throughout the year, we pulled data from March through May 2019.
Results: Deliveries and immediate postpartum family planning have decreased by 27.6% and 66.7% respectively during the pandemic compared to the same months last year. Overall, the number of clients presenting for family planning was reduced by 27%. Safe abortion services and comprehensive abortion care were reduced by 16.4% and 20.31% respectively. Likewise, family planning service utilization among safe abortion and post-abortion clients were reduced by 40.6%, and 39.7% respectively.
Conclusion and recommendations: The COVID-19 pandemic is significantly impairing safe abortion and contraception services. Both contraception and abortion services have decreased significantly following the COVID-19 pandemic. These findings underscore that the Ethiopia Federal Ministry of Health (FMOH) and their partners (donors and non-government organizations) must take swift action, including defining abortion care and contraceptive services as essential services to continue during the pandemic. Innovative methods, such as telehealth (voice or video calls), self-care interventions, and utilization of health extension workers, need to be maximized to maintain and increase access to these essential health services.
2. Rate C-F. Characteristics of Patients Dying in Relation to COVID-19 in Italy Onder G, Rezza G, Brusaferro S. JAMA Published online March. 2020;23.
3. FIGO. COVID-19 Contraception and Family Planning. https://www.figo.org/covid-19-contraception-and-family-planning[Available from https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/.
4. FSRH, RCOG & RCM statement provision of postpartum contraception during Covid-19 - Faculty of Sexual and Reproductive Healthcare [Available from https://www.fsrh.org/documents/fsrh-rcog-rcm-statement-postpartum-contraception-covid19/.
5. Tolu LB, Feyissa GT. Guidelines and best practice recommendations on contraception and safe abortion care service provision amid COVID-19 pandemic: Scoping review. available at Research Square [+https://doi.org/10.21203/rs.3.rs-25326/v1+].
6. Current performance of COVID-19 test methods and devices and proposed performance criteria - Working document of Commission services. https://eceuropaeu/docsroom/documents/40805.
7. Riley T, Sully E, Ahmed Z, Biddlecom A. Estimates of the potential impact of the COVID-19 pandemic on sexual and reproductive health in low-and middle-income countries. Int Perspect Sex Reprod Health. 2020;46:46.
8. Sochas L, Channon AA, Nam S. Counting indirect crisis-related deaths in the context of a low-resilience health system: the case of maternal and neonatal health during the Ebola epidemic in Sierra Leone. Health policy and planning. 2017;32(suppl_3):iii32-iii9.
9. Camara BS, Delamou A, Diro E, Béavogui AH, El Ayadi AM, Sidibé S, et al. Effect of the 2014/2015 Ebola outbreak on reproductive health services in a rural district of Guinea: an ecological study. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2017;111(1):22-9.
10. Remme M, Narasimhan M, Wilson D, Ali M, Vijayasingham L, Ghani F, et al. Self-care interventions for sexual and reproductive health and rights: costs, benefits, and financing. BMJ. 2019;365.
11. Tolu LB, Jeldu WG. Guidelines and best practice recommendations on reproductive health services provision amid COVID-19 pandemic: Scoping review. 2020.