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

Bolarinwa, Obasanjo ORCID: https://orcid.org/0000-0002-9208-6408, Odimegwu, Clifford, Ajayi, Kobi V., Oni, Tosin Olajide, Sah, Rajeeb Kumar and Akinyemi, Akanni (2024) 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. BMC Health Services Research, 24 (1).

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Official URL: https://doi.org/10.1186/s12913-024-12028-2

Abstract

Background: 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. Methods: 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. Results: 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). Conclusion: 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. Trial registration: PROSPERO registration number: CRD42022373335.