Evidence on sexual and reproductive health service delivery during and post COVID-19: a multi-country facility assessment

The COVID-19 pandemic significantly disrupted global health systems, and sexual and reproductive health (SRH) were among the services often receiving less priority compared to other urgent health needs. Anticipated disruptions included limited access to contraception, abortion care, sexually transmitted infections (STI) prevention, and gender-based violence (GBV) support, particularly in low- and middle-income countries. This study aimed to assess the availability, readiness, and recovery of SRH services during and after the pandemic across nine countries. This repeated cross-sectional, mixed-methods study was implemented in collaboration with national Ministries of Health across nine countries: Brazil, Burkina Faso, China, England, Ghana, Italy, Kenya, Pakistan, and Thailand. Data were collected from health facilities and SRH clients at two time points: during peak COVID-19 transmission and post-pandemic. Standardized facility assessments and client interviews were analyzed using multilevel logistic regression models. Qualitative data were collected through in-depth interviews and focus group discussions in selected countries to explore service disruptions, health system adaptations, and psychosocial impacts. Thematic analysis identified context-specific challenges and coping strategies. Of 4,346 clients interviewed, 2,292 from seven countries were included in the final analysis. Post-pandemic improvements were modest, with gains in STI testing and GBV response training. Family planning and abortion services showed minimal recovery. Systemic vulnerabilities such as outpatient closures, staff shortages, and supply chain failures contributed to service disruptions. Facilities adopted resilience strategies including telemedicine, task shifting, and triaging. Qualitative findings revealed emotional strain among healthcare providers, stigma, and informal coping mechanisms, underscoring the need for integrated mental health support and flexible service delivery models. The pandemic exposed critical weaknesses in SRH service delivery but also highlighted opportunities for strengthening health system resilience. Integrating qualitative insights enhances understanding of lived experiences and local innovations, essential for building adaptable and accessible SRH systems. Sustained investment in workforce support, supply chains, and context-specific service models is vital for future health emergency preparedness.

Authors

Institutions

Publication Details

Journal
Reproductive Health
Published
2025-11-20
DOI
https://doi.org/10.1186/s12978-025-02185-w
Citations
1
Primary Topic
COVID-19 Impact on Reproduction
Type
article
Field-Weighted Citation Impact
2.06
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Evidence on sexual and reproductive health service delivery during and post COVID-19: a multi-country facility assessment

Vanessa Brizuela, Deborah Williams, Séni Kouanda, Deda Ogum Alangea et al.
1 citations
Reproductive Health
COVID-19 Impact on Reproduction
2.06
article

Evidence on sexual and reproductive health service delivery during and post COVID-19: a multi-country facility assessment

Vanessa Brizuela, Deborah Williams, Séni Kouanda, Deda Ogum Alangea, Igor Toskin, Jörg Huber, Jaime H. Vera, Marina Baig, Stefano Uccella, Jen Sothornwit, Karla Simônia de Pádua, Aline Munezero, Hamsadvani Kuganantham, Hanxiyue Zhang, Xizhuo Xie, Simone Garzon, Armando Seuc, Ranieri Poli, Moazzam Ali, Abdu Mohiddin, Adom Manu, Yifan Zhu, Anna Thorson, Marleen Temmerman, José Guilherme Cecatti, Rozina Karmaliani, Karayna Gil Fernandes, Kwasi Torpey, Yang Ge, Laila Ladak, Caron Kim, Vilma Zotareli, Hao Wang, Ernest Maya, Silvana Ferreira Bento, Arusa Lakhani, Grace Kapustianyk, Gabriela Garcia Camacho, Luís Bahamondes, Joy J. Chebet, Somporn Rungreangkulkij, Chunxiao Peng, Flore Marie Gisèle Donessouné, Alexandra Sawyer, Eunice Chomi, Mariana B. Rogerio, Alessia Savoldi, Nigel Sherriff, Massimo Mirandola, Montas Laporte, Rachel Esteves Soeiro, Nampet Jampathong, Ferdinand Okwaro, Charles M. Charles, Emefa Modey, Yasmin Nadeem Parpio, Maddalena Cordioli, Salima Somani, Armel Emmanuel Sogo, Yueping Guo, Kun Tang, Samira M. Haddad, Pisake Lumbiganon, Catherine Aicken, Soe Soe Thwin, Hugo Gamerro Abrego
article en
1 citations

Abstract

The COVID-19 pandemic significantly disrupted global health systems, and sexual and reproductive health (SRH) were among the services often receiving less priority compared to other urgent health needs. Anticipated disruptions included limited access to contraception, abortion care, sexually transmitted infections (STI) prevention, and gender-based violence (GBV) support, particularly in low- and middle-income countries. This study aimed to assess the availability, readiness, and recovery of SRH services during and after the pandemic across nine countries. This repeated cross-sectional, mixed-methods study was implemented in collaboration with national Ministries of Health across nine countries: Brazil, Burkina Faso, China, England, Ghana, Italy, Kenya, Pakistan, and Thailand. Data were collected from health facilities and SRH clients at two time points: during peak COVID-19 transmission and post-pandemic. Standardized facility assessments and client interviews were analyzed using multilevel logistic regression models. Qualitative data were collected through in-depth interviews and focus group discussions in selected countries to explore service disruptions, health system adaptations, and psychosocial impacts. Thematic analysis identified context-specific challenges and coping strategies. Of 4,346 clients interviewed, 2,292 from seven countries were included in the final analysis. Post-pandemic improvements were modest, with gains in STI testing and GBV response training. Family planning and abortion services showed minimal recovery. Systemic vulnerabilities such as outpatient closures, staff shortages, and supply chain failures contributed to service disruptions. Facilities adopted resilience strategies including telemedicine, task shifting, and triaging. Qualitative findings revealed emotional strain among healthcare providers, stigma, and informal coping mechanisms, underscoring the need for integrated mental health support and flexible service delivery models. The pandemic exposed critical weaknesses in SRH service delivery but also highlighted opportunities for strengthening health system resilience. Integrating qualitative insights enhances understanding of lived experiences and local innovations, essential for building adaptable and accessible SRH systems. Sustained investment in workforce support, supply chains, and context-specific service models is vital for future health emergency preparedness.

Reproductive HealthVol. 22(S3)
World Health Organization (CH), Instituto Nacional de Higiene, Epidemiología y Microbiología (CU)
Openalex Percentile: Top 10%
COVID-19 Impact on Reproduction
2.06
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.