International Food Policy Research Institute, Washington, DC, United States of America.
Department of Economics, American University, Washington, DC, United States of America.
PLoS One. 2021 Mar 25;16(3):e0249195. doi: 10.1371/journal.pone.0249195. eCollection 2021.
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.
新冠疫情 大流行导致大量政府发布紧急状态命令以停止服务提供，从而越来越多地打乱了全球预防性保健服务的开展。然而，迄今为止，关于大流行和相关紧急命令对低收入国家获取服务的实际影响的证据有限。为了解决这一差距，本文分析了莫桑比克两个大城市和城郊地区通过社区卫生促进者转介的妇女使用避孕保健服务的管理数据。我们重点关注与 2020 年 3 月 31 日宣布的与新冠疫情相关的国家紧急状态相关的时期。使用逻辑回归、中断时间序列分析和风险分析对 132 名独特的促进者和 192 个独特的公共卫生机构所服务的 109,129 名妇女报告的数据进行了分析。结果表明，紧急状态的实施与服务提供和利用的适度短期下降有关，随后是相对较快的反弹。我们的结论是，在这种情况下，生殖健康服务的可及性在与疫情相关的紧急情况的第一阶段并没有大幅降低。
