Department of Bioengineering, University of Washington, Seattle, Washington, USA.
Department of Sexual and Reproductive Health, WHO, Geneve, Switzerland.
BMJ Glob Health. 2022 Oct;7(10). doi: 10.1136/bmjgh-2022-009594.
The COVID-19 pandemic has negatively impacted health systems globally and widened preexisting disparities. We conducted a scoping review on the impact of the COVID-19 pandemic on women and girls' access to and utilisation of sexual and reproductive health (SRH) services for contraception, abortion, gender-based and intimate partner violence (GBV/IPV) and sexually transmitted infections (STIs).
We systematically searched peer reviewed literature and quantitative reports, published between December 2019 and July 2021, focused on women and girls' (15-49 years old) access to and utilisation of selected SRH services during the COVID-19 pandemic. Included studies were grouped based on setting, SRH service area, study design, population and reported impact. Qualitative data were coded, organised thematically and grouped by major findings.
We included 83 of 3067 identified studies and found that access to contraception, in-person safe abortion services, in-person services for GBV/IPV and STI/HIV testing, prevention and treatment decreased. The geographical distribution of this body of research was uneven and significantly less representative of countries where COVID-19 restrictions were very strict. Access was limited by demand and supply side barriers including transportation disruptions, financial hardships, limited resources and legal restrictions. Few studies focused on marginalised groups with distinct SRH needs.
Reports indicated negative impacts on access to and utilisation of SRH services globally, especially for marginalised populations during the pandemic. Our findings call for strengthening of health systems preparedness and resilience to safeguard global access to essential SRH services in ongoing and future emergencies.
COVID-19 大流行对全球卫生系统产生了负面影响,并扩大了先前存在的差距。我们对 COVID-19 大流行对妇女和女孩获得和利用避孕、堕胎、基于性别的和亲密伴侣暴力(GBV/IPV)以及性传播感染(STIs)等生殖健康(SRH)服务的影响进行了范围界定审查。
我们系统地搜索了同行评议文献和定量报告,这些文献和报告发表于 2019 年 12 月至 2021 年 7 月之间,重点关注 COVID-19 大流行期间妇女和女孩(15-49 岁)获得和利用选定的 SRH 服务的情况。纳入的研究根据背景、SRH 服务领域、研究设计、人群和报告的影响进行分组。定性数据进行了编码、主题组织,并按主要发现进行分组。
我们纳入了 3067 项已识别研究中的 83 项,发现避孕、现场安全堕胎服务、现场 GBV/IPV 和 STI/HIV 检测、预防和治疗服务的可及性降低。该研究的地理分布不均,明显不能代表 COVID-19 限制非常严格的国家。可及性受到供需双方障碍的限制,包括交通中断、经济困难、资源有限和法律限制。很少有研究关注具有不同 SRH 需求的边缘化群体。
报告表明,全球范围内获得和利用 SRH 服务的情况受到负面影响,尤其是在大流行期间,边缘化人群受到的影响更大。我们的研究结果呼吁加强卫生系统的准备和恢复能力,以保障在当前和未来的紧急情况下全球获得基本的 SRH 服务。