UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland.
Reproductive Health Supplies Coalition, Washington, DC, USA.
BMJ Open. 2022 Oct 27;12(10):e064848. doi: 10.1136/bmjopen-2022-064848.
This scoping review aimed to systematically search, retrieve and map the extent and characteristics of available literature on the evidenced disruptions to medical abortion (MA) medicine procurement caused by the COVID-19 outbreak.
Scoping review using Arksey and O'Malley's methodology and Levac 's methodological enhancement with adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews.
PubMed, Embase, PMC, Science Direct, the Cochrane Library and Google Scholar were searched from January 2020 to April 2022.
We included articles in English that: (1) contained information on MA medicines; (2) included descriptions of procurement disruptions, including those with examples, characteristics and/or statistics; (3) documented events during the COVID-19 pandemic; and (4) presented primary data.
Two reviewers independently screened search results, performed a full-text review of preliminarily included articles and completed data extraction in a standard Excel spreadsheet. Extracted data from was compared for validation and synthesised qualitatively.
The two articles included are unpublished grey literature demonstrating evidence of short-lived disruptions in sexual and reproductive health commodity procurement, including MA medicines, in sub-Saharan Africa during the early months of the pandemic. Findings from the two included grey literature articles show that in sub-Saharan contexts, emergency preparedness, stockpiling, adaptations and flexibility of key actors, including donors, alleviated COVID-19 disruptions allowing for resumption of services within weeks.
There is a need for increased empirical evidence of MA procurement challenges to understand which barriers to MA procurement may persist and impact continuity of supply while others can fuel resilience and preparedness efforts at the country and subregional levels. The lack of evidence from social marketing organisations and their networks is a significant gap as these actors constitute a vital artery in the distribution of MA commodities in low-income and middle-income countries.
本范围综述旨在系统地搜索、检索和绘制关于 COVID-19 大流行导致的医学流产（MA）药物采购中断的现有文献的范围和特征。
使用 Arksey 和 O'Malley 的方法和 Levac 的方法增强进行范围综述，同时遵守系统评价和荟萃分析扩展的首选报告项目。
从 2020 年 1 月至 2022 年 4 月，在 PubMed、Embase、PMC、Science Direct、Cochrane 图书馆和 Google Scholar 上进行了搜索。
我们纳入了英语文章，内容包括：（1）含有 MA 药物信息；（2）包括采购中断的描述，包括有示例、特征和/或统计数据；（3）记录了 COVID-19 大流行期间的事件；（4）呈现了原始数据。
两名评审员独立筛选检索结果，对初步纳入的文章进行全文审查，并在标准 Excel 电子表格中完成数据提取。从纳入的两篇灰色文献中提取的数据进行了比较验证，并进行了定性综合。
这两篇纳入的文章都是未发表的灰色文献，证明了在 COVID-19 大流行的早期几个月，撒哈拉以南非洲地区性和生殖健康商品采购，包括 MA 药物，出现了短暂中断。这两篇灰色文献文章的结果表明，在撒哈拉以南地区，包括捐助者在内的关键行为者的应急准备、库存、调整和灵活性，缓解了 COVID-19 的中断，使服务在数周内得以恢复。
需要增加 MA 采购挑战的实证证据，以了解哪些 MA 采购障碍可能持续存在并影响供应的连续性，而其他障碍则可以在国家和次区域层面增强弹性和准备工作。社会营销组织及其网络缺乏证据是一个重大差距，因为这些行为者构成了在低收入和中等收入国家分配 MA 商品的重要渠道。
