非洲在新冠疫情期间获取和利用性与生殖健康服务的障碍及促进因素：一项系统综述与荟萃分析

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.

作者信息

Bolarinwa Obasanjo Afolabi, Odimegwu Clifford, Ajayi Kobi V, Oni Tosin Olajide, Sah Rajeeb Kumar, Akinyemi Akanni

机构信息

Department of Public Health, York St John University, London, United Kingdom.

Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

BMC Health Serv Res. 2024 Dec 5;24(1):1554. doi: 10.1186/s12913-024-12028-2.

DOI:10.1186/s12913-024-12028-2

PMID:39639274

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11622569/

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.

摘要

背景

确保性与生殖健康（SRH）服务的不间断获取和利用对于预防不良的性与生殖健康结果仍然至关重要。然而，2019年冠状病毒病（COVID-19）的空前出现严重扰乱了非洲的大多数此类服务。因此，我们系统地回顾并研究了在非洲COVID-19大流行期间获取和利用SRH服务的障碍与促进因素。

方法

我们系统地检索了五个数据库，以查找2020年1月至2022年12月期间发表的相关文章，并按照JBI和PRISMA指南对文章进行筛选。报告了在COVID-19大流行期间获取和利用SRH服务的障碍与促进因素的元综合分析，同时使用R软件对非洲在COVID-19大流行期间获取和利用SRH服务障碍的合并患病率进行了荟萃分析。

结果

非洲在COVID-19大流行期间获取和利用SRH服务障碍的合并患病率为26%。针对已确定的障碍制定了七个主题（医疗服务中断、恐惧和错误信息、资源可用性有限、居住地点和地区、医护人员态度/人力、交通不便以及耻辱和歧视），而针对已确定的促进因素制定了六个主题（对弱势群体的支持、社会人口特征、社区外展项目、政策调整、远程医疗和数字健康以及性与生殖商品选择的变化）。