Adefalu Adewole Adebola, Bankole Olufunke Abimbola, Olabode Funmilayo, Afolabi Mojuba Bimbo, Buba Miranda Atare, Dafe Victor, Kalu Mishael Nnanna, Watkins Emily
JSI Research & Training Institute, Inc., Atlanta, GA, USA.
JSI Research & Training Institute, Inc., Abuja, FCT, Nigeria.
Open Access J Contracept. 2025 May 26;16:59-70. doi: 10.2147/OAJC.S494588. eCollection 2025.
The COVID-19 pandemic caused significant disruptions to sexual and reproductive health (SRH) services globally, with a pronounced impact on low- and middle-income countries like Nigeria. This study investigates how COVID-19 travel restrictions influenced the uptake of depot medroxyprogesterone acetate subcutaneous (DMPA-SC) and other injectable contraceptives in Nigeria.
This study analyzed 26 months of secondary logistics data from the national electronic Health Logistics Management Information System (e-HLMIS), covering 36 states and encompassing periods before, during, and after the implementation of travel restrictions. Statistical analyses, including one-way ANOVA and independent samples -tests, were applied to assess trends in the consumption of DMPA-SC and compare them with other injectable contraceptives, such as intramuscular DMPA (DMPA-IM) and norethisterone enanthate (NET-EN).
Findings showed a significant increase in DMPA-SC consumption during the travel restriction period, with mean consumption rising from 57,187 units pre-restriction to 103,249 units during the restriction. This increase persisted post-restriction, with mean consumption reaching 124,561 units. While the use of other injectable contraceptives also rose during the pandemic, their growth did not sustain as consistently as DMPA-SC.
The results suggest that promoting self-administration of DMPA-SC was essential in maintaining contraceptive access when conventional healthcare services were disrupted. This study highlights the importance of adaptable healthcare delivery models, such as self-administration, in ensuring SRH service continuity during global crises. Additionally, it underscores the need for resilient supply chain management to secure contraceptive availability in emergencies, providing critical insights for policymakers and healthcare providers aiming to enhance SRH service resilience in future public health challenges.
新冠疫情对全球的性与生殖健康服务造成了重大干扰,对尼日利亚等低收入和中等收入国家产生了显著影响。本研究调查了新冠疫情期间的旅行限制如何影响尼日利亚醋酸甲羟孕酮皮下注射剂(DMPA-SC)及其他注射用避孕药具的使用情况。
本研究分析了来自国家电子卫生物流管理信息系统(e-HLMIS)的26个月的二级物流数据,数据覆盖36个州,涵盖旅行限制实施前、实施期间和实施后的时间段。采用包括单因素方差分析和独立样本检验在内的统计分析方法,评估DMPA-SC的消费趋势,并将其与其他注射用避孕药具进行比较,如醋酸甲羟孕酮肌肉注射剂(DMPA-IM)和庚酸炔诺酮(NET-EN)。
研究结果显示,在旅行限制期间,DMPA-SC的消费量显著增加,平均消费量从限制前的57,187单位增至限制期间的103,249单位。这种增长在限制解除后仍持续,平均消费量达到124,561单位。虽然在疫情期间其他注射用避孕药具的使用也有所增加,但其增长不如DMPA-SC那样持续稳定。
结果表明,在传统医疗服务受到干扰时,推广DMPA-SC的自我给药对于维持避孕措施的可及性至关重要。本研究强调了适应性医疗服务提供模式(如自我给药)在全球危机期间确保性与生殖健康服务连续性方面的重要性。此外,它还强调了在紧急情况下确保避孕药具供应的弹性供应链管理的必要性,为旨在增强未来公共卫生挑战中性与生殖健康服务弹性的政策制定者和医疗服务提供者提供了关键见解。