Factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown: An online cross-sectional survey

Abstract

Background The COVID-19 pandemic has disrupted health care access in many countries. The aim of this study was to explore factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown. Methods This was across-sectional study carried out from April 2020 to May 2020 in Uganda. A questionnaire was administered online to participants aged 18 to 30 years. Subjects were recruited using a snowballing approach. STATA version 14.2 was used for statistical analysis.Results Of 724 participants, 203 (28%) reported that they did not have access to information and/or education concerning sexual and reproductive health (SRH). More than a quarter of the participants (26.9%, n=195) reported that testing and treatment services of sexually transmitted infections were not available during the lockdown. 27.2% could not obtain contraceptive supplies. Access to HIV services and menstrual supplies were also impaired. Lack of transportation was the commonest factor cited as limiting access to SRH services during the lockdown (68.7%), followed by the long distance from home to SRH facilities (55.2%), high cost of services (42.2%) and the curfew (39.1%). Sexually transmitted infections were the commonest SRH problems related to SRH during the lockdown (40.4%) followed by unwanted pregnancy (32.4%) and sexual abuse (32.4%). Marital, educational, and employment status were significantly correlated with the reported experiences of the participants. Conclusion Access to SRH information and services for Ugandan youths was restricted during the COVID-19 lockdown and may have increased the incidence of poor SRH outcomes. Lack of transportation, distance to health facilities, and high cost of services were important limiting factors. The Government and other stakeholders should incorporate SRH among the priority services to be preserved during future outbreaks.

Impact of the COVID-19 Pandemic on Adolescents’ Sexual and Reproductive Health in Low- and Middle-Income Countries

“…Moreover, adolescents reported not having access to contraceptives and menstrual hygiene products. This was also reported in other studies and was due to the social distancing or lockdown in most countries during the peak of COVID-19 [ 35 , 36 ]. However, there were alternative measures deployed in some countries to reach out to adolescents and youth, to access some sexual and reproductive health services.…”

Young people’s choice and voice concerning sex and relationships: effects of the multicomponent Get Up Speak Out! Programme in Iganga, Uganda

“…The impact of these efforts may have been eclipsed by changes at the policy level. COVID-19 has also reduced the access to SRHR information and services in Uganda [18,38] and may partially explain the decreasing percentages of SRH service and contraception use over time as found in this study.…”

Impact of the COVID-19 pandemic on access to and utilisation of services for sexual and reproductive health: a scoping review

“…Studies were conducted in all seven major geographical (World Bank) regions of the world; 28% of the studies were done in North America,28–50 28% in sub-Saharan Africa,51–73 20% in Europe and Central Asia,74–90 8% in East Asia & Pacific,91–97 5% in Latin America and the Caribbean,98–101 2% in South Asia102 103 and 1% in the Middle East and North Africa 104. Studies were conducted in more than 34 countries.…”

“…105 STIs/HIV services Nearly half of included studies (40, 48%) found a decrease in access or utilisation of STIs/HIV services. 35 40 41 44 53 55-62 64-66 69-73 79 85 91-96 100 104 106 108 STI testing reductions were reported in Uganda, 53 the USA, 35 Jordan, 104 Thailand 95 and Uganda. 60 Simões et al 79 found that 95% of community STI testing clinics in 53 countries in Europe and Central Asia experienced decreased testing for all STIs, while Nagendra et al and Chow et al noted significant reductions in asymptomatic STI screening in the USA and Australia, respectively.…”