COVID-19: How the pandemic disrupted contraceptive access in Tanzania, India and Nigeria
When the COVID-19 pandemic hit, many women across the globe faced more than just the threat of the virus. For thousands in Tanzania, India and Nigeria the crisis disrupted access to contraceptives and family planning (FP) services — leaving many vulnerable to unplanned pregnancies and the social and economic hardships that came with them.
A 2022 World Health Organization (WHO) study, published in Reproductive Health, sheds light on these experiences, showing how a mix of strained health systems and cultural pressures created major barriers for women at the primary healthcare level in the three countries.
WHO, Ifakara and partners lead the study
The study was led by Rita Kabra and James Kiarie of the WHO’s Department of Sexual and Reproductive Health and Research, with contributions from Ifakara Health Institute scientists Dr. Ester Elisaria, Mary Ramesh, and Donat Shamba.
Two layers of challenges
The research team interviewed 644 clients seeking contraceptive services across 11, 6 and 33 primary health facilities in India, Nigeria and Tanzania, alongside dozens of focus groups discussions, between May and August 2022. Their findings reveal two broad categories of obstacles.
- Health system failures
On one hand were health system failures such as a shortage of health workers, stock out of contraceptives or high cost of FP services. “Sometimes we went to the clinic and were told there were no supplies,” one participant in Tanzania explained. “We had to go home with nothing.”
- Barriers beyond the health sector
On the other hand, were challenges beyond the health sector. These included insufficient knowledge amongst clients about the availability of FP services, socio-cultural issues like spousal and in-law’s dominance on decision making, restriction in movement due to lockdown and fear of COVID-19 infection further complicated access. “Even if services were open, many of us feared leaving home,” a woman in Nigeria shared.
A call for preparedness
The study’s authors emphasize that these findings highlight the importance of building resilient systems that can withstand future crises. They recommend that ministries of health put emergency preparedness at the heart of family planning programs, ensuring not only consistent contraceptive supplies but also sufficient numbers of skilled providers — including female staff, who are often preferred for FP services.
Digital platforms, the researchers suggest, could play a key role in keeping communities informed about where and how to access services during emergencies. “Technology like e-health can help spread information about family planning services during emergencies,” the authors wrote.
And crucially, they emphasize the need for health education programs that actively involve men in family planning conversations, reducing the social and cultural barriers women often face.
Beyond the pandemic: magnifying gaps in sexual, reproductive health services
While COVID-19 has eased, the lessons remain urgent. The pandemic magnified longstanding gaps in sexual and reproductive health services that must be addressed before the next crisis strikes.
As the study concludes, protecting access to contraceptives in future emergencies will require more than medical supplies. The authors call for strong health systems, engaged communities, and a strong commitment to meeting women’s healthcare needs — even in the middle of a global health crisis.
Read the publication here.