The Effects of COVID-19 Pandemic on Family Planning Access and Use at Primary Health Centres in Rivers State, Nigeria

Introduction: The COVID-19 pandemic has posed challenges especially to health systems and population health. Many countries enforced border closures and implemented lockdowns which affected many sectors of the society. Increasing case load has led to many health authorities reassigning healthcare professionals and reorganizing existing health services to combat COVID-19 which may have affected routine and essential healthcare services, including family planning.

Aims: This study aimed to assess the impact of COVID-19 pandemic and restrictions on the access and use of family planning among clients in primary health facilities in Rivers State, Nigeria.

Study Design: Cross sectional survey.

Place and Duration of Study: Participants were recruited from eighteen primary health centres across six Local Government Areas (district) of Rivers State. Data was collected between 7th July and 9th August 2021.

Methodology: Women of reproductive age attending family planning clinic, antenatal sessions, post-natal clinic and immunizations sessions were interviewed using systematic random sampling. The questionnaire was adapted from the Research for Scalable Solution standardized questionnaire on family planning.

Results: A total of 759 women were interviewed and the mean age of participants was 32.19 (SD±7.49). 44.3% (n=314) of respondents had met need of family planning before the pandemic which increased to 64.8% (n=305) post-lockdown. Also, the unmet need for family planning was higher than the State average during the lockdown. 21.0% (n=50) had an unmet need for child birth spacing while 10.5% (n=25) had an unmet need for limiting. Furthermore, 34.2% (n=26) of respondents reported unintended pregnancies. Finally, there was a family planning method shift post-pandemic to long-acting reversible contraception being preferred.

Conclusion: The lockdown and restrictions had impacted the met and unmet need for family planning. Also, there was a method shift of family planning method seen. These findings can be taken into consideration in cases of future public health emergencies.