ArticleReproductive health2022
Health system resilience during COVID-19 understanding SRH service adaptation in North Kivu.
Article in Reproductive health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- A systematic review of the indirect impacts of COVID-19 on sexual and reproductive health services and outcomes in humanitarian settings.BMJ global health · 2023Pooled it
- Getting unstuck: reframing health systems strengthening and resilience in fragile and conflict-affected settings.BMJ global health · 2026Review
- Resilience of health systems in Africa to infectious disease shocks: A qualitative evidence synthesis.PLOS global public health · 2026Article
- No Matter When or Where: Addressing the Need for Continuous Family Planning Services During Shocks and Stressors.Global health, science and practice · 2024Article
- COVID-19 epidemiology, health services utilisation and health care seeking behaviour during the first year of the COVID-19 pandemic in Mweso health zone, Democratic Republic of Congo.Journal of global health · 2024Article
- Covid-19 vaccination: a mixed methods analysis of health system resilience in Latin America.International journal for equity in health · 2024Article
- Adapting to a global pandemic: a qualitative assessment of programmatic responses to COVID-19 in the multi-country Women's Integrated Sexual Health (WISH) programme.Sexual and reproductive health matters · 2023Article
- Estimating induced abortion incidence and the use of non-recommended abortion methods and sources in two provinces of the Democratic Republic of the Congo (Kinshasa and Kongo Central) in 2021: results from population-based, cross-sectional surveys of reproductive-aged women.Sexual and reproductive health matters · 2023Article
- Assessing the impact of COVID-19 pandemic on maternal healthcare usage: evidence from routine health data in Kenya and Ethiopia.BMJ public health · 2023Article
- Resilience of undergraduate health sciences students during COVID-19: An integrative review.Health SA = SA Gesondheid · 2023Article
- COVID-19 impacts on healthcare access in sub-Saharan Africa: an overview.The journal of venomous animals and toxins including tropical diseases · 2023Article
- Uptake of reproductive, maternal and child health services during the first year of the COVID-19 pandemic in Uganda: A mixed methods study.PLOS global public health · 2023Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThere is often collateral damage to health systems during epidemics, affecting women and girls the most, with reduced access to non-outbreak related services, particularly in humanitarian settings. This rapid case study examines sexual and reproductive health (SRH) services in the Democratic Republic of the Congo when the COVID-19 hit, towards the end of an Ebola Virus Disease (EVD) outbreak, and in a context of protracted insecurity.
methodsThis study draws on quantitative analysis of routine data from four health zones, a document review of policies and protocols, and 13 key-informant interviews with staff from the Ministry of Public Health, United Nations agencies, international and national non-governmental organizations, and civil society organizations.
resultsUtilization of SRH services decreased initially but recovered by August 2020. Significant fluctuations remained across areas, due to the end of free care once Ebola funding ceased, insecurity, number of COVID-19 cases, and funding levels. The response to COVID-19 was top-down, focused on infection and prevention control measures, with a lack of funding, technical expertise and overall momentum that characterized the EVD response. Communities and civil society did not play an active role for the planning of the COVID-19 response. While health zone and facility staff showed resilience, developing adaptations to maintain SRH provision, these adaptations were short-lived and inconsistent without external support and funding.
conclusionThe EVD outbreak was an opportunity for health system strengthening that was not sustained during COVID-19. This had consequences for access to SRH services, with limited-resources available and deprioritization of SRH.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.