ArticleBMJ open2023
Trends in fertility intentions and contraceptive practices in the context of COVID-19 in sub-Saharan Africa: insights from four national and regional population-based cohorts.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 11 citations in OpenAlex.
- The dynamics of family planning and abortion services during COVID-19: perspectives from healthcare providers and clients in Burkina Faso.Reproductive health · 2026Article
- Household wealth and timing of first birth among highly educated women in sub-Saharan Africa: evidence from survey-adjusted survival analysis.Frontiers in reproductive health · 2026Article
- From fertility intentions to contraceptive behaviour: evidence among women with children in Malawi.Frontiers in reproductive health · 2026Article
- Changes in Age-Specific Pregnancy Prevalence Proportions over the Covid-19 Pandemic in Manicaland, Zimbabwe.medRxiv : the preprint server for health sciences · 2025Article
- Cohort Profile: The Performance Monitoring for Action (PMA) panel surveys.International journal of epidemiology · 2024Article
- Trends in Adolescent Sexual and Reproductive Health Outcomes Before and Into the COVID-19 Pandemic in Burkina Faso and Kenya: Evidence From Panel Data.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2024Article
- Family planning service disruptions in the first two years of the COVID-19 pandemic: Evidence from health facilities in seven low- and middle-income countries.PLOS global public health · 2024Article
- Effects of the COVID-19 pandemic on sales of sexual and reproductive health products: an ecological study of pharmacies in Kenya.BMJ open · 2023Article
- Article
- Pregnancy and pregnancy intention after experiencing infertility: A longitudinal study of women in Malawi.PLOS global public health · 2023Article
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Authors and funding
10 authors at 5 institutions in 6 countries.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesStudies in several sub-Saharan geographies conducted early in the COVID-19 pandemic suggested little impact on contraceptive behaviours. Initial results may mask widening disparities with rising poverty, and changes to women's pregnancy desires and contraceptive use amid prolonged health service disruptions. This study examined trends in contraceptive behaviours in four sub-Saharan African settings 1 year into the pandemic.
designNationally and regionally representative longitudinal surveys.
settingBurkina Faso, Kenya, Democratic Republic of Congo (Kinshasa) and Nigeria (Lagos).
participantsWomen aged 15-49 years with sample size ranging from 1469 in Nigeria to 9477 in Kenya. OUTCOME MEASURES: Fertility preferences, contraceptive use and unintended pregnancies measured before COVID-19 (November 2019 to January 2020) and during COVID-19 (November 2020 to January 2021). ANALYSIS: We described population-level and individual-level changes by socioeconomic characteristics using generalised equation modelling. We used logistic regression models to identify factors related to contraceptive adoption and discontinuation and to experiencing an unintended pregnancy.
resultsAt the population level, we found no change in women's exposure to unintended pregnancy risk, alongside 5-9 percentage point increases in contraceptive prevalence in Burkina Faso, Kenya and Lagos. Reliance on provider-dependent methods dropped by 2 and 4 percentage points in Kenya and Burkina Faso, respectively, although these declines were not statistically significant. Between 1.0% and 2.8% of women across sites experienced an unintended pregnancy during COVID-19, with no significant change over time. Individual-level trajectories showed contraceptive adoption was more common than discontinuation in Burkina Faso, Kenya and Lagos, with little difference by sociodemographic characteristics. Women's COVID-19-related economic vulnerability was unrelated to unintended pregnancy across sites.
conclusionsThis study highlights the resilience of African women across diverse settings in sustaining contraceptive practices amid the COVID-19 pandemic. However, with reports of rising poverty in sub-Saharan Africa, there is continued need to monitor access to essential sexual and reproductive health services.
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