Evidence map›Paper›PMID 40983932›Full record

ArticleReproductive health2025

Evaluating health system barriers to sexual and reproductive health service delivery during the COVID-19 pandemic in China: a mixed-methods study.

Hanxiyue Zhang, Hao Wang, Xizhuo Xie, Angela Y Xiao, Moazzam Ali, Caron Kim, Grace H M Kapustianyk, Kun Tang

Abstract read
In one paragraph

Article in Reproductive health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hanxiyue ZhangVanke School of Public Health, Tsinghua University, Beijing, China.
Hao WangVanke School of Public Health, Tsinghua University, Beijing, China.
Xizhuo XieVanke School of Public Health, Tsinghua University, Beijing, China.
Angela Y XiaoVanke School of Public Health, Tsinghua University, Beijing, China.
Moazzam AliDepartment of Sexual and Reproductive Health and Research, WHO, Geneve, Switzerland.
Caron KimDepartment of Sexual and Reproductive Health and Research, WHO, Geneve, Switzerland.
Grace H M KapustianykDepartment of Sexual and Reproductive Health and Research, WHO, Geneve, Switzerland.
Kun TangVanke School of Public Health, Tsinghua University, Beijing, China. tangk@mail.tsinghua.edu.cn.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundThe disruption of sexual and reproductive health (SRH) services emerged as a key issue during the early COVID-19 outbreak. We aimed to assess the availability of SRH services in China during the COVID-19 pandemic.

methodsThe study is part of a larger cross-country study on the impact of COVID-19 pandemic on health system. A cross-sectional panel survey design with two data collection points was used to capture changes in SRH service availability as a result of the COVID-19 pandemic. We developed a questionnaire to assess the readiness and resilience of China's health system. We conducted 109 in-depth interviews with healthcare providers, clients, and their partners in seven purposively selected health facilities in Wuhan, Beijing, and Changsha between November 2020 and December 2022. An adapted grounded theory and thematic analysis approach were applied to analyze the interview data. Direct quotes and findings from the coding and categorization process were used to develop the results.

resultsThe quantitative data showed that family planning, including contraception, and safe abortion services were completely or partially disrupted by the COVID-19 pandemic. The effects were greater at baseline. The disruption of services can be attributed to both supply-side and demand-side factors. Facilities responded to the pandemic's adverse impact on essential health services in multiple ways, most commonly through telemedicine, task shifting/role delegation, and triaging, to prioritize resource allocation. Three major themes emerged from the qualitative data: (1) barriers to SRH service delivery, (2) barriers to access and utilization of SRH services, and (3) resilient innovations in response to COVID-19. Service providers experienced barriers in providing SRH services to women during the pandemic. Women also faced numerous barriers and challenges to accessing SRH services, including lockdowns and mobility restrictions, lack of access to information, and limited access to SRH products. Most participants expressed support for the further expansion of telehealth strategies to improve access to SRH resources.

conclusionsThe COVID-19 pandemic negatively impacted SRH service provision and utilization in China. Our findings highlight the challenges of SRH service delivery during the COVID-19 pandemic and can be used to guide policy development and enhance service provision in alignment with societal needs. These findings underscore the importance of strengthening health systems by supporting telehealth expansion, tailoring provider-client communication, addressing the gender-specific needs of female providers, and leveraging community engagement to sustain essential SRH services during future crises.

Indexed as

COVID-19Delivery of Health CareHealth Services AccessibilityReproductive Health ServicesAdultChinaCross-Sectional StudiesFamily Planning ServicesFemaleHumansMaleMiddle AgedPandemicsReproductive HealthSARS-CoV-2Sexual HealthChinaCOVID-19 pandemicFamily planningHealth systemSexual and reproductive health

Identifiers

PMID40983932
PMCPMC12455775

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.