COVID-19 Pandemisinde Kadınların Kontraseptif Yöntem Kullanımı ve Kontraseptif Yöntemlere Erişimi ile İlişkili Faktörler

Yıl 2024, Cilt: 17 Sayı: 3, 374 - 384, 15.07.2024

Aliye Doğan Gangal , Eda Şimşek Şahin , Serap Alkaş Şengül Yaman Sözbir , Ayten Şentürk Erenel

https://doi.org/10.46483/jnef.1516055

Öz

Giriş: Pandemi nedeniyle kadınlarda kontraseptif yöntem kullanımı kısıtlanmış, hatta birçoğu yöntemlere ulaşamadığı için düşük, plansız gebelik gibi sorunlarla karşı karşıya kalmıştır.

Amaç: Bu çalışmada COVID-19 pandemisinde kadınların modern kontraseptif yöntem kullanımını belirlemek ve yöntemlere erişiminin belirleyicilerini incelemek amaçlanmıştır.

Yöntem: Çalışmaya 18-49 yaş arası, fertil (n=502) ve herhangi bir kontraseptif yöntem kullanan kadınlar dahil edildi. Veriler çevrimiçi anket ile toplanmıştır. Pandemi döneminde kontrasepsif kullanımı ve erişim durumu tanımlayıcı istatistik ile analiz edilmiştir. Kontrasepsiyon erişim güçlüğü ve kontraseptif yöntem değişikliğinin yordayıcılarını araştırmak için çoklu regresyon analizi yapılarak, olasılık oranları ve %95 güven aralıkları hesaplanmıştır.

Bulgular: Bu çalışmaya katılan kadınların %64.9’unun pandemi sırasında modern kontraseptif yöntem kullandığı ve %23.5’inin kontraseptiflere erişim konusunda endişeli olduğu belirlendi. Kadınların %6’sı pandemi sırasında kontraseptif yönteme erişimde zorluk yaşadığını ve %6.2’si doğum kontrol yöntemlerini değiştirdiğini ifade etmiştir. Pandemi döneminde kadınların kontraseptiflere erişim güçlüğünün en önemli belirleyicisi, pandemi öncesi dönemde de benzer şekilde yönteme erişememeleridir (OR:40.0 %95 CI=12.3-129.9; p=.001). Ayrıca pandemi sırasında yöntemlerini değiştiren kadınların yeni yönteme erişimde 4.47 kat daha fazla zorluk yaşadıkları tespit edildi.

Sonuç: Bu çalışmada, pandeminin kontraseptif yönteme erişimi etkilediğine dair kanıtlar bulunmuştur. Pandemi öncesi istenmeyen gebelik yaşamanın ve pandemide gebe kalma korkusunun kontraseptif değişikliğinin önemli yordayıcıları olduğu belirlendi. Bu doğrultuda kontrasepsiyon hizmetlerine erişimin artırılmasına yönelik girişimlerin planlanması önerilmektedir.

Anahtar Kelimeler

Covid-19, Kontrasepsiyon, Pandemi, Üreme Sağlığı

Factors Associated with Women’s Contraceptive Use and Access to Contraceptive Methods During the COVID-19 Pandemic

Öz

Background: Due to the pandemic, the use of contraceptive methods in women was restricted, and many of them even faced problems such as abortion and unplanned pregnancy because they could not access the contraceptive methods.

Objective: This study aimed to determine women’s use of modern contraceptive methods during the COVID-19 pandemic and to examine the predictors of access to modern contraceptives.

Method: Women (n=502) aged 18-49, fertile and using any contraceptive methods were included in the study. Data were collected via an online survey. The use and access to contraceptives during the pandemic were analyzed with descriptive statistics. Multiple regression analysis, odds ratios (OR), and 95% confidence intervals were calculated to investigate contraception access difficulties and change predictors.

Results: The results of this study indicate that 64.9% of the participants were utilizing modern contraceptive methods, while 23.5% were concerned about obtaining contraceptives during the pandemic. Furthermore, 6% of the women experienced difficulty accessing contraceptives during this period, and 6.2% altered their contraceptive methods. The primary predictor of women’s difficulty in accessing contraceptives during the pandemic was the absence of access to the method prior to the pandemic in a similar manner (OR:40.0 95%CI=12.3-129.9; p=.001). Additionally, It was also found that women who changed their methods during the pandemic had 4.47 times more difficulty in accessing the new method.

Conclusion: Having experienced an unintended pregnancy before the pandemic and fear of 48 becoming pregnant during the pandemic were found to be important determinants of the contraceptive change. This study shows evidence that the pandemic has affected contraceptive access. In this regard, planning initiatives to increase access to contraception services is recommended.

Anahtar Kelimeler

Covid-19, Contraception, Pandemic, Reproductive Health

Kaynakça

• Ahinkorah, B. O. (2020). Predictors of modern contraceptive use among adolescent girls and young women in sub-Saharan Africa: a mixed effects multilevel analysis of data from 29 demographic and health surveys. Contraception and reproductive medicine, 5, 1-12.https://doi.org/10.1186/s40834-020-00138-1
• Aly, J., Haeger, K. O., Christy, A. Y., & Johnson, A. M. (2020). Contraception access during the COVID-19 pandemic. Contraception and Reproductive Medicine, 5, 1-9. https://doi.org/10.1186/s40834-020-00114-9.
• Anderson, R. M., Heesterbeek, H., Klinkenberg, D., & Hollingsworth, T. D. (2020). How will country-based mitigation measures influence the course of the COVID-19 epidemic?. The lancet, 395(10228), 931-934.DOI:https://doi.org/10.1016/S0140-6736(20)30567-5.
• Apanga, P. A., Kumbeni, M. T., Ayamga, E. A., Ulanja, M. B., & Akparibo, R. (2020). Prevalence and factors associated with modern contraceptive use among women of reproductive age in 20 African countries: a large population-based study. BMJ open, 10(9), e041103. http://dx.doi.org/10.1136/bmjopen-2020-041103.
• Asfaw, M., Tolu, L. B., Urgie, T., Nigatu, B., Bekele, D., & Shiferaw, M. A. (2021). Guidelines and best practice recommendations on contraception and safe abortion care service provision amid COVID-19 pandemic: Scoping review. Ethiopian Journal of Reproductive Health, 13(01). DOI: 10.1186/s12889-021-10346-2
• Baxter, A. J., Geary, R. S., Dema, E., Bosó Pérez, R., Riddell, J., Willis, M., Conolly, A., Oakley, L. L., Copas, A. J., Gibbs, J., Bonell, C., Sonnenberg, P., Mercer, C. H., Clifton, S., Field, N., & Mitchell, K. (2023). Contraceptive use and pregnancy planning in Britain during the first year of the COVID-19 pandemic: findings from a large, quasi-representative survey (Natsal-COVID). BMJ sexual & reproductive health, 49(4), 260–273. https://doi.org/10.1136/bmjsrh-2022-201763
• FIGO. COVID-19 Contraception and Family Planning: FIGO Committee for Contraception and Family Planning.2020. https://www.figo.org/covid-19-contraception-family-planning.
• Fruzzetti, F., Cagnacci, A., Primiero, F., De Leo, V., Bastianelli, C., Bruni, V., ... & Volpe, A. (2020). Contraception during coronavirus-Covid 19 pandemia. Recommendations of the board of the Italian Society of Contraception. The European Journal of Contraception & Reproductive Health Care, 25(3), 231-232. https://doi.org/10.1080/13625187.2020.1766016
• Hall, K. S., Samari, G., Garbers, S., Casey, S. E., Diallo, D. D., Orcutt, M., ... & McGovern, T. (2020). Centring sexual and reproductive health and justice in the global COVID-19 response. The lancet, 395(10231), 1175-1177. https://doi.org/10.1016/s0140-6736(20)30801-1.
• Hunie Asratie, M. (2021). Unintended pregnancy during COVID-19 pandemic among women attending antenatal care in Northwest Ethiopia: magnitude and associated factors. International Journal of Women’s Health, 461-466. https://doi.org/10.2147/ijwh.s304540
• International Planned Parenthood Federation. (2020). IMAP statement on COVID-19 and sexual and reproductive health and rights. https://www.ippf.org/resource/imap-statement-covid-19-and-sexual-and-reproductive-health-and-rights.
• IPPF.(2020). COVID-19 pandemic cuts access to sexual and reproductive healthcare for women around the World: International Planned Parenthood Federation 2020 https://www.ippf.org/news/covid-19-pandemic-cuts-access-sexual-and-reproductive- healthcare-women-around-world
• Koçoğlu, F., Aşcı, Ö., & Kocaöz, S. (2023). The impact of the COVID-19 pandemic on the contraceptive use and fertility preferences and behaviors of married women in Turkey. Journal of Public Health, 1-10. https://doi.org/10.1007/s10389-023-02086-x
• Lin, T. K., Law, R., Beaman, J., & Foster, D. G. (2021). The impact of the COVID-19 pandemic on economic security and pregnancy intentions among people at risk of pregnancy. Contraception, 103(6), 380-385. https://doi.org/10.1016/j.contraception.2021.02.001.
• Lindberg, L. D., VandeVusse, A., Mueller, J., & Kirstein, M. (2020). Early impacts of the COVID-19 pandemic: findings from the 2020 Guttmacher survey of reproductive health experiences. https://www.guttmacher.org/report/early-impacts-covid-19-pandemic-findings-2020-guttmacher-survey-reproductive-health
• Luppi, F., Arpino, B., & Rosina, A. (2022). Fertility plans in the early times of the COVID-19 pandemic: The role of occupational and financial uncertainty in Italy. Plos one, 17(12), e0271384. https://doi.org/10.31235/osf.io/wr9jb
• Micelli, E., Cito, G., Cocci, A., Polloni, G., Russo, G. I., Minervini, A., ... & Coccia, M. E. (2020). Desire for parenthood at the time of COVID-19 pandemic: an insight into the Italian situation. Journal of Psychosomatic Obstetrics & Gynecology, 41(3), 183-190. https://doi.org/10.1080/0167482X.2020.1759545
• Pradhan, M. R., & Dwivedi, L. K. (2019). Changes in contraceptive use and method mix in India: 1992–92 to 2015–16. Sexual & Reproductive Healthcare, 19, 56-63. https://doi.org/10.1016/j.srhc.2018.12.006.
• Purdy, C. (2020). Opinion: How will COVID-19 affect global access to contraceptives–and what can we do about it. Devex Retrieved May, 10, 2020.https://www.devex.com/news/opinion-how-will-covid-19-affect-global-access-to-contraceptives-and-what-can-we-do-about-it-96745.
• Polis, C. B., Biddlecom, A., Singh, S., Ushie, B. A., Rosman, L., & Saad, A. (2022). Impacts of COVID-19 on contraceptive and abortion services in low- and middle-income countries: a scoping review. Sexual and reproductive health matters, 30(1), 2098557. https://doi.org/10.1080/26410397.2022.2098557
• Rezaei, F., Amiri-Farahani, L., Haghani, S., Pezaro, S., & Behmanesh, F. (2023). The impact of the COVID-19 pandemic on contraceptive methods, abortion, and unintended pregnancy: a cross-sectional study. BMC Women’s Health, 23(1), 1-12. https://doi.org/10.1186/s12905-023-02512-y
• Riley, T., Sully, E., Ahmed, Z., & Biddlecom, A. (2020). Estimates of the potential impact of the COVID-19 pandemic on sexual and reproductive health in low-and middle-income countries. International perspectives on sexual and reproductive health, 46, 73-76.DOI: 10.1363/46e9020
• Sohrabi, C., Alsafi, Z., O’neill, N., Khan, M., Kerwan, A., Al-Jabir, A., ... & Agha, R. (2020). World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International journal of surgery, 76, 71-76. https://doi.org/10.1016/j.ijsu.2020.02.034.
• Szucs, L. E., Pampati, S., Li, J., Copen, C. E., Young, E., Leonard, S., & Carman-McClanahan, M. N. (2023). Role of the COVID-19 Pandemic on Sexual Behaviors and Receipt of Sexual and Reproductive Health Services Among US High School Students—Youth Risk Behavior Survey, United States, 2019–2021. MMWR supplements, 72(1), 55. doi: 10.15585/mmwr.su7201a7
• Tang, K., Gaoshan, J., Ahonsi, B., Ali, M., Bonet, M., Broutet, N., ... & Thwin, S. S. (2020). Sexual and reproductive health (SRH): a key issue in the emergency response to the coronavirus disease (COVID-19) outbreak. Reproductive Health, 17(1), 1-3.https://doi.org/10.1186/s12978-020-0900-9
• TDHS. (2018). Turkey Demographic and Health Survey. Hacettepe University Institute of Population Studies. Ankara, Turkey. Available from URL: http://www.hips.hacettepe.edu.tr/en/menu/demographic_and_health_survey_serie-101.
• Tu, P., Li, J., Jiang, X., Pei, K., & Gu, Y. (2021). Impact of the COVID-19 pandemic on sexual and reproductive health among women with induced abortion. Scientific Reports, 11(1), 16310.https://doi.org/10.1038/s41598-021-95868-w
• UNDP. Socio-economic impact of COVID-19 United Nations Development Programme.2020.(Cited by: 05.05.2021 https://www.undp.org/content/undp/en/home/coronavirus/socio-economic-impact-of-covid-19/.
• UNFPA (2020). Impact of Covıd-19 on Access to Contraceptıves ın the Lac Region. https://lac.unfpa.org/sites/default/files/pub-pdf/technical_report_impact_of_covid_19_in_the_access_to_contraceptives_in_lac_1_2.pdf
• UNFPA. (2020). Impact of the COVID-19 pandemic on family planning and ending gender-based violence, female genital mutilation and child marriage. Interim Tech Note, 7. https://www.unfpa.org/resources/impact-covid-19-pandemic-family-planning-and-ending-gender-based-violence-female-genital.
• UNFPA. (2020a) Coronavirus Disease (COVID-19) Pandemic UNFPA Global Respons Plan Revised June. United Nations Population Fund 2020. https://www.unfpa.org/es/node/24085.
• United Nations. World Contraceptive Use 2022. https://www.un.org/development/desa/pd/data/world-contraceptive-use
• Weinberger, M., Hayes, B., White, J., & Skibiak, J. (2020). Doing Things Differently: What It Would Take to Ensure Continued Access to Contraception During COVID-19. Global health, science and practice, 8(2), 169–175. https://doi.org/10.9745/GHSP-D-20-00171
• World Health Organization (WHO). COVID-19: operational guidance for maintaining essential health services during an outbreak: interim guidance, 25 March 2020. Geneva: World Health Organization. https://apps.who.int/iris/handle/10665/331561.
• World Health Organization (WHO). Weekly epidemiological update- 27 October 2020. World Health Organization.2020. https://www.who.int/publications/m/item/weekly-epidemiological-update 27-october-2020.
• Wood, S. N., Byrne, M. E., Thiongo, M., Devoto, B., Wamue-Ngare, G., Decker, M. R., & Gichangi, P. (2023). Fertility and contraceptive dynamics amidst COVID-19: who is at greatest risk for unintended pregnancy among a cohort of adolescents and young adults in Nairobi, Kenya?. BMJ open, 13(5), e068689. doi: 10.1136/bmjopen-2022-068689
• World Health Organization. (2020). Q&A: Contraception/family planning and COVID-19. https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-contraception-and-family-planning.
• World Health Organization. (2022). Weekly epidemiological update on COVID-19-25 January 2022. World Health Orgnization.https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19 25-january-2022.