Influence of Movement Restriction During the COVID-19 Pandemic on Uptake of DMPA-SC and Other Injectable Contraceptive Methods in Nigeria.

Abstract

Introduction: The COVID-19 pandemic caused significant disruptions to sexual and reproductive health (SRH) services globally, with a pronounced impact on low- and middle-income countries like Nigeria. This study investigates how COVID-19 travel restrictions influenced the uptake of depot medroxyprogesterone acetate subcutaneous (DMPA-SC) and other injectable contraceptives in Nigeria.

Methods: This study analyzed 26 months of secondary logistics data from the national electronic Health Logistics Management Information System (e-HLMIS), covering 36 states and encompassing periods before, during, and after the implementation of travel restrictions. Statistical analyses, including one-way ANOVA and independent samples t-tests, were applied to assess trends in the consumption of DMPA-SC and compare them with other injectable contraceptives, such as intramuscular DMPA (DMPA-IM) and norethisterone enanthate (NET-EN).

Results: Findings showed a significant increase in DMPA-SC consumption during the travel restriction period, with mean consumption rising from 57,187 units pre-restriction to 103,249 units during the restriction. This increase persisted post-restriction, with mean consumption reaching 124,561 units. While the use of other injectable contraceptives also rose during the pandemic, their growth did not sustain as consistently as DMPA-SC.

Discussion: The results suggest that promoting self-administration of DMPA-SC was essential in maintaining contraceptive access when conventional healthcare services were disrupted. This study highlights the importance of adaptable healthcare delivery models, such as self-administration, in ensuring SRH service continuity during global crises. Additionally, it underscores the need for resilient supply chain management to secure contraceptive availability in emergencies, providing critical insights for policymakers and healthcare providers aiming to enhance SRH service resilience in future public health challenges.