TY - JOUR T1 - Contraceptive dynamics during COVID-19 in sub-Saharan Africa: longitudinal evidence from Burkina Faso and Kenya JF - BMJ Sexual & Reproductive Health JO - BMJ Sex Reprod Health SP - 252 LP - 260 DO - 10.1136/bmjsrh-2020-200944 VL - 47 IS - 4 AU - Celia Karp AU - Shannon N Wood AU - Georges Guiella AU - Peter Gichangi AU - Suzanne O Bell AU - Philip Anglewicz AU - Elizabeth Larson AU - Linnea Zimmerman AU - Caroline Moreau Y1 - 2021/10/01 UR - http://jfprhc.bmj.com/content/47/4/252.abstract N2 - Introduction Evidence from health emergencies suggests COVID-19 will disrupt women’s sexual and reproductive health (SRH). In sub-Saharan Africa, which experiences the highest rates of unintended pregnancy and unsafe abortion globally, COVID-19 is projected to slow recent progress toward universal access to contraceptive services.Methods We used longitudinal data collected from women at risk of unintended pregnancy in Burkina Faso (n=1186) and Kenya (n=2784) before (November 2019–February 2020) and during (May–July 2020) COVID-19 to quantify contraceptive dynamics during COVID-19; examine sociodemographic factors and COVID-19 experiences related to contraceptive dynamics; and assess COVID-19-related reasons for contraceptive non-use. Bivariate and multivariate logistic regressions were used to examine correlates of contraceptive dynamics amid COVID-19.Results Most women did not change their contraceptive status during COVID-19 (68.6% in Burkina Faso and 81.6% in Kenya) and those who did were more likely to adopt a method (25.4% and 13.1%, respectively) than to discontinue (6.0% and 5.3%, respectively). Most women who switched contraceptives were using methods as or more effective than their pre-pandemic contraception. Economic instability related to COVID-19 was associated with increased contraceptive protection in Burkina Faso but not in Kenya. Altogether, 14.4% of non-contraceptive users in Kenya and 3.8% in Burkina Faso identified COVID-19-related reasons for non-use.Conclusions The vast majority of women at risk of unintended pregnancy did not change their contraceptive status during COVID-19, and more women adopted than discontinued methods. A minority of women reported COVID-19-related reasons for non-use, underscoring the importance of expanding safe modes of service delivery during health crises.Data are available in a public, open access repository. Individual, deidentified participant data that underlie the results reported in this article will be publicly accessible to researchers by January 2021. ER -