The dynamics of family planning and abortion services during COVID-19: perspectives from healthcare providers and clients in Burkina Faso

Background The novel SARS-CoV-2 (COVID-19) led to an unprecedented increase in demand on health systems to care for people infected, necessitating the allocation of significant resources, especially medical resources, towards the response. This, compounded by the restrictions on movement led to disruptions in the provision of essential services, including sexual and reproductive health (SRH) services. This study assessed the effects of the COVID-19 pandemic on demand, utilisation and delivery of family planning and abortion services in Burkina Faso. Methods The study used a mixed method, cross-sectional panel survey to collect data at two time points in eight health facilities in Ouagadogou and Bobo Dioulasso. Data was collected using in-depth interviews (IDI) and focus group discussion (FGDs) with women, their male partners, and healthcare providers and health facility availability and readiness assessments. Results Demand for family planning services declined during the lockdown period due to movement restrictions, fear of infection and of being quarantined if found to be infected. Despite no direct demand for abortion services, healthcare providers reported increased unintended pregnancies and demand for treatment of complications of abortion, suggesting recourse to unsafe abortions. At least 30% of facilities experienced partial disruption in delivery of services, including staff shortages, supply chain challenges and reduced outpatient volumes. Health facility readiness scores remained moderate, implying existing constraints worsened by the pandemic. Conclusions COVID-19 response and containment measures indirectly affected demand, delivery and utilisation of family planning and abortion services in Burkina Faso, by increasing the existing barriers for women and girls. Strengthening health system resilience, community-based service delivery and communication strategies is essential to ensure uninterrupted access during health emergencies.