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.

中文翻译：

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撒哈拉以南非洲 COVID-19 期间的避孕动态：来自布基纳法索和肯尼亚的纵向证据

简介 来自突发卫生事件的证据表明 COVID-19 会破坏女性的性健康和生殖健康 (SRH)。在全球意外怀孕和不安全流产率最高的撒哈拉以南非洲地区，COVID-19 预计将减缓近期普遍获得避孕服务的进展。方法 我们使用从布基纳法索 (n=1186) 和肯尼亚 (n=2784) 之前（2019 年 11 月至 2020 年 2 月）和期间（2020 年 5 月至 2020 年 7 月）COVID-19 COVID-19 期间的动态；检查与避孕动态相关的社会人口因素和 COVID-19 经历；并评估与 COVID-19 相关的不使用避孕药具的原因。双变量和多变量逻辑回归用于检查 COVID-19 中避孕动态的相关性。结果 大多数女性在 COVID-19 期间没有改变其避孕状态（布基纳法索为 68.6%，肯尼亚为 81.6%），并且那些改变了避孕方法的女性（分别为 25.4% 和 13.1%）比停止避孕（6.0 % 和 5.3%）。大多数改用避孕药具的女性所使用的方法与大流行前的避孕方法相同或更有效。与 COVID-19 相关的经济不稳定与布基纳法索的避孕保护增加有关，但与肯尼亚无关。总的来说，肯尼亚 14.4% 的非避孕用户和布基纳法索的 3.8% 确定了与 COVID-19 相关的不使用原因。结论 绝大多数有意外怀孕风险的女性在 COVID-19 期间没有改变她们的避孕状态，并且采用的女性多于停止使用的方法。少数女性报告了与 COVID-19 相关的不使用原因，这强调了在健康危机期间扩大安全服务提供方式的重要性。数据在公共、开放存取的存储库中可用。到 2021 年 1 月，研究人员可以公开访问作为本文报告结果基础的个人、未识别身份的参与者数据。