Determinants of Family Planning Utilisation During Covid-19 Pandemic in Mutare City, Zimbabwe, 2019-2020: A Cross-sectional Study

Abstract

COVID-19 is exacerbating the unmet need in family planning (FP) world over and Zimbabwe included due to regulations which were erected to fight COVID -19. To this end, there has been a decline in number of women receiving FP services leading to unintended pregnancies and huge spike in maternal deaths in Mutare. The study sought to determine factors associated with utilization of FP during COVID-19 pandemic in Mutare city for the period 2019 to 2020. A cross sectional mixed-method design was used through face to face interviews with FP users and providers from Mutare City clinics. The quantitative arm involved the collection of longitudinal data from Mutare City clinics six months before and after the first recorded case of COVID-19 in Zimbabwe whilst the qualitative arm assessed acceptability of different access models for use in future similar pandemics. Factors associated with the utilization of FP during COVID-19 were computed using Chi-square test, paired t test and ANOVA test in SPSS 22.0. Four hundred women were enrolled into the study and the most commonly used FP methods during COVID-19 were control pill (60.2%) and implant (12.6%). The sociodemographics that were associated with utilization status were namely age (p<0.000), marital status (p<0.000), partner education level (p<0.000), income (p=0.000) and religion (p<0.000). Moreover, there was a significant average diference between period before and period during COVID-19 for utilization shifts and method used and P Values of 0.001 and 0.020 respectively were obtained. Furthermore, the effects of COVID-19 on FP utilization were statistically significantly different within groups and the following P Values were obtained age (p<0.000), marital status (p=0.005), income (p <0.000) and religion (p<0.000). In conclusion, Covid 19 had an effect on choice of method and utilisation status. The determinants of family planning utilization during covid 19 were high user fees, lack of entertainment, high exposure to partners, proximity to clinics, pregnancy and partner familiarization. To this end, variety of FP methods should be made available to enable clients to choose their preferred method and FP services should be made free.