Report: Impact of the COVID-19 Pandemic on Sexual and Reproductive Health Services in Burkina Faso, Ethiopia, Kenya, Malawi and Uganda

Abstract

This report presents a comparative analysis of the impact of the COVID-19 pandemic on the availability of, access to, and use of sexual and reproductive health (SRH) services across five sub-Saharan African countries: Burkina Faso, Ethiopia, Kenya, Malawi, and Uganda. Drawing on interviews with 3,473 women and girls and 466 healthcare providers, along with in-depth interviews involving 211 women and girls, 176 healthcare providers, 64 representatives of civil society and non-governmental organizations, and 13 Ministry of Health policymakers across the five countries, the study documents how public health emergency responses, including lockdowns, curfews, and travel restrictions, disrupted the continuity of SRH service delivery. It finds that national COVID-19 guidelines frequently failed to prioritize SRH services, exacerbating existing gaps in access for women and girls, including among underserved and low-income populations. The report situates its findings within the broader context of fragile health systems in the region and offers evidence to guide response and mitigation strategies for current and future public health emergencies, with recommendations for strengthening the resilience of SRH service delivery systems.