Trends in Adolescent Sexual and Reproductive Health Outcomes Before and Into the COVID-19 Pandemic in Burkina Faso and Kenya: Evidence From Panel Data

Overview

Journal J Adolesc Health

Publisher Elsevier

Specialty Pediatrics

Date 2024 Jun 15

PMID 38878048

Authors

Claire Silberg

Caroline Moreau

Celia Karp

Fiacre Bazie

Peter Gichangi

Georges Guiella

Yentema Onadja

Mary Thiongo

Philip Anglewicz

Affiliations

Soon will be listed here.

Abstract

Purpose: Many predicted that COVID-19 would have a substantial impact on the sexual and reproductive health (SRH) trajectories of adolescents in sub-Saharan Africa. The lack of longitudinal data with information collected before and into the pandemic has limited investigation into this topic.

Methods: We performed a secondary analysis using nationally representative longitudinal data from Kenya and Burkina Faso, collected at three time points (pre-COVID-19 in late 2019, and during COVID-19 in 2020 and 2021), to determine the extent to which SRH outcomes and behaviors, including pregnancy, contraceptive use, partnership status, and sexual activity, changed during the pandemic among adolescent women.

Results: Among adolescents aged 15-19 years (Kenya n = 1,893, Burkina Faso n = 1,422), there was a reduction in both partnership and pregnancy in 2021 as compared to pre-COVID 2019. Contraception use significantly increased between 2019 and 2021 in Kenya only (adjusted odds ratio [aOR]: 1.42, 95% confidence interval [CI] 1.03-1.97). COVID-19-related household income loss was associated with a decline in sexual activity among unmarried Kenyan girls (aOR: 0.47, 95% CI 0.25-0.87) and lower odds of pregnancy in Burkina Faso (aOR: 0.13, 95% CI 0.02-0.91). We did not find a relationship between COVID-19 measures and initiation of partnership or marriage in either setting.

Discussion: Contrary to expectations, our results suggest that COVID-19 did not have a consistent or sustaining impact on adolescent SRH and behaviors in Burkina Faso and Kenya. Further research is needed to assess the longer-term implications of the pandemic on adolescent social and health outcomes.

References

Murewanhema G . Adolescent girls, a forgotten population in resource-limited settings in the COVID-19 pandemic: implications for sexual and reproductive health outcomes. Pan Afr Med J. 2021; 37(Suppl 1):41. PMC: 7846263. DOI: 10.11604/pamj.supp.2020.37.41.26970. View

Decker M, Wood S, Thiongo M, Byrne M, Devoto B, Morgan R . Gendered health, economic, social and safety impact of COVID-19 on adolescents and young adults in Nairobi, Kenya. PLoS One. 2021; 16(11):e0259583. PMC: 8577767. DOI: 10.1371/journal.pone.0259583. View

Meherali S, Adewale B, Ali S, Kennedy M, Salami B, Richter S . Impact of the COVID-19 Pandemic on Adolescents' Sexual and Reproductive Health in Low- and Middle-Income Countries. Int J Environ Res Public Health. 2021; 18(24). PMC: 8701118. DOI: 10.3390/ijerph182413221. View

Karp C, Moreau C, Sheehy G, Anjur-Dietrich S, Mbushi F, Muluve E . Youth Relationships in the Era of COVID-19: A Mixed-Methods Study Among Adolescent Girls and Young Women in Kenya. J Adolesc Health. 2021; 69(5):754-761. PMC: 8460286. DOI: 10.1016/j.jadohealth.2021.07.017. View

Gittings L, Toska E, Medley S, Cluver L, Logie C, Ralayo N . 'Now my life is stuck!': Experiences of adolescents and young people during COVID-19 lockdown in South Africa. Glob Public Health. 2021; 16(6):947-963. PMC: 10105067. DOI: 10.1080/17441692.2021.1899262. View

Moreau C, Karp C, Wood S, Williams K, OlaOlorun F, Akilimali P . Trends in fertility intentions and contraceptive practices in the context of COVID-19 in sub-Saharan Africa: insights from four national and regional population-based cohorts. BMJ Open. 2023; 13(1):e062385. PMC: 9852736. DOI: 10.1136/bmjopen-2022-062385. View

Lindberg L, Bell D, Kantor L . The Sexual and Reproductive Health of Adolescents and Young Adults During the COVID-19 Pandemic. Perspect Sex Reprod Health. 2020; 52(2):75-79. PMC: 7323157. DOI: 10.1363/psrh.12151. View

Khan S, Kemigisha E, Turyakira E, Chaput K, Kabakyenga J, Kyomuhangi T . Dramatic effects of COVID-19 public health measures and mass reverse migration on youth sexual and reproductive health in rural Uganda. Paediatr Child Health. 2022; 27(Suppl 1):S40-S46. PMC: 9126275. DOI: 10.1093/pch/pxab107. View

Hussein J . COVID-19: What implications for sexual and reproductive health and rights globally?. Sex Reprod Health Matters. 2020; 28(1):1746065. PMC: 7887905. DOI: 10.1080/26410397.2020.1746065. View

10.

Zulaika G, Bulbarelli M, Nyothach E, van Eijk A, Mason L, Fwaya E . Impact of COVID-19 lockdowns on adolescent pregnancy and school dropout among secondary schoolgirls in Kenya. BMJ Glob Health. 2022; 7(1). PMC: 8761596. DOI: 10.1136/bmjgh-2021-007666. View

11.

Assefa N, Sie A, Wang D, Korte M, Hemler E, Abdullahi Y . Reported Barriers to Healthcare Access and Service Disruptions Caused by COVID-19 in Burkina Faso, Ethiopia, and Nigeria: A Telephone Survey. Am J Trop Med Hyg. 2021; 105(2):323-330. PMC: 8437171. DOI: 10.4269/ajtmh.20-1619. View

12.

Bain L, Zweekhorst M, de Cock Buning T . Prevalence and Determinants of Unintended Pregnancy in Sub -Saharan Africa: A Systematic Review. Afr J Reprod Health. 2021; 24(2):187-205. DOI: 10.29063/ajrh2020/v24i2.18. View

13.

Asante K, Quarshie E, Andoh-Arthur J . COVID-19 school closure and adolescent mental health in sub-Saharan Africa. Int J Soc Psychiatry. 2020; 67(7):958-960. DOI: 10.1177/0020764020973684. View

14.

Zidouemba P, Kinda S, Ouedraogo I . Could Covid-19 Worsen Food Insecurity in Burkina Faso?. Eur J Dev Res. 2020; 32(5):1379-1401. PMC: 7586363. DOI: 10.1057/s41287-020-00324-6. View

15.

Ikamari L, Izugbara C, Ochako R . Prevalence and determinants of unintended pregnancy among women in Nairobi, Kenya. BMC Pregnancy Childbirth. 2013; 13:69. PMC: 3607892. DOI: 10.1186/1471-2393-13-69. View

16.

Rosenstock I, Strecher V, BECKER M . Social learning theory and the Health Belief Model. Health Educ Q. 1988; 15(2):175-83. DOI: 10.1177/109019818801500203. View

17.

Browne L, Cooper S, Tiendrebeogo C, Bicaba F, Bila A, Bicaba A . Using experience to create evidence: a mixed methods process evaluation of the new free family planning policy in Burkina Faso. Reprod Health. 2022; 19(1):67. PMC: 8932047. DOI: 10.1186/s12978-022-01375-0. View

18.

Karp C, Wood S, Guiella G, Gichangi P, Bell S, Anglewicz P . Contraceptive dynamics during COVID-19 in sub-Saharan Africa: longitudinal evidence from Burkina Faso and Kenya. BMJ Sex Reprod Health. 2021; 47(4):252-260. PMC: 7886665. DOI: 10.1136/bmjsrh-2020-200944. View

19.

Newby H, Marsh A, Moller A, Adebayo E, Azzopardi P, Carvajal L . A Scoping Review of Adolescent Health Indicators. J Adolesc Health. 2021; 69(3):365-374. PMC: 8405182. DOI: 10.1016/j.jadohealth.2021.04.026. View

20.

Cluver L, Lachman J, Sherr L, Wessels I, Krug E, Rakotomalala S . Parenting in a time of COVID-19. Lancet. 2020; 395(10231):e64. PMC: 7146667. DOI: 10.1016/S0140-6736(20)30736-4. View