Adaptations to family planning and reproductive health services in humanitarian settings in Nigeria during the COVID-19 pandemic (R4S study 4.5A)

We conducted a mixed methods study to identify adaptations made to Family Planning/Reproductive Health (FP/RH) services during the COVID-19 pandemic and quantify the impact of COVID-19 on key FP/RH indicators. Data were collected through: 1) Analysis of trends in FP/RH data routinely collected service statistics by projects, from January 2020 (4 months prior to lockdown in Nigeria) through December 2020 and 2) Key informant interviews with project staff including: clinical health care providers, programmatic staff and outreach workers. Two projects supporting FP/RH services for women in humanitarian settings in Nigeria in the time of COVID-19 were part of this study: The IHANN II (Integrated Humanitarian Assistance to Northeast Nigeria, April 2019 – December 2020) project in Borno State and the UNHCR-SS-HNIR (United Nations High Commissioner for Refugees South-South Health and Nutrition Intervention, April 2019 – December 2020) project in Cross River State. The study team analyzed routine programmatic monitoring data from the two projects to describe monthly trends in the provision of FP/RH services during COVID-19 from January 2020 through December 2020. Monthly numbers of clients for each of these services were collected for each facility: ANC attendees, deliveries attended by skilled personnel, women receiving FP services, individuals reached with RH community outreach, children receiving oral polio vaccines (OPV) 1 and 3, and pregnant women who received HIV counselling and testing. Service utilization data was collated from project registers as a part of projects’ routine monitoring system. Research assistants conducted 40 semi-structured in-depth interviews to gather information on the effect of COVID-19 on FP/RH service provision, project modifications, staff recommendations and lessons learned. Twenty staff were purposively selected from each of the two projects and stratified to ensure representation of clinical/health care providers, project staff and outreach workers. Data from IDIs are not included in these data. This work is made possible by the generous support of the American people through the U.S. Agency for International Development (USAID), provided to FHI 360 through Cooperative Agreement 7200AA19CA00041. Partners on this work include Evidence for Sustainable Human Development Systems in Africa (EVIDAF).