What Can We Learn from These Varied Responses to COVID-19?
While WHO guidance provided a generic platform for responses to COVID-19, the countries discussed here customized according to their own goals, policies, and political contexts. The most commonly adopted WHO recommendation is to relax requirements to allow easier access to short-acting methods for up to three months. However, as for the recommendation that substitutions be made when the preferred method is not available, countries’ guidance varies quite a bit. For instance, Zimbabwe prioritizes FAMs, while Tanzania prioritizes emergency contraception. There is also significant variation in the level of flexibility: While Uganda and Kenya have more open approaches that encourage innovation, Tanzania and Zambia seem to be more restrictive.
The pandemic has caused countries to rapidly adjust their policies and adopt measures that, under normal circumstances, could take years to implement. When the emergency lifts, there will be rich opportunities to study what worked, what did not, and what measures might be applied not only to future pandemics but also to everyday family planning guidance. Illustrative programmatic and research questions include:
- Did women who were provided three-month refills of pills continue taking them as prescribed, or did they forget without the usual monthly check-ins with providers? Did they have issues with storing three months of pills?
- In the absence of other choices, how many couples used FAMs and how were pregnancy rates affected? Where FAMs were effective, what kind of counseling did women and couples receive?
- How successful were the innovations, such as the use of motorcycle taxi operators to deliver contraception during lockdowns? Could women afford the costs in poor urban settlements or rural areas?
- How were countries able to change their policies so swiftly? What can family planning advocates and policy researchers learn from the process
- How satisfied were women and couples who had to change from their usual methods to something more readily available during the pandemic? Did they switch back after regulations eased?
- How were birth rates affected in each country?
It remains to be seen whether any country’s response will be more successful than others. Going forward, it will be important to track all the key metrics of reproductive health/family planning to learn valuable lessons from the experiences of women and couples using voluntary family planning during these extraordinary times.
Document COVID’s Impact on FP With This Tool
The USAID-funded Research for Scalable Solutions (R4S) Project, with technical assistance from the USAID-funded EnvisionFP Project, developed a series of survey questions that can be added to ongoing studies and activities to systematically capture the effects of the COVID-19 pandemic and recovery process on voluntary family planning access and use.