The Impact of the 2018-2020 Ebola Epidemic in DR Congo on Access to Family Planning and Post Abortion Care Services, a Mixed Methods Analysis Open Access
Snyder, Allison (Summer 2020)
Published
Abstract
Objective: This study aims to evaluate the impact of the 2018-2020 Ebola epidemic in DRC on access to and utilization of sexual and reproductive health services, with a focus on family planning (FP) and post abortion care services (PAC).
Design: Mixed methods study, including an analysis of primary qualitative data (key informant interviews (KII) and focus group discussions (FGD)) from care providers and women community members in North Kivu DRC, plus an analysis of secondary program data from CARE International’s SAFPAC initiative.
Methods: 10 KII and 12 FGD were conducted with 130 total participants. Data were analyzed in MAXQDA and major themes were identified. Secondary program data containing monthly totals of women who utilized FP and/or PAC services at identified SAFPAC supported health facilities in 3 health zones in North Kivu, DRC (Butembo, Kayna and Lubero) from 2017 through 2020 were analyzed to identify trends.
Results: FGD and KII feedback indicated that FP and PAC use dropped significantly during the EVD epidemic in the health zones in question. However, SAFPAC initiative health facility data on FP and PAC use indicated that use of the services remained relatively stable, with slight drops in FP use and a more significant drop of PAC use in Butembo, the health zone hardest-hit by the EVD epidemic. Interview and discussion participants shared that fear and rumors were the main drivers of decisions around seeking SRH care during the epidemic.
Conclusion: A mixed methods approach to this topic is extremely valuable in order to understand the nuance and complexity of the challenge. Overall, SRH services continued through the course of the EVD epidemic, with only slight reductions in numbers of women accessing the services via the SAFPAC initiative. One of the most important findings regarding mitigation planning/techniques to ensure continued access to SRH services in epidemic settings is to involve local organizations and leaders in community outreach and sensitization efforts.
Table of Contents
Table of Contents
Acknowledgements
Abstract
Chapter I: Introduction
Introduction and Rationale
Problem Statement
Purpose Statement
Research Questions
Significance Statement
Definition of Terms
Abbreviations
Chapter II: Review of the Literature
Introduction to the Literature
Learning from Past Experiences
DRC Context
The latest EVD outbreak in DRC, and its impact on SRH
Summary of current problem and study relevance
Chapter III: Contribution of the Student
Chapter IV: Journal Article Manuscript
Title Page for Manuscript
Abstract
Introduction
Methods
Results
Access to and utilization of family planning (FP) services during the EVD epidemic
Access to and utilization of post abortion care (PAC) during the EVD epidemic
Interruptions in the availability of SRH services during the EVD epidemic
Drivers of women's decisions to seek SRH services
Possible long-term impacts of the EVD on SRH
Proposed mitigation techniques
Discussion
Key findings
Limitations
Conclusion
Recommendations
References
Tables and Figures
Table 1
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
Chapter V: Public Health Implications
Appendix
I. Qualitative Analysis Code Book
II. Key Informant Interview Questions:
III. Focus Group Discussion Questions:
About this Master's Thesis
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