{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T18:09:04Z","timestamp":1765822144188,"version":"3.48.0"},"reference-count":31,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"unspecified","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,8,24]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The emergence of the COVID-19 pandemic led to multiple preventive actions as primary interventions to contain the spread of the virus. Globally, countries are facing enormous challenges with consequences for use of social, economic and health services. The Democratic Republic of Congo (DRC) was among the African countries implementing strict lockdown at the start of the pandemic, resulting in shortages and decreased access to services. The adverse effects of the pandemic had unpleasant consequences for the country. This study aimed to examine the association between COVID-19 pandemic-related factors, sociodemographic factors, and the need to visit healthcare facilities, including family planning services, among women aged 15\u201349 years in the DRC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary analysis of a performance monitoring for action (PMA) cross-sectional COVID-19 phone survey in Kinshasa, DRC, which had a response rate of 74.7%. In total, 1325 randomly selected women aged 15\u201349 years from the Kinshasa province who had previously participated in the PMA baseline survey participated in the survey. Bivariate and multivariate logistic regressions were used to assess associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The COVID-19 pandemic and related factors affected 92% of women in the Kinshasa province socioeconomically. A majority were highly economically dependent on their partner or some other sources for their basic needs to be met, and even more worried about the future impact of the pandemic on their household finances. Over 50% of women did not attempt visiting a health service, with some of the top reasons being fear of being infected with COVID-19 and not being able to afford services. We found a significant association between age groups and contraceptive use. The need for and use of contraceptives was higher among women aged 25\u201334 years than those aged 15\u201324 or 35\u201349 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Effective social\/economic support to women and girls during pandemics and in crises is essential as it can have lasting beneficial effects on many domains of their lives, including their ability to access health services and the contraceptives of their choice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-072869","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T11:46:44Z","timestamp":1694087204000},"page":"e072869","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["COVID-19 pandemic hits differently: examining its consequences for women\u2019s livelihoods and healthcare access \u2013 a cross-sectional study in Kinshasa DRC"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7826-9382","authenticated-orcid":false,"given":"Falone","family":"Nkweleko Fankam","sequence":"first","affiliation":[{"name":"Dalarna University, School of Health and Welfare, Falun, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Ugarte","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Akilimali","sequence":"additional","affiliation":[{"name":"Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junior","family":"Ewane Etah","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"\u00c5kerman","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"2025121510072960000_13.9.e072869.1","unstructured":"World Health Organization . Overview of public health and social measures in the context of COVID-19, interim guide. 2020. Available: https:\/\/www.who.int\/publications\/i\/item\/overview-of-public-health-and-social-measures-in-the-context-of-covid-19"},{"key":"2025121510072960000_13.9.e072869.2","doi-asserted-by":"crossref","first-page":"436","DOI":"10.3390\/healthcare9040436","article-title":"Mapping evidence of impacts of COVID-19 outbreak on sexual and reproductive health: a Scoping review","volume":"9","author":"Bolarinwa","year":"2021","journal-title":"Healthcare"},{"key":"2025121510072960000_13.9.e072869.3","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1057\/s41287-020-00325-5","article-title":"Intersecting Vulnerabilities: the impacts of COVID-19 on the psycho-emotional lives of young people in Low- and middle-income countries","volume":"32","author":"Banati","year":"2020","journal-title":"Eur J Dev Res"},{"key":"2025121510072960000_13.9.e072869.4","doi-asserted-by":"crossref","DOI":"10.1186\/s41182-021-00356-6","article-title":"Ebola and COVID-19 in democratic Republic of Congo: grappling with two plagues at once","volume":"49","author":"Khan","year":"2021","journal-title":"Trop Med Health"},{"key":"2025121510072960000_13.9.e072869.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2020-003607","article-title":"What questions we should be asking about COVID-19 in humanitarian settings: perspectives from the social sciences analysis cell in the Democratic Republic of the Congo","volume":"5","author":"Carter","year":"2020","journal-title":"BMJ Glob Health"},{"key":"2025121510072960000_13.9.e072869.6","doi-asserted-by":"crossref","first-page":"597","DOI":"10.4269\/ajtmh.20-0642","article-title":"Responding to the challenge of the dual COVID-19 and Ebola epidemics in the Democratic Republic of Congo-priorities for achieving control","volume":"103","author":"Nachega","year":"2020","journal-title":"Am J Trop Med Hyg"},{"key":"2025121510072960000_13.9.e072869.7","doi-asserted-by":"crossref","DOI":"10.11604\/pamj.supp.2020.35.2.22606","article-title":"Public trust in the time of the Coronavirus disease 2019 (COVID-19): the case of the DR Congo","volume":"35","author":"Whembolua","year":"2020","journal-title":"Pan Afr Med J"},{"key":"2025121510072960000_13.9.e072869.8","unstructured":"UNFPA . Impact of COVID-19 on family planning: what we know one year into the pandemic. 2021. 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