{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T18:29:47Z","timestamp":1786472987721,"version":"build-2736575974"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43TW010060"],"award-info":[{"award-number":["D43TW010060"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Following its declaration as a pandemic, COVID-19 spread extensively, affecting millions globally. Concerns emerged that it could have a detrimental impact on sexual and reproductive health services. Specifically, these worries centred on the potential disruption of family planning and HIV-related care. We conducted a mixed methods study to understand the impact of the pandemic and its associated measures on access to FP and HIV services among women in a peri-urban area of Lilongwe, Malawi. We used descriptive statistics to assess what proportion of eligible women accessed FP\/HIV services and understand experiences and challenges faced. 400 women responded to a questionnaire, and 30 of them completed in-depth interviews. We used frameworks by Peters (2008) and; Ensor and Cooper (2004) to analyse qualitative data. The mean age of the study participants was 30 years, with less than a third aged 18\u201325. Of the 269 who tried to access FP services, 254 (94.4%) received it, and 248 (92.2%) received their preferred method. Only 2 (6.1%) out of 33 women living with HIV reported difficulties in obtaining ART. For HIV Testing &amp; Counselling (HTC) services, 97.0% (n\u2009=\u2009293) of the 302 women who wanted the service attempted to access them, and 99.0% (n\u2009=\u2009290) of the 293 were successful. The most commonly reported challenges were: being sent away if they did not have a mask, being sent away if the maximum number of clients per day had been reached, and higher fares for the few who used minibus. Overall, access to FP and HIV services was sustained. Women, however, faced some challenges while accessing the services, which were more pronounced among FP clients compared to ART clients. Our findings emphasize the need to implement strategies that will minimize challenges to health care access during pandemics, to ensure gains in FP and HIV services are sustained.<\/jats:p>","DOI":"10.1371\/journal.pgph.0007041","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:33:06Z","timestamp":1786469586000},"page":"e0007041","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the impact of COVID-19 on access to family planning and HIV services among women in Lilongwe, Malawi"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9520-8864","authenticated-orcid":true,"given":"Clara","family":"Lemani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agatha","family":"Bula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Thom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4238-2791","authenticated-orcid":true,"given":"Jennifer H.","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"pgph.0007041.ref001","article-title":"Estimation of the potential impact of COVID-19 responses on the HIV epidemic: analysis using the Goals Model","author":"J Stover","year":"2020","journal-title":"MedRxin"},{"issue":"9","key":"pgph.0007041.ref002","doi-asserted-by":"crossref","DOI":"10.1016\/S2352-3018(20)30211-3","article-title":"Potential effects of disruption to HIV programmes in sub-Saharan Africa caused by COVID-19: results from multiple mathematical models","volume":"7","author":"BL Jewell","year":"2020","journal-title":"Lancet HIV"},{"key":"pgph.0007041.ref003","doi-asserted-by":"crossref","first-page":"100483","DOI":"10.1016\/j.eclinm.2020.100483","article-title":"Understanding the impact of interruptions to HIV services during the COVID-19 pandemic: A modelling study","volume":"26","author":"BL Jewell","year":"2020","journal-title":"EClinicalMedicine"},{"key":"pgph.0007041.ref004","author":"UNFPA","year":"2021"},{"issue":"6","key":"pgph.0007041.ref005","article-title":"Need for and use of contraception by women before and during COVID-19 in four sub-Saharan African geographies: results from population-based national or regional cohort surveys","volume":"9","author":"SN Wood","year":"2021","journal-title":"Lancet Glob Health"},{"issue":"1","key":"pgph.0007041.ref006","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0002435","article-title":"Family planning service disruptions in the first two years of the COVID-19 pandemic: evidence from health facilities in seven low- and middle-income countries","volume":"4","author":"C Karp","year":"2024","journal-title":"PLOS Glob Public Health"},{"key":"pgph.0007041.ref007","doi-asserted-by":"crossref","DOI":"10.1363\/2020.31482","volume-title":"Early impacts of the COVID-19 pandemic: Findings from the 2020 Guttmacher survey of reproductive health experiences","author":"LD Lindberg","year":"2020"},{"key":"pgph.0007041.ref008","volume-title":"How COVID-19 prevention measures have affected young people\u2019s sexual reproductive health in Ghana, Indonesia, Kenya, Nepal, Uganda and Zimbabwe","author":"R Both","year":"2021"},{"key":"pgph.0007041.ref009","unstructured":"Marie Stopes International. 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