Abstract
BACKGROUND: COVID-19 pandemic has put tremendous burden on health services. Only limited evidence, however, is available to identify the impact of COVID-19 on sexual and reproductive health (SRH). This world health organization (WHO)-led research sought to evaluate health systems focusing on SRH in Brazil, Burkina Faso, China, Ghana, Italy, Pakistan, Thailand, and the United Kingdom. METHODS: The study was conducted in Thailand on two levels using a mixed-methods design: 1) Individual level included in-depth interviews and focus group discussions with clients (and their partners, where applicable) and healthcare providers (HCPs) to investigate service perceptions and obstacles to SRH service utilization; 2) health facility level, a quantitative evaluation of health facility preparedness for SRH service provision was performed using an adapted version of the WHO Service Availability and Readiness Assessment (SARA) tool. The data was collected at two timepoints, baseline and endline, at time intervals of 9 months. RESULTS: Almost all SRH services were maintained with some shortage of supply such as medications for safe abortion during the first few months. Both providers and clients perceived that all SRH services should be maintained. Some clients were concerned about fear of getting COVID-19 infection while visiting the facility. Some clients switched from short-acting to long-acting contraceptive methods. At the endline, this affect was less obvious since a large proportion of clients were familiar with the pandemic and already received vaccination. The Centre for COVID-19 Situation Administration (CCSA) was established to update COVID-19 pandemic situation, new government policy and intervention to reduce fake news. Telemedicine was used to reduce avoidable appointments. For postpartum women, appointment tended to be more individualized. For those who required pregnancy protection, contraceptive methods were offered to clients before discharge from the hospital. A follow-up visit was performed using both telemedicine and in-person visit at the hospital. For those required medications such as antibiotics for STI, home delivery to clients was provided. CONCLUSIONS: This study demonstrated that COVID-19 pandemic had some but non-significant effect on SRH services. The two major referral hospitals in Northeast, Thailand had service readiness to provide SRH services during the COVID-19 pandemic and pandemic recovery.