Factors associated with access to condoms and sources of condoms during the COVID-19 pandemic in South Africa

  1. Obasanjo Afolabi Bolarinwa

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Abstract

Background

Evidence has shown that the prescribed lockdown and physical distancing due to the novel coronavirus disease 2019 (COVID-19) have made accessing essential health care services much more difficult in low-and middle-income countries. Access to contraception is an essential service and should not be denied, even in a global crisis, because of its associated health benefits. Therefore, it is important to maintain timely access to contraception without unnecessary barriers. Hence, this study examines the factors contributing to limited access to condoms and sources of condoms during the COVID-19 pandemic in South Africa.

Methods

This study used the National Income Dynamics Study-Coronavirus Rapid Mobile Survey (NIDS-CRAM) wave 1 survey dataset. The NIDS-CRAM is a nationally representative survey of the National Income Dynamics Survey (NIDS) conducted via telephone interview during COVID-19 in the year 2020. This is the first secondary dataset on COVID-19 conducted by NIDS during pandemic. A total of 5304 respondents were included in the study. Data were analysed using frequencies distribution percentages, chi-square test and multivariable logistic regression analysis.

Results

Almost one-quarter (22.40%) of South Africans could not access condoms, and every 7 in 10 South Africans preferred public source of condoms during the COVID-19 pandemic. Those who were from other population groups [AOR = 0.37; 95% CI = 0.19–0.74] and those who were in the third wealth quintile [AOR = 0.60; 95% CI = 0.38–0.93] had lower odds of having access to condoms while those respondents who were aged 25–34 [AOR = 0.48; 95% CI = 0.27–0.83] and those with a secondary level of education and above [AOR = 0.24; 95% CI = 0.08–0.71] were less likely to prefer public source of condom.

Conclusions

This study concludes that there was limited access to condoms during the COVID-19 pandemic and that the preferred source of condoms was very skewed to public sources in South Africa. Strategic interventions such as community distribution of free condoms to avert obstruction of condom access during the COVID-19 pandemic or any future pandemics should be adopted.

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  1. Version published to 10.1186/s13690-021-00701-5
  2. Version published to 10.1101/2020.09.11.20192849v3 on medRxiv
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    SciScore for 10.1101/2020.09.11.20192849: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Ethics approval and consent to participate: This study is a secondary analysis of the NIDS-CRAM wave 1 dataset.
    IRB: Ethical approval for NIDS-CRAM was granted by the University of Cape Town (UCT) Commerce Faculty Ethics Committee.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical Analysis: NIDS_CRAM wave 1 dataset was recoded and analyzed using STATA version 16.
    STATA
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and Limitations: The use of secondary datasets has its limitations as some questions of interest to further probe the respondents in terms of retrospective questions were not asked during data collection, and this limited the scope of the study. The strength of this study is the use of aboriginal staff during the telephone interview. The use of computer-assisted telephone interviewing during 2019-nCoV is another important strength of the study. Conclusion and Recommendations: Limited access to condoms is the ignored elephant in the room. This study added to the body of literature that there was limited access to condoms during 2019-nCoV and that the preferred source of condoms was very skewed in South Africa. The study concluded that demographic and economic characteristics of South Africans influenced their adopted sources of condoms and that limited access to condoms was more experienced among the aged population, Black South African population groups, those who reside in Free state, Mpumalanga and KwaZulu-Natal provinces and those who were either poor nor rich, i.e., those in the 4th quintile of wealth income and those uneducated. Policies, strategies, and interventions that will consider the contraception demands of South Africans during the ongoing or future pandemic should be targeted at similar demographic and economic characteristics. This will reduce the unmet need for contraception in South Africa and tackle the unequal family planning use coverage.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  4. Version published to 10.1101/2020.09.11.20192849v2 on medRxiv
  5. Version published to 10.1101/2020.09.11.20192849v1 on medRxiv