Utilization and contributing factors of sexual and reproductive health services in Ethiopia during COVID-19 pandemic፡ A systematic review and meta-analysis

Abstract Background: The COVID-19 pandemic has reduced access to and utilization of essential health services, including sexual and reproductive health services. The indirect supply-side and demand-side effects of the coronavirus pandemic has shown moderate service reduction scenarios can lead to a large number of additional maternal deaths Objective: Determine the pooled proportion and contributing factors of sexual and reproductive health care in Ethiopia during the COVID-19 pandemic was the primary goal of this systematic review and meta-analysis. Methods: The Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-2020) statement guided the conduct of this systematic review and meta-analysis. Electronic databases like SCOPUS, EMBASE, PubMed, and Science Direct were used to search for the papers. Studies were searched utilizing additional data sources such as Google scholar's advanced search and Google. The COVID 19 period and the latest search dates of June 6, 2022 were used for the primary research. Heterogeneity was evaluated using I2 and Q-statistics. Wherever possible subgroup analysis was planned by study setting, and overall risk of bias (study quality). To test the small study effect; funnel plot and egger's test were applied in the Meta-analysis Result: A total of six studies with 3848 participants included in this Meta-analysis. the pooled proportion of sexual and reproductive health service utilization reported by 6 studies was 32% (95%CI (18,46%)). In the sub group analysis, the pooled proportion of SRH service utilization for study done at the community level was 26% (95% CI:6-46%) and 38% (95% CI: 26-50%) among institutional based studies. Participants age 20-24 (OR=2.4 95% CI:1.07-5.3) Participate in youth club (OR=2.74; 95% CI:10.07-6.99), Ever had sexual partner (OR=1.65; 95% CI:1.11-2.45), Participated in peer-to-peer education (OR=1.71; 95% CI:1.12-2.62), and having pocket money (OR=2.5;3 95% CI:1.03-6.19) where variables had positively associated with sexual and reproductive health service utilization. Conclusion: The pooled SRH service utilization in Ethiopia during COVID 19 was decreased compared to SRH service utilization before the pandemic. Participants age 20-24, Participate in youth, ever had sexual partner, participated in peer-to-peer education, and having pocket money where variables had positively associated with sexual and reproductive health service utilization.