Scoping Review on the Impact of Outbreaks on Sexual and Reproductive Health Services: Proposed Frameworks for Pre-, Intra-, and Postoutbreak Situations

Table 4

Study objectives and key findings.

Sr#	Study ID	Year	Objective	Outcome measure	Key findings 1	Key findings 2	Key findings 3
1	Adams et al.	2016	Burden of disease	Incidence of Zika virus case in Puerto Ricco	Zika virus epidemic is gaining momentum	Need vector control and personal protection equipment
2	Ali et al.	2018		Contraceptive sales	Little variation during Zika outbreak;	Very low access to LARC methods
3	Ali et al.	2018	Health system readiness	The facility records for contraceptive stock availability, methods mix offered, and utilization pattern; the facility managers and senior health officials in the state were also interviewed	Shortage and stockouts of both short- and long-term contraceptives and long-acting reversible contraceptives (LARCs) were either absent or mostly out of stock	None of the facilities surveyed had either a national abortion guideline or safe abortion check lists
4	Ali et al.	2018	Contraceptive use	Sales of various contraceptive products	The results from this assessment showed that the sales of contraceptives presented little variation during the ZIKV outbreak in Brazil
5	Rao	2016			Lack of awareness, poverty	Sex education and access to contraceptives, safe motherhood, safe abortion, and programs to prevent discrimination and exclusion of people living with disabilities
6	Bahamondes et al.	2017	Contraceptive use	Sales of various contraceptive products	No significant change in contraceptive sales
7	Bebell et al.	2017	Update on Ebola	Mental mortality	Improved survival with time
8	Besnard et al.	2016	Report on pregnancy outcomes	Pregnancy outcomes	Medical Abortion in 11/19 cases, infant death in 2/19 cases, neurological impairment in 6/19 cases
9	Borges et al.	2018	KAP	Pregnancy intentions, contraceptive practice knowledge	Awareness is relatively low, few women changing pregnancy intentions
10	Camara et al.	2017	SRH & healthcare utilization	Contraceptive, antenatal care use, and institutional deliveries	All services affected by Ebola. Decline in all three types of services	Contraceptive services recovered postoutbreak; ANC and institutional deliveries did not
11	Castro et al.	2018	Assessment of decline in number of live births	Liver births, Zika virus syndrome	Observed and forecasted number of live births
12	Ciglenecki et al.	2013	Documenting outcomes in pregnant women with Cholera	Pregnancy outcomes	86% preserved pregnancy, 8% fetal death, 6% live birth
13	da et al.	2014	Documenting outcomes in pregnant women exposed to H1N1	Pregnancy outcomes	Higher health service consumption and deaths observed as compared to non-HIN1 influenza cases and influenza-negative patients
14	Delamou et al.	2017	Effect of Ebola on MNCH service delivery	Eight MNCH health service indicators	Health service utilization indicators worsened during outbreak. Worsening improved postoutbreak but did not indicate recovery
15	Flamand et al.	2017	Asymptomatic cases burden	Asymptomatic cases of Zika	A considerable proportion of women are asymptomatic
16	Fonseca et al.	2016	Describe healthcare provision during double epidemic in ER	Burden of disease	DF disrupted routine care
17	Garde et al.	2016	Describe healthcare provision using triage and isolation	EVD disease protocol implementation	Increased efficiency and quality were seen in patient flow, screening accuracy, nursing skills, IPC, and quality of care	This model can be followed at other places for better service provision
18	Guetiya et al.	2017	Implementation of mobile health clinics	Utilization of mobile clinics	Mobile health clinics were received enthusiastically by the communities	Mobile health clinics address many barriers related to uptake of services among EVD survivors, particularly in remote areas
19	Gunaratne et al.	2006	Outbreak investigation		Suboptimal storage conditions for medical supplies (regular & donated posttsunami)	In availability of optimal storage space for donated medical supplies
20	Henwood et al.	2017	Report on pregnancy outcomes	Maternal and neonatal deaths	Maternal deaths are not different from non-Ebola-infected mothers	Neonatal outcomes are poor suggested by limited data
21	Hyjazi et al.	2015	Report on healthcare service utilization	Utilization of institutional care	The results from this assessment showed that the healthcare utilization reduced greatly due to outbreak
22	Jones et al.	2017	Role of nurses/midwives in providing healthcare during Ebola outbreak	(Qualitative study)	Nurses and midwives faced higher risk of catching Ebola compared to their health workers but continued to provide essential maternity care	Due to profession duty, responsibility to community, and religious beliefs
23	Journel et al.	2017	Implementation of surveillance system	Burden of disease	Implementation of monitoring of Zika virus disease including labs, vector control, social mobilization, and clinical care
24	Kallam et al.	2017	Upgradation of ultrasonographic capacity	Care of equipment, ultrasound provided capacity, service delivery observation, and client volume referral pattern	Ongoing data collection	Need upgradation of diagnostic services
25	Kanmaz et al.	2011	Strategies to handle patient load during influenza A outbreak	Patient handling strategy	Reduction of adverse outcomes likely due to strategic handling of pregnant women
26	Lathrop et al.	2018	Providing free-of-cost reversible contraception to women through a network of providers	Increased utilization of contraception by women	Increased adoption of most effective methods, reduction in nonusers, and users of least effective methods
27	Leno et al.	2018	Healthcare service utilization	Antenatal care visits	Reduction of utilization of healthcare services during Ebola outbreak in centers located in affected areas but not in unaffected areas of Guinea
28	Lori et al.	2015	Healthcare service utilization	Facility-based deliveries	EVD adversely affected rising trend of facility-based deliveries in the Bong county
29	Luginaah et al.	2016	Healthcare service utilization	Timing of first ANC visit	Women delayed first ANC due to stigma attached to the facility
30	Ly et al.	2016	Healthcare service utilization	Facility-based deliveries	Facility-based deliveries reduced	Reduction was significant among those who believed the facility to be a risk factor for contracting Ebola
31	Marteleto et al.	2017	Reproductive intentions and behavior of women during Zika outbreak	—	Most women intend to delay pregnancy	High-SES women had more control on their choices as compared to low-SES women
32	Mupapa et al.	1999	Mortality in EHF mothers admitted to a hospital	Pregnancy outcomes	Very high mortality in mothers admitted with EHF in Kiewit, DRC
33	Tavares et al.	2016	Availability of emergency contraception in northern urban Brazil	Availability of EC at pharmacy	Almost all of the pharmacies have EC available	The knowledge of pharmacist need to be improved
34	Tepper et al.	2016	Contraceptive needs and access to contraception	Unmet need	There is large gap between need and availability of contraception in Puerto Rico	In the backdrop of a large number of unintended pregnancies, there is a need to improve availability and access to contraception
35	Borlin et al.	2016	Impact of outbreak on institutional deliveries & C-sections	Institutional deliveries & C-sections	Outbreak broke the upward trend of higher utilization of SRH in Sierra Leone
36	Theuring et al.	2018	External and intrinsic barriers to facility-based delivery	Facility-based delivery	More supportive staff attitudes; acceptance of an accompanying person throughout delivery	Better referral system and ambulance services
37	Miller et at.	2018	Impact of Ebola on community-based maternal, newborn, and child health (MNCH) services	MNCH services	Sharp decline in MNCH services due to weak service delivery, confusion over policy, and overwhelming nature of outbreak	Services rebounded when clear instructions were given. Despite mistrust, CHWs were more effective than outsiders	Service delivery weaknesses, especially related to supply chain and supervision, limited the effectiveness of community health services before, during, and after the outbreak