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Article

Barriers to Contraceptive Access in Nigeria During COVID-19: Lessons for Future Crisis Preparedness

by
Turnwait Otu Michael
Department of Sociology, University of Johannesburg, Johannesburg P.O. Box 524, South Africa
COVID 2025, 5(9), 160; https://doi.org/10.3390/covid5090160
Submission received: 25 August 2025 / Revised: 16 September 2025 / Accepted: 18 September 2025 / Published: 19 September 2025
(This article belongs to the Special Issue COVID and Public Health)
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Abstract

Background: The COVID-19 pandemic disrupted essential health services globally, including contraceptive provision. This study examined barriers to contraceptive access in Nigeria during the national lockdown and lessons for future health crisis preparedness. Methods: A cross-sectional online survey of 1273 respondents was conducted during the COVID-19 lockdown. Descriptive statistics and multivariate logistic regression were used to identify predictors of unmet contraceptive need. Online convenience sampling may limit representativeness. Results: Fear of contracting COVID-19 at health facilities (76.6%), closure of drug and chemist shops (53.7%), movement restrictions (48.4%), and inability to reach healthcare providers (43.5%) were the most reported barriers. Adults aged 26–33 years (AOR = 2.00, 95% CI: 1.05–3.73), those married or cohabiting (AOR = 3.87, 95% CI: 2.58–5.68), and Yoruba respondents (AOR = 1.70, 95% CI: 1.04–2.58) were significantly more likely to report unmet need. Tertiary education (AOR = 0.28, 95% CI: 0.13–0.55) and rural residence (AOR = 0.57, 95% CI: 0.37–0.86) were protective factors. Conclusion: COVID-19-related restrictions exposed systemic weaknesses in Nigeria’s contraceptive delivery. Addressing fragile supply chains, strengthening community-based alternatives, and embedding reproductive health into emergency preparedness plans will be critical to building resilient systems for future crises.

1. Introduction

The COVID-19 pandemic exposed significant weaknesses in health systems worldwide, disrupting essential health services and threatening decades of progress in sexual and reproductive health. Globally, the diversion of resources to the emergency pandemic response led to widespread interruptions in contraceptive services, particularly in low- and middle-income countries (LMICs) where fragile health infrastructure and supply chains were already overburdened [1,2,3]. The United Nations Population Fund (UNFPA) estimated that in the first year of the pandemic alone, nearly 12 million women in 115 LMICs experienced contraceptive interruptions, resulting in approximately 1.4 million unintended pregnancies [4]. Global modelling further suggested that even a 10% decline in contraceptive access in LMICs could lead to more than 15 million unintended pregnancies and 28,000 additional maternal deaths annually [5].
Across Africa, studies highlighted how COVID-19 heightened inequities in sexual and reproductive health service delivery. Movement restrictions, stock-outs of contraceptives, and fear of visiting health facilities discouraged many women from seeking care [6,7,8]. Research from sub-Saharan Africa showed that disruptions extended beyond contraception to maternal and child health services, compounding risks of preventable morbidity and mortality [9,10]. Comparable findings were reported in Cambodia [11], India [12], Brazil [13], and Spain [14], underscoring that the pandemic’s effects on reproductive health were both widespread and context-specific.
In Nigeria, the most populous country in Africa with over 230 million people, these challenges were particularly acute [15]. Even before COVID-19, contraceptive prevalence was low (modern contraceptive prevalence rate of 17%) while unmet need remained high, especially among married women and adolescents [16,17]. Structural weaknesses such as uneven distribution of commodities, inconsistent supply chains, socio-cultural stigma, and limited provider availability were already well documented [18,19]. When lockdown measures were imposed, these vulnerabilities were exacerbated: closures of health facilities and pharmacies, enforcement of movement restrictions, and heightened fear of COVID-19 infection further constrained access to contraceptives [20,21].
Emerging Nigerian studies provide further evidence of these disruptions. Adefalu et al. [21] reported an estimated 10% decline in the use of injectable contraceptives, largely due to supply interruptions and reduced mobility. Adelekan et al. [20,22] found that women often resorted to informal sources such as medicine vendors or self-medication when formal health services were inaccessible. Samson et al. [23] further documented declines in contraceptive uptake during the pandemic and highlighted persistent barriers in the post-COVID period, suggesting that recovery has been uneven across regions and social groups. Similar concerns were echoed in multi-country studies across Africa, where respondents consistently cited fear of infection, financial hardship, and health system closures as drivers of unmet contraceptive need [24,25,26]. The Nigerian case is critical not only because of the country’s size and demographic profile, but also because setbacks in contraceptive access threaten broader commitments, including Family Planning 2030 targets, Sustainable Development Goal 3 (health and well-being), and Goal 5 (gender equality) [27,28]. Unmet need for contraception translates directly into unplanned pregnancies, unsafe abortions, and elevated maternal risks; burdens that disproportionately affect the poor and vulnerable [29,30].
Most previous studies on contraceptive access during COVID-19 in Nigeria have relied on secondary data analyses or small, localized qualitative studies that document service disruptions and women’s experiences [17,20,23]. These challenges highlight the need to understand the barriers faced during COVID-19 in order to inform preparedness for future crises. This study fills a critical gap by using primary, nationally distributed survey data, collected during the lockdown to examine barriers and socio-demographic predictors of unmet contraceptive need, offering evidence to guide policies and practices that safeguard contraceptive access in times of emergency and ensure that essential reproductive health services remain a priority within both national and global health agendas. As such, this study addresses the following research question: What were the major barriers to contraceptive access during the COVID-19 lockdown in Nigeria, and which socio-demographic groups were most affected by unmet need? It hypothesizes that socio-demographic factors were significantly associated with unmet contraceptive need.

2. Materials and Methods

2.1. Study Design and Setting

This study employed a cross-sectional analytical design to investigate barriers to contraceptive access during the COVID-19 pandemic in Nigeria. Data were collected between May and September 2020, during the period immediately following the national lockdown and the partial resumption of non-emergency health services. Nigeria, with the largest population in Africa, is marked by variations in socio-economic status, cultural norms, and health system capacity across its 36 states and the Federal Capital Territory (FCT) [15].

2.2. Study Population

The target population comprised adults aged 18 years and older residing in Nigeria during the COVID-19 pandemic. The analysis focused on 1273 respondents after data cleaning and exclusion of incomplete responses. Both men and women were included to capture demand- and supply-side perspectives on contraceptive access.

2.3. Eligibility Criteria

The inclusion criteria were adults aged ≥18 years; residing in Nigeria during the COVID-19 lockdown period; provided informed consent; and reported knowledge of at least one modern contraceptive method. The exclusion criteria were responses with >20% missing data and individuals not residing in Nigeria during the study period.

2.4. Sampling and Recruitment

A non-probability convenience sampling approach was adopted, given the movement restrictions and safety considerations during the pandemic. Recruitment was conducted primarily via online platforms, including WhatsApp, Facebook, and email networks, complemented by referral through professional and community groups. The survey link was disseminated with a brief study description, inclusion criteria, and assurances of confidentiality.

2.5. Data Collection Instrument

Data were collected using a pre-tested, structured, self-administered online questionnaire developed in English. The questionnaire was informed by the existing literature on contraceptive access in LMICs, WHO recommendations on reproductive health service continuity during pandemics, and input from reproductive health experts. The instrument comprised the following sections: socio-demographic characteristics (age, sex, marital status, education, religion, ethnicity, place of residence, and number of children); contraceptive use and access (type of method used, source of supply, availability during COVID-19 lockdown); barriers to access (facility closure, commodity stock-outs, transport restrictions, fear of COVID-19 infection, increased costs, and stigma), and outcome variable (unmet need for contraception during the COVID-19 lockdown (binary: Yes/No). The questionnaire was piloted with 30 respondents to test clarity, internal consistency, and online functionality. Based on feedback, ambiguous items were revised (e.g., simplifying wording on contraceptive method used and types) and technical issues in skip patterns were corrected.

2.6. Variables and Measures

2.6.1. Dependent Variable

Unmet contraceptive need during COVID-19 lockdown was the dependent variable, coded as 1 if the respondent reported wanting to avoid pregnancy but was unable to obtain or use contraception during lockdown, and 0 otherwise. Unmet contraceptive need during COVID-19 lockdown was defined as respondents wanting to avoid pregnancy but unable to obtain or use contraception. This measure aligns with DHS/UN indicators [16], but adapted to the lockdown context. The study distinguished “needs” (intention to avoid pregnancy) from “wants” (preference for a specific method), though its binary measure captures only the former.

2.6.2. Independent Variables

These included Sex (male, female); Age group (18–25, 26–33, 34–41, ≥42); Marital status (single, married/cohabiting, divorced/separated); Education (below tertiary, tertiary); Religion (Christianity, Islam, other); Ethnicity (Hausa, Yoruba, Igbo, other); Residence (urban, suburban, rural); and Number of children born (0, 1–2, 3–4, ≥5).

2.7. Bias Control and Sample Size Determination

To minimize recall bias, participants were specifically asked about experiences during the COVID-19 lockdown period. Social desirability bias was reduced through anonymous data collection, with no personally identifiable information requested. The online format helped mitigate interviewer bias. The minimum required sample size was calculated using the Cochran formula for cross-sectional studies, assuming a 50% prevalence of unmet need for contraception during pandemics (to maximize sample size), 95% confidence level, and 5% margin of error. The required minimum was 384 respondents; the final sample size of 1273 exceeded this threshold, improving statistical power.

2.8. Data Management and Analysis

Data were downloaded from Google Forms into Microsoft Excel and exported to SPSS version 25 for cleaning and analysis. Descriptive statistics (frequencies, percentages, means, and standard deviations) summarized socio-demographic characteristics and reported barriers. To assess multicollinearity among predictors in regression models, the study examined variance inflation factors (VIFs), all of which were <2, indicating no problematic collinearity. Bivariate analysis using Chi-square tests assessed associations between unmet contraceptive need and independent variables. Variables with p < 0.05 in bivariate analysis were entered into multivariable logistic regression models to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Model fit was assessed using the Nagelkerke R-square and −2 log-likelihood statistics. Statistical significance was set at p < 0.05. Strengthening the Reporting of Observational Studies in Epidemiology’ (STROBE) statement guideline shaped the drafting of this manuscript [31].

2.9. Directed Acyclic Graph (DAG) Construction

To clarify the assumed causal relationships guiding the analysis, the study constructed a Directed Acyclic Graph (DAG) using the open-source software DAGitty https://dagitty.net/dags.html (accessed on 10 September 2025). The DAG (Figure 1) illustrates hypothesized pathways between socio-demographic characteristics (e.g., sex, age, marital status, education, ethnicity, residence, and parity), barriers to contraceptive access (fear of infection, facility closures, mobility restrictions), and unmet contraceptive need. In addition, potential confounders such as economic status, digital access, and local health system factors were included to reflect contextual influences that may affect both barriers and unmet need. Although not all confounders were directly measured in the survey, explicitly mapping them strengthens transparency about possible sources of bias. The DAG informed the multivariable regression model specification and highlights the importance of considering both measured and unmeasured determinants when interpreting associations. Barriers were measured but not included in regression due to the focus on socio-demographic predictors. However, they are included in the DAG to reflect their conceptual role as mediators.

2.10. Ethical Considerations

Ethical approval was obtained from the Afe Babalola University Ado-Ekiti Health Research Ethical Committee (Approval No: AB/EC/20/12118). The study adhered to the principles of the Declaration of Helsinki. Participation was voluntary, with informed consent obtained online before survey commencement. Data were stored in password-protected files accessible only to the research team.

3. Results

3.1. Participants’ Socio-Demographic Characteristics

A total of 1273 respondents participated in the survey, as shown in Table 1. Slightly more than half were male (52.7%), and the largest proportion were aged 26–33 years (42.9%), followed by those aged 34–41 years (30.9%). Most were married (58.6%) and highly educated, with 81.1% holding tertiary qualifications. Christianity was the dominant religion (65.7%), while Yoruba respondents formed the largest ethnic group (48.3%). The majority resided in urban areas (71.2%), and just under two-fifths (38.7%) reported having no children, compared with 30.8% who had one to two and 22.6% who had three to four children. Women (46.5%) reported significantly higher unmet contraceptive needs compared to men (37.9%, χ2 = 4.21, p = 0.040). Younger adults aged 26–33 years (45.1%) and 34–41 years (42.2%) showed the highest levels of unmet need, whereas only 26.7% of those aged 50 years or older reported difficulties (χ2 = 12.58, p = 0.014). Marital and cohabiting respondents were also disproportionately affected, with nearly half (48.9%) of married individuals reporting unmet need compared to just 30.2% of singles (χ2 = 25.67, p < 0.001).
Education, ethnicity, residence, and parity further shaped patterns of access. Respondents with lower education levels were more likely to experience unmet need (53.4% among those with primary education vs. 40.2% among tertiary-educated, χ2 = 18.34, p < 0.001). By ethnicity, Yoruba respondents recorded the highest unmet need (47.0%), significantly higher than their Hausa counterparts (32.1%, χ2 = 22.71, p < 0.001). Urban and suburban residents were more affected than rural dwellers, with 44.5% and 46.6% reporting unmet need, respectively, compared to 27.3% in rural areas (χ2 = 15.49, p < 0.001). Similarly, unmet need was strongly associated with parity, rising to 52.0% among respondents with five or more children compared to 31.8% among those with no children (χ2 = 29.83, p < 0.001).

3.2. Contraceptive Methods Previously Used

Male condoms were the most frequently reported method (52.4%), followed closely by the withdrawal method (46.8%). Pills were used by 21.1% of respondents, and 22.2% reported using the rhythm/calendar method. While condoms and pills fall under modern contraceptive methods, withdrawal and rhythm are traditional methods (Figure 2).

3.3. Barriers to Access During the COVID-19 Lockdown

Fear of contracting illness in healthcare facilities was the most cited barrier to contraceptive access, reported by 76.6% of participants. Over half (53.7%) indicated that closures of drug or chemist shops limited their access, while 48.4% reported that movement restrictions posed a major obstacle. In addition, 43.5% stated they could not reach healthcare providers for contraceptive services or advice (Figure 3).

3.4. Predictors of Unmet Contraceptive Need

The logistic regression analysis shown in Table 2 identified key socio-demographic factors significantly associated with unmet contraceptive need. Model 1 included only the core socio-demographic variables (sex, age, marital status, education, and ethnicity). The results show that women aged 26–33 years and 34–41 years had about two times higher odds of reporting unmet need compared to younger adults (18–25 years). Being married or cohabiting strongly predicted unmet need (OR = 7.25, p < 0.001), while having tertiary education reduced the likelihood substantially (OR = 0.38, p < 0.001). Ethnic differences were also notable, with Yoruba, Igbo, and respondents from other groups more likely than Hausa respondents to report unmet need. Model 2 extended the analysis by adding contextual variables (residence and number of children born). The model shows that rural residence was protective (OR = 0.51, p < 0.001), while having one to four children dramatically increased the odds of unmet need (OR = 7.71 for 1–2 children; OR = 7.58 for 3–4 children, both p < 0.001).
Model 3, the fully adjusted model, combined all variables. The inclusion of fertility status and residence reduced some effect sizes observed in Model 1, but key predictors remained significant. For example, adults aged 26–33 years were more likely to report unmet need compared to the 18–25-year reference group (OR = 2.04; 95% CI: 1.17–3.64) in model 1. While those aged 34–41 years initially appeared more likely to have unmet need (OR = 2.24; 95% CI: 1.15–3.95) in model 1, the association was no longer significant when controlling for other factors in the full model. Being married or cohabiting was strongly associated with higher odds of unmet need (OR = 3.87; 95% CI: 2.58–5.68) compared to single respondents. Having a tertiary education significantly reduced the likelihood of unmet need (OR = 0.28; 95% CI: 0.13–0.55). Respondents identifying as Yoruba had higher odds of unmet need than Hausa participants (OR = 1.70; 95% CI: 1.04–2.58). Rural residents had lower odds of unmet need than urban residents (OR = 0.57; 95% CI: 0.37–0.86). Having two to four children was associated with higher odds of unmet need (OR = 4.04; 95% CI: 2.40–6.49) compared to having no children. No significant association was found between sex and unmet need in any of the models. Across models, the model fit improved (Nagelkerke R2 increasing from 0.276 in Model 1 to 0.340 in Model 3), indicating that adding contextual and fertility-related factors better explained variations in unmet contraceptive need.
Model statistics:
  • Model 1 χ2 = 321.76 ***; Nagelkerke R2 = 0.276; -2LL = 1608.12.
  • Model 2 χ2 = 328.41 ***; Nagelkerke R2 = 0.281; -2LL = 1601.92.
  • Model 3 χ2 = 411.03 ***; Nagelkerke R2 = 0.340; -2LL = 1519.11.

4. Discussion

This study examined contraceptive access in Nigeria during the COVID-19 lockdown, highlighting barriers, socio-demographic predictors, and lessons for post-pandemic preparedness. The most commonly reported barrier to contraceptive access was fear of contracting COVID-19 at health facilities, which is consistent with evidence from India, Kenya, and Uganda where fear of infection discouraged routine health service use [8,12]. Similar patterns were observed in Spain, where women reported avoiding reproductive health services due to heightened infection concerns during confinement [14]. In Nigeria, Adelekan et al. [20] also documented women’s reluctance to attend facilities because of mandatory testing and stigma, echoing the present study’s finding that fear was a major deterrent. Beyond fear, structural barriers such as closure of drug and chemist shops, restricted mobility, and lack of contact with providers were widely cited in this study. Comparable challenges were identified in South Africa and Zambia, where contraceptive users reported stock-outs and service closures as major obstacles [25]. Likewise, a multi-country survey in Malawi, Niger, Uganda, and Nepal confirmed that COVID-19 restrictions led to widespread disruption of family planning services [24].
The present study analysis further showed that adults aged 26–33 years and those in marital or cohabiting relationships were disproportionately affected. This is in line with studies in Cambodia and India, which found that women in unions expressed higher unmet need during the pandemic due to increased coital frequency and restricted access to modern methods [11,12]. Samson et al. [23] similarly reported from Nigeria that married women experienced a sharper decline in contraceptive use during COVID-19 compared to singles, reinforcing the pattern observed in the current study’s findings. Cultural differences also played a role, as Yoruba respondents had higher unmet need compared to Hausa participants. Such ethnic or regional disparities have been previously noted in Nigeria and other multi-ethnic societies, where cultural attitudes, fertility norms, and health system inequities shape contraceptive outcomes [17,18].
A particularly novel finding was that rural residents reported lower odds of unmet need compared to their urban counterparts. While this finding is unexpected and contrasts with pre-pandemic patterns [16], it should be interpreted cautiously. It may reflect reduced enforcement of lockdown restrictions in rural areas and reliance on informal or community-based supply channels, but further evidence is required. Studies found that women in rural Nigeria relied on local medicine vendors during the pandemic, partially insulating them from formal supply chain breakdowns [22,32]. Similar adaptive responses were documented in Nepal and the Democratic Republic of Congo, where rural communities maintained access through informal networks while urban centres faced stricter restrictions [29,33].
The protective effect of tertiary education aligns with evidence from sub-Saharan Africa and Asia showing that higher educational attainment enhances health literacy, decision-making autonomy, and ability to navigate service disruptions [6,34]. Women and men with greater education are also more likely to use digital platforms for health information or telemedicine consultations, a trend observed in Nigeria, Brazil, and the United States [13,35,36]. The association between having two to four children and higher unmet need demonstrates the importance of prioritizing multiparous individuals in crisis-responsive reproductive health interventions. Similar findings were reported in Egypt and Brazil, where women with multiple children faced greater difficulty maintaining contraceptive use during COVID-19 disruptions [37,38]. This suggests that in times of health crises, families with established fertility may carry greater unmet needs for spacing and limiting births but encounter the same systemic barriers to access.
Taken together, the Nigerian evidence contributes to a broader global narrative of reproductive health service fragility during crises. Studies from Kenya, Uganda, and Zambia [8], South Africa [39], and Latin America [13] demonstrate that disruptions were not unique to Nigeria but reflect a structural vulnerability across LMICs. Yet, Nigeria’s demographic scale and already low contraceptive prevalence [16] make these disruptions particularly consequential for national and global health goals. From a policy perspective, these findings emphasize the importance of embedding contraceptive services within emergency preparedness frameworks. This includes ensuring contraceptive supply chains are categorized as essential, establishing decentralized and community-based distribution systems, and leveraging digital health platforms for counselling and follow-up [28,35]. Effective communication strategies to reduce fear of facility visits, coupled with regulatory support for pharmacy- and telemedicine-based contraceptive delivery, could safeguard access in future crises [40,41]. Strengthening these systems is not only essential for protecting reproductive health during pandemics but also for advancing global commitments to Sustainable Development Goals 3 and 5, and Nigeria’s Family Planning 2030 agenda [42,43].

4.1. Strengths and Limitations

The strengths and limitations of this study must be acknowledged. The nationwide scope and inclusion of both men and women provide a detailed overview of contraceptive access patterns during the lockdown. However, the reliance on self-reported online survey data may have excluded individuals without internet access, potentially underrepresenting certain rural and low-income populations. The non-probability convenience sampling method, while pragmatic during lockdown restrictions, limits external validity, generalizability and national representativeness. Additionally, while logistic regression identified significant associations, the cross-sectional design limits causal interpretation. This limitation applies particularly to predictors of unmet need and should be borne in mind when interpreting results. Also, some subgroups or categories showed slightly wide confidence intervals, suggesting uncertainty in subgroup estimates. Overall, this study contributes valuable evidence on the nature and extent of contraceptive service disruptions in Nigeria during COVID-19. It underscores the importance of building flexible, resilient reproductive health systems capable of withstanding future pandemics or other public health emergencies.

4.2. Lessons for Future Crisis Preparedness

The findings of this study highlight important lessons for strengthening health system resilience and safeguarding contraceptive access during future crises. First, essential reproductive health services must be explicitly integrated into emergency preparedness frameworks at national and sub-national levels. The pandemic exposed how quickly supply chains, facility operations, and provider availability can be disrupted, leaving vulnerable populations without access to critical services. Ensuring stockpiles of contraceptives, decentralized distribution channels, and adaptable logistics systems is vital to maintaining continuity.
Second, the evidence emphasises the importance of community-based and alternative delivery mechanisms. In contexts where fear of infection or mobility restrictions hindered facility-based care, reliance on pharmacies, patent medicine vendors, and community health workers provided some level of continuity. Future preparedness should strengthen such networks, including safe self-care options (e.g., self-injectables, over-the-counter emergency contraception), which can reduce service disruption during emergencies.
Third, information and communication strategies proved to be crucial. Fear of contracting illness in healthcare facilities was the single most significant barrier identified in this study. Public health messaging that reassures communities of safe service provision, coupled with telehealth and digital platforms for counselling, could mitigate such fears. Lessons from other countries, such as the expansion of telemedicine for reproductive health in South Africa and Brazil, demonstrate that digital health interventions can reduce inequalities in access during crises.
Fourth, this study highlights the need for equity-focused approaches in preparedness planning. Groups such as women with multiple children, married or cohabiting individuals, and specific ethnic sub-populations reported disproportionately high unmet needs. Tailored interventions that recognize the diverse needs of these groups will help ensure no community is left behind during future disruptions.
Together, these lessons emphasize that protecting contraceptive access is not just a health issue but also a strategic imperative for social and economic stability. Investing in crisis-proof reproductive health systems today will help Nigeria and other countries facing similar challenges avoid the cascading consequences of unintended pregnancies, maternal morbidity, and poverty in future emergencies.

4.3. Implications for Policy, Research, and Practice

The findings highlight the need for policies that embed contraceptive access as a core component of Nigeria’s emergency preparedness and health system resilience strategies. Pandemic-related service disruptions revealed the fragility of supply chains and the absence of contingency planning for essential reproductive health services. Policymakers should establish decentralized contraceptive distribution systems, integrate contraceptive commodities into national emergency stockpiles, and develop flexible service delivery models such as mobile clinics and community-based distribution during crises. In addition, regulatory frameworks should be strengthened to ensure that pharmacies and accredited patent medicine vendors remain operational during public health emergencies, with clear guidelines to maintain continuity of care.
The study emphasizes the necessity for ongoing surveillance and context-specific research on the determinants of contraceptive access during health emergencies. Future research should employ mixed-methods approaches to capture both quantitative trends and qualitative experiences, enabling a nuanced understanding of how barriers manifest in different population groups. Longitudinal studies will be critical to assess the long-term effects of pandemic-related service disruptions on contraceptive uptake, fertility intentions, and maternal health outcomes. Furthermore, comparative studies across sub-Saharan Africa could provide insights into best practices and adaptable models for resilience in reproductive health service delivery.
For practitioners, the results call for proactive engagement with communities to sustain contraceptive access even during movement restrictions or facility closures. Health care providers should be trained in delivering remote counselling and follow-up via mobile and digital platforms, ensuring clients receive timely guidance on contraceptive options and side-effect management. Community health workers can play a pivotal role by providing doorstep delivery of commodities, linking clients to alternative service points, and countering misinformation that may deter contraceptive use during emergencies. Importantly, integrating contraceptive services with other essential health interventions, such as immunization and chronic disease care, could improve efficiency and safeguard access in both routine and crisis settings.

5. Conclusions

This study demonstrates that barriers to contraceptive access in Nigeria during the COVID-19 pandemic were shaped by intersecting socio-demographic and systemic factors. Rather than simply noting disruption, the findings highlight specific vulnerabilities by marital status, parity, education, and ethnicity, which must inform preparedness. Ensuring continuity of contraceptive access is a critical component of national resilience strategies for future public health crises. These findings are of immediate relevance to both national and global commitments, including Nigeria’s Family Planning 2030 targets, the Sustainable Development Goals (SDGs), and the World Health Organization’s Universal Health Coverage (UHC) framework. They show the importance of integrating contraceptive services into national emergency preparedness plans and ensuring their continuity under all circumstances.
The importance of this evidence cannot be overstated. Without decisive action to address the barriers identified, such as supply chain fragility, inequitable access across regions, and the lack of adaptive service delivery models, Nigeria risks reversing hard-won gains in reproductive health, increasing the rates of unintended pregnancies, unsafe abortions, and maternal morbidity. At a global level, inaction would weaken collective progress towards SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality) and exacerbate existing inequalities in health outcomes. Failure to act now will not only perpetuate avoidable health burdens but also compromise the resilience of communities to withstand future health crises. Conversely, swift, evidence-based interventions, grounded in the lessons of this pandemic, offer a unique opportunity to strengthen health systems, protect reproductive rights, and safeguard the well-being of women, families, and communities for years to come.

Funding

This research received no external funding.

Institutional Review Board Statement

Ethical approval was obtained from the Afe Babalola University Ado-Ekiti Health Research Ethical Committee (Approval No: AB/EC/20/12118) on 11 January 2020. The study adhered to the principles of the Declaration of Helsinki.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Data is available from the author upon reasonable request.

Acknowledgments

We would like to thank all the volunteers who participated in this study.

Conflicts of Interest

The author declares no conflicts of interest.

References

  1. Sully, E.; Biddlecom, A.; Darroch, J.; Riley, T.; Ashford, L.; Lince-Deroche, N.; Firestein, L.; Murro, R. Adding It Up: Investing in Sexual and Reproductive Health 2019; Guttmacher Institute: New York, NY, USA, 2020. [Google Scholar]
  2. Pujolar, G.; Oliver-Anglès, A.; Vargas, I.; Vázquez, M.-L. Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review. Int. J. Environ. Res. Public Health 2022, 19, 1749. [Google Scholar] [CrossRef]
  3. Chippaux, J.-P. COVID-19 Impacts on Healthcare Access in Sub-Saharan Africa: An Overview. J. Venom. Anim. Toxins Incl. Trop. Dis. 2023, 29, e20230002. [Google Scholar] [CrossRef] [PubMed]
  4. UNFPA One Year into the Pandemic, UNFPA Estimates 12 Million Women Have Seen Contraceptive Interruptions, Leading to 1.4 Million Unintended Pregnancies. Available online: https://www.unfpa.org/news/one-year-pandemic-unfpa-estimates-12-million-women-have-seen-contraceptive-interruptions (accessed on 23 August 2025).
  5. Riley, T.; Sully, E.; Ahmed, Z.; Biddlecom, A. Estimates of the Potential Impact of the COVID-19 Pandemic on Sexual and Reproductive Health In Low-and Middle-Income Countries Impacts of the Pandemic on SRH Outcomes. Int. Perspect. Sex. Reprod. Health 2020, 46, 73–76. [Google Scholar] [CrossRef] [PubMed]
  6. Bolarinwa, O.A.; Odimegwu, C.; Ajayi, K.V.; Oni, T.O.; Sah, R.K.; Akinyemi, A. Barriers and Facilitators to Accessing and Utilising Sexual and Reproductive Health Services during the COVID-19 Pandemic in Africa: A Systematic Review and Meta-Analysis. BMC Health Serv. Res. 2024, 24, 1554. [Google Scholar] [CrossRef]
  7. Yu, J.; Grace, K.; Boyle, E.H.; Mikal, J.P.; Gunther, M.; Kristiansen, D. COVID-19 and Contraceptive Use in Two African Countries: Examining Conflicting Pressures on Women. Popul. Dev. Rev. 2024, 50, 395–419. [Google Scholar] [CrossRef]
  8. Kuria-Ndiritu, S.; Karanja, S.; Mubita, B.; Kapsandui, T.; Kutna, J.; Anyona, D.; Murerwa, J.; Ferguson, L. Impact of the COVID-19 Pandemic and Policy Response on Access to and Utilization of Reproductive, Maternal, Child and Adolescent Health Services in Kenya, Uganda and Zambia. PLoS Glob. Public Health 2024, 4, e0002740. [Google Scholar] [CrossRef] [PubMed]
  9. Murewanhema, G.; Mpabuka, E.; Moyo, E.; Tungwarara, N.; Chitungo, I.; Mataruka, K.; Gwanzura, C.; Musuka, G.; Dzinamarira, T. Accessibility and Utilization of Antenatal Care Services in Sub-Saharan Africa during the COVID-19 Pandemic: A Rapid Review. Birth 2023, 50, 496–503. [Google Scholar] [CrossRef]
  10. Michael, T.O.; Ekpenyong, A.S.; Nwokocha, E.E. Women’s Empowerment and Sexual Autonomy in Sub-Saharan Africa: A Survey Based Analysis of 22 Countries. Sex. Gend. Policy 2025, 8, e70008. [Google Scholar] [CrossRef]
  11. Ung, M.; Lam, S.T.; Tuot, S.; Chhoun, P.; Prum, V.; Nagashima-Hayashi, M.; Neo, P.; Marzouk, M.; Durrance-Bagale, A.; De Beni, D.; et al. Sexual and Reproductive Health Services Access and Provision in Cambodia during the COVID-19 Pandemic: A Mixed-Method Study of Urban–Rural Differences. Reprod. Health 2023, 20, 74. [Google Scholar] [CrossRef]
  12. Prusty, R.K.; Khan, S.; MK, B.; Tandon, D.; Kabra, R.; Allagh, K.P.; Joshi, B. Client Perspectives on Barriers and Facilitators to Avail Family Planning Services During the COVID-19 Pandemic in Maharashtra, India: A Qualitative Study. J. Health Manag. 2025, 27, 533–542. [Google Scholar] [CrossRef]
  13. Bahamondes, L.; Cecatti, J.G.; Munezero, A.; Soeiro, R.E.; Fernandes, K.G.; Haddad, S.M.; Bento, S.F.; Padua, K.S.; Zotareli, V.; Charles, C.M.; et al. Disruption and Recovery of Family Planning, Contraception and Other Sexual and Reproductive Health Services in Brazil with COVID-19 Pandemic: A Mixed Methods Approach. Reprod. Health 2025, 22, 143. [Google Scholar] [CrossRef]
  14. Leon-Larios, F.; Silva Reus, I.; Lahoz Pascual, I.; Quílez Conde, J.C.; Puente Martínez, M.J.; Gutiérrez Ales, J.; Correa Rancel, M. Women’s Access to Sexual and Reproductive Health Services during Confinement Due to the COVID-19 Pandemic in Spain. J. Clin. Med. 2022, 11, 4074. [Google Scholar] [CrossRef]
  15. Worldometer Nigeria Population. 2025. Available online: https://www.worldometers.info/world-population/nigeria-population/ (accessed on 8 July 2025).
  16. National Population Commission (NPC) [Nigeria]; ICF. Nigeria Demographic and Health Survey 2018; NPC: Abuja, Nigeria, 2019.
  17. Esievoadje, E.S.; Odimegwu, C.L.; Agoyi, M.O.; Jimoh, A.O.; Emeagui, O.D.; Emeribe, N.; Ogbonna, V.I.; Oseji, M.; Buowari, D.Y. Accessibility and Utilization of Family Planning Services in Nigeria During the Coronavirus Disease-2019 Pandemic. Niger. J. Med. 2022, 31, 133–137. [Google Scholar] [CrossRef]
  18. Oyewo, E. Systemic Effects on Access to and Utilization of Quality Contraceptive Services by Women of Reproductive Age During Covid-19 Pandemics in Oyo State, Nigeria. Texila Int. J. Public Health 2022, 55–65. [Google Scholar] [CrossRef]
  19. Folayan, M.O.; Arije, O.; Enemo, A.; Sunday, A.; Muhammad, A.; Nyako, H.Y.; Abdullah, R.M.; Okiwu, H.; Undelikwo, V.A.; Ogbozor, P.A.; et al. Factors Associated with Poor Access to HIV and Sexual and Reproductive Health Services in Nigeria for Women and Girls Living with HIV during the COVID-19 Pandemic. Afr. J. AIDS Res. 2022, 21, 171–182. [Google Scholar] [CrossRef] [PubMed]
  20. Adelekan, B.; Ikuteyijo, L.; Goldson, E.; Abubakar, Z.; Adepoju, O.; Oyedun, O.; Adebayo, G.; Dasogot, A.; Mueller, U.; Fatusi, A.O. When One Door Closes: A Qualitative Exploration of Women’s Experiences of Access to Sexual and Reproductive Health Services during the COVID-19 Lockdown in Nigeria. BMC Public Health 2024, 24, 1124. [Google Scholar] [CrossRef] [PubMed]
  21. Adefalu, A.; Bankole, O.; Olabode, F.; Afolabi, M.; Buba, M.; Dafe, V.; Kalu, M.; Watkins, E. Influence of Movement Restriction During the COVID-19 Pandemic on Uptake of DMPA-SC and Other Injectable Contraceptive Methods in Nigeria. Open Access J. Contracept. 2025, 16, 59–70. [Google Scholar] [CrossRef]
  22. Adelekan, B.; Goldson, E.; Ntoimo, L.F.C.; Adonri, O.; Aliyu, Y.; Onoja, M.; Araoyinbo, I.; Anakhuekha, E.; Mueller, U.; Ekwere, E.-O.; et al. Clients’ Perspectives on the Utilization of Reproductive, Maternal, Neonatal, and Child Health Services in Primary Health Centers during COVID-19 Pandemic in 10 States of Nigeria: A Cross-Sectional Study. PLoS ONE 2023, 18, e0288714. [Google Scholar] [CrossRef]
  23. Samson, T.; Omoyajowo, A.; Adeleke, O. Contraceptive Use and Its Associated Factors in Nigeria: Evidence from during and after COVID-19. Babcock Univ. Med. J. 2025, 8, 348–355. [Google Scholar] [CrossRef]
  24. Brunie, A.; Austin, G.; Arkin, J.; Archie, S.; Amongin, D.; Ndejjo, R.; Acharya, S.; Thapa, B.; Brittingham, S.; McLain, G.; et al. Women’s Experiences With Family Planning Under COVID-19: A Cross-Sectional, Interactive Voice Response Survey in Malawi, Nepal, Niger, and Uganda. Glob. Health Sci. Pract. 2022, 10, e2200063. [Google Scholar] [CrossRef]
  25. Callahan, R.L.; Cartwright, A.F.; Beksinska, M.; Kasaro, M.; Tang, J.H.; Milford, C.; Wong, C.; Velarde, M.; Maphumulo, V.; Fawzy, M.; et al. Contraceptive Access and Use before and during the COVID-19 Pandemic: A Mixed-Methods Study in South Africa and Zambia. Gates Open Res. 2024, 7, 61. [Google Scholar] [CrossRef]
  26. Cavagnis, S.; Ryan, R.; Mussa, A.; Hargreaves, J.R.; Tucker, J.D.; Morroni, C. Disparities in Adult Women’s Access to Contraception during COVID-19: A Multi-Country Cross-Sectional Survey. Front. Glob. Women’s Health 2024, 5, 1235475. [Google Scholar] [CrossRef] [PubMed]
  27. Michael, T.O.; Agbana, R.D.; Ojo, T.F.; Kukoyi, O.B.; Ekpenyong, A.S.; Ukwandu, D. COVID-19 Pandemic and Unmet Need for Family Planning in Nigeria. Pan Afr. Med. J. 2021, 40, 186. [Google Scholar] [CrossRef]
  28. Crespi, S.; Cambron-Mellott, M.J.; Yong, C.; Balkaran, B.L. Contraceptive Access and Use of Long-Acting Reversible Contraceptives during the COVID-19 Pandemic and Beyond. Women’s Health 2025, 21, 17455057251351740. [Google Scholar] [CrossRef] [PubMed]
  29. Nkweleko Fankam, F.; Ugarte, W.; Akilimali, P.; Ewane Etah, J.; Åkerman, E. COVID-19 Pandemic Hits Differently: Examining Its Consequences for Women’s Livelihoods and Healthcare Access—A Cross-Sectional Study in Kinshasa DRC. BMJ Open 2023, 13, e072869. [Google Scholar] [CrossRef]
  30. Asogwa, U.S.; Okafor, N.I.; Ajaero, C.K. COVID-19 and Access to Sexual and Reproductive Health Services: Perspectives from Adolescents and Women in Rural Areas of Enugu State, Nigeria. Int. J. Popul. Stud. 2023, 10, 58. [Google Scholar] [CrossRef]
  31. Vandenbroucke, J.P.; von Elm, E.; Altman, D.G.; Gøtzsche, P.C.; Mulrow, C.D.; Pocock, S.J.; Poole, C.; Schlesselman, J.J.; Egger, M.; Blettner, M.; et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration. Int. J. Surg. 2014, 12, 1500–1524. [Google Scholar] [CrossRef]
  32. Michael, T.O.; Funmilola Ojo, T.; Scent, G.A.T.; Kukoyi, O.B.; Alhassan, O.I.; Agbana, R.D. COVID-19 Health Knowledge and Practices among Nigerian Residents during the Second Wave of the Pandemic: A Quick Online Cross-Sectional Survey. Afr. J. Health Sci. 2021, 34, 482–497. [Google Scholar]
  33. Sigdel, A.; Bista, A.; Sapkota, H.; van Teijlingen, E. Barriers in Accessing Family Planning Services in Nepal during the COVID-19 Pandemic: A Qualitative Study. PLoS ONE 2023, 18, e0285248. [Google Scholar] [CrossRef]
  34. Marzouk, M.; Lam, S.T.; Durrance-Bagale, A.; Nagashima-Hayashi, M.; Neo, P.; Ung, M.; Zaseela, A.; Aribou, Z.M.; Agarwal, S.; Howard, N. Effects of COVID-19 on Sexual and Reproductive Health Services Access in the Asia-Pacific Region: A Qualitative Study of Expert and Policymaker Perspectives. Sex. Reprod. Health Matters 2023, 31, 2247237. [Google Scholar] [CrossRef]
  35. Alhaji, M.M.; Balarabe, M.R.; Atama, D.; Okafor, A.; Solana, D.; Meyo, F.; Okoye, C.J.; Okafor, U.; Oyelana, B.; Anyanti, J. Motivators and Barriers to the Uptake of Digital Health Platforms for Family Planning Services in Lagos, Nigeria: A Mixed-Methods Study. Digit. Health 2025, 11, 20552076251349624. [Google Scholar] [CrossRef]
  36. Comfort, A.B.; Rao, L.; Goodman, S.; Raine-Bennett, T.; Barney, A.; Mengesha, B.; Harper, C.C. Assessing Differences in Contraceptive Provision through Telemedicine among Reproductive Health Providers during the COVID-19 Pandemic in the United States. Reprod. Health 2022, 19, 99. [Google Scholar] [CrossRef]
  37. Abdel Tawab, N.; Tayel, S.A.; Radwan, S.M.; Ramy, M.A. The Effects of COVID-19 Pandemic on Women’s Access to Maternal Health and Family Planning Services in Egypt: An Exploratory Study in Two Governorates. BMC Health Serv. Res. 2024, 24, 267. [Google Scholar] [CrossRef]
  38. Juliato, C.R.T.; Laporte, M.; Surita, F.; Bahamondes, L. Barriers to Accessing Post-Pregnancy Contraception in Brazil: The Impact of COVID-19. Best. Pract. Res. Clin. Obstet. Gynaecol. 2024, 94, 102482. [Google Scholar] [CrossRef] [PubMed]
  39. Osadebe, N.; Ajaero, C.K.; Asogwa, U.S.; Onuh, J.C. Access to Contraceptives amidst COVID-19 Pandemic in South Africa. IKENGA Int. J. Inst. Afr. Stud. 2025, 26, 241–265. [Google Scholar] [CrossRef]
  40. Solomons, N.; Gihwala, H. The Provision of Safe and Legal Abortion Services in South Africa: Expanding Access Through Telemedicine and Lessons Learned During the Covid-19 Pandemic. In Reproductive Health and Assisted Reproductive Technologies in Sub-Saharan Africa; Palgrave Macmillan: Singapore, 2023; pp. 73–101. [Google Scholar]
  41. Patterson, S.; Rennie, N.; Mann, S.; McCarthy, O.; Palmer, M.; French, R.S. Preference for Face-to-Face Contraceptive Service Delivery Post-COVID-19 Pandemic: A Cross-Sectional Study. BJOG 2025, 1–12. [Google Scholar] [CrossRef] [PubMed]
  42. Govender, D.; Naidoo, S.; Taylor, M. Don’t Let Sexual and Reproductive Health Become Collateral Damage in the Face of the COVID-19 Pandemic: A Public Health Perspective. Afr. J. Reprod. Health 2020, 24, 56–63. Available online: https://pubmed.ncbi.nlm.nih.gov/34077054/ (accessed on 17 August 2024).
  43. World Health Organization. SDG Target 3.7 Sexual and Reproductive Health. Available online: https://www.who.int/data/gho/data/themes/topics/sdg-target-3_7-sexual-and-reproductive-health (accessed on 17 August 2024).
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Figure 1. Directed Acyclic Graph (DAG) illustrating assumed pathways between socio-demographic characteristics, barriers, potential confounders, and unmet contraceptive need during COVID-19 in Nigeria. Yellow nodes represent exposure variables (socio-demographic characteristics), blue nodes represent unobserved or conceptually included confounders/mediators (e.g., barriers, economic status, digital access, health system factors), and the black node (with “I” inside) represents the outcome (unmet contraceptive need).
Figure 1. Directed Acyclic Graph (DAG) illustrating assumed pathways between socio-demographic characteristics, barriers, potential confounders, and unmet contraceptive need during COVID-19 in Nigeria. Yellow nodes represent exposure variables (socio-demographic characteristics), blue nodes represent unobserved or conceptually included confounders/mediators (e.g., barriers, economic status, digital access, health system factors), and the black node (with “I” inside) represents the outcome (unmet contraceptive need).
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Figure 2. Contraceptive methods used by respondents (n = 1273).
Figure 2. Contraceptive methods used by respondents (n = 1273).
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Figure 3. Barriers to contraceptive access during the COVID-19 Lockdown (n = 535).
Figure 3. Barriers to contraceptive access during the COVID-19 Lockdown (n = 535).
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Table 1. Socio-demographic characteristics of respondents and association with barriers to contraceptive access (N = 1273).
Table 1. Socio-demographic characteristics of respondents and association with barriers to contraceptive access (N = 1273).
CharacteristicsTotal n (%)Unmet Need
No n (%)		Unmet Need
Yes n (%)		χ2p-Value
Sex 4.210.040 *
Male671 (52.7)416 (61.9)255 (38.0)
Female602 (47.3)322 (53.5)280 (46.5)
Age (years) 12.580.014 *
18–2589 (7.0)61 (68.5)28 (31.5)
26–33546 (42.9)300 (54.9)246 (45.1)
34–41393 (30.9)227 (57.8)166 (42.2)
42–49215 (16.9)128 (59.5)87 (40.5)
50+30 (2.4)22 (73.3)8 (26.7)
Marital Status 25.67<0.001 ***
Single440 (34.6)307 (69.8)133 (30.2)
Married746 (58.6)381 (51.1)365 (48.9)
Cohabiters64 (5.0)36 (56.2)28 (43.8)
Divorced/separated23 (1.8)14 (60.9)9 (39.1)
Education 18.34<0.001 ***
Primary103 (8.1)48 (46.6)55 (53.4)
Secondary137 (10.8)72 (52.6)65 (47.4)
Tertiary1032 (81.1)617 (59.8)415 (40.2)
Religion 3.920.141
Christianity836 (65.7)493 (59.0)343 (41.0)
Islam416 (32.7)235 (56.5)181 (43.5)
Other20 (1.6)9 (45.0)11 (55.0)
Ethnicity 22.71<0.001 ***
Hausa224 (17.6)152 (67.9)72 (32.1)
Yoruba615 (48.3)326 (53.0)289 (47.0)
Igbo165 (13.0)94 (57.0)71 (43.0)
Other270 (21.2)167 (61.9)103 (38.1)
Residence 15.49<0.001 ***
Urban906 (71.2)503 (55.5)403 (44.5)
Suburban163 (12.8)87 (53.4)76 (46.6)
Rural205 (16.1)149 (72.7)56 (27.3)
No. of children born 29.83<0.001 ***
0493 (38.7)336 (68.2)157 (31.8)
1–2392 (30.8)207 (52.8)185 (47.2)
3–4288 (22.6)148 (51.4)140 (48.6)
5 or more102 (8.0)49 (48.0)53 (52.0)
Significant at * p < 0.05, *** p < 0.001.
Table 2. Logistic regression analysis of predictors of unmet contraceptive need among respondents (N = 1273).
Table 2. Logistic regression analysis of predictors of unmet contraceptive need among respondents (N = 1273).
CharacteristicsModel 1 OR (95% CI)Model 2 OR (95% CI)Model 3 OR (95% CI)
Sex
Male (ref)1.00 1.00
Female0.77 (0.60–1.00) 0.90 (0.64–1.09)
Age group (years)
18–25 (ref)1.00 1.00
26–332.04 ** (1.17–3.64) 2.00 * (1.05–3.73)
34–412.24 ** (1.15–3.95) 1.84 (0.85–3.33)
42+1.14 (0.58–2.18) 0.85 (0.37–1.78)
Marital status
Single (ref)1.00 1.00
Married/cohabiting7.25 *** (4.94–10.41) 3.87 *** (2.58–5.68)
Divorced/separated0.88 (0.33–2.18) 0.65 (0.21–1.78)
Education
Below tertiary (ref)1.00 1.00
Tertiary0.38 *** (0.20–0.66) 0.28 *** (0.13–0.55)
Ethnicity
Hausa (ref)1.00 1.00
Yoruba2.75 *** (1.69–4.14) 1.70 * (1.04–2.58)
Igbo2.03 ** (1.33–3.44) 1.83 * (1.05–2.92)
Other2.75 *** (1.73–4.26) 2.24 ** (1.35–3.48)
Residence
Urban (ref) 1.001.00
Suburban 1.32 (0.91–1.89)1.54 (1.02–2.27)
Rural 0.51 *** (0.36–0.73)0.57 ** (0.37–0.86)
Number of children
0 (ref) 1.001.00
1–2 7.71 *** (5.80–9.42)2.96 *** (1.90–4.63)
3–4 7.58 *** (5.36–10.16)4.04 *** (2.40–6.49)
5+ 1.26 (0.74–1.93)0.24 * (0.06–0.87)
Significant at * p < 0.05, ** p < 0.01, *** p < 0.001; (ref) = reference category.
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Michael, T.O. Barriers to Contraceptive Access in Nigeria During COVID-19: Lessons for Future Crisis Preparedness. COVID 2025, 5, 160. https://doi.org/10.3390/covid5090160

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Michael TO. Barriers to Contraceptive Access in Nigeria During COVID-19: Lessons for Future Crisis Preparedness. COVID. 2025; 5(9):160. https://doi.org/10.3390/covid5090160

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Michael, Turnwait Otu. 2025. "Barriers to Contraceptive Access in Nigeria During COVID-19: Lessons for Future Crisis Preparedness" COVID 5, no. 9: 160. https://doi.org/10.3390/covid5090160

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Michael, T. O. (2025). Barriers to Contraceptive Access in Nigeria During COVID-19: Lessons for Future Crisis Preparedness. COVID, 5(9), 160. https://doi.org/10.3390/covid5090160

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