Trends in Adolescent Sexual and Reproductive Health Outcomes Before and Into the COVID-19 Pandemic in Burkina Faso and Kenya: Evidence From Panel Data

TL;DR

This study examines how the COVID-19 pandemic affected adolescent sexual and reproductive health in Burkina Faso and Kenya, finding limited long-term impacts.

Contribution

The study uses longitudinal data from Kenya and Burkina Faso to assess changes in adolescent SRH outcomes before and during the pandemic.

Findings

Adolescent partnership and pregnancy rates decreased in 2021 compared to 2019 in both countries.

Contraception use increased in Kenya during the pandemic, but not in Burkina Faso.

Household income loss during the pandemic was linked to reduced sexual activity and pregnancy rates in Kenya and Burkina Faso.

Abstract

Many predicted that COVID-19 would have a substantial impact on the sexual and reproductive health (SRH) trajectories of adolescents in sub-Saharan Africa. The lack of longitudinal data with information collected before and into the pandemic has limited investigation into this topic.

We performed a secondary analysis using nationally representative longitudinal data from Kenya and Burkina Faso, collected at three time points (pre–COVID-19 in late 2019, and during COVID-19 in 2020 and 2021), to determine the extent to which SRH outcomes and behaviors, including pregnancy, contraceptive use, partnership status, and sexual activity, changed during the pandemic among adolescent women.

Among adolescents aged 15–19 years (Kenya n = 1,893, Burkina Faso n = 1,422), there was a reduction in both partnership and pregnancy in 2021 as compared to pre-COVID 2019. Contraception use significantly increased between 2019 and 2021 in Kenya only (adjusted odds ratio [aOR]: 1.42, 95% confidence interval [CI] 1.03–1.97). COVID-19–related household income loss was associated with a decline in sexual activity among unmarried Kenyan girls (aOR: 0.47, 95% CI 0.25–0.87) and lower odds of pregnancy in Burkina Faso (aOR: 0.13, 95% CI 0.02–0.91). We did not find a relationship between COVID-19 measures and initiation of partnership or marriage in either setting.

Contrary to expectations, our results suggest that COVID-19 did not have a consistent or sustaining impact on adolescent SRH and behaviors in Burkina Faso and Kenya. Further research is needed to assess the longer-term implications of the pandemic on adolescent social and health outcomes.