Title: Health systems analysis and evaluations of the barriers to availability, utilisation, and readiness of selected sexual and reproductive health services in COVID-19 affected areas.

Background: This project is a result of a collaboration between the Infectious Diseases Section and the Obsetrics & Gynecology Section, University Hospital Verona with the WHO Sexual and Reproductive Health (SRH) & Research. This is a multicentric study, involving SRH centres from nine distinct countries with different income and resources (Brazil, Burkina, China, Ghana, Italy, United Kingdom, Kenya, Pakistan, Thailand). Centro MISTRA (Multidisciplinary Center for Sexually Transmitted Infections, STIs, including HIV), Abortion Service, Family Planning and Contraceptive Service, and P.e.t.r.a (Pratiche Esperienze Teorie Relazioni Antiviolenza) center were involved in the study for the Verona site.

Study: The overarching study purpose was to provide a comprehensive evaluation of the health system barriers to availability, utilisation and readiness of SRH centres in COVID-19 affected areas from both clients’ and healthcare workers’ perspectives. In particular, the study aimed to i) explore the status of availability and the health facility readiness to provide services in contraception and abortion care, including the treatment of abortion-related complications and the provision of post abortion contraceptive care, STIs treatment and care, and support of women (and others) experiencing violence against women (VAW); ii) assess the post-pandemic recovery of the facilities, and iii) enhance the reproductive service capacity in COVID-19 through advocacy, policy briefs, media dissemination and academic papers towards the national and regional stakeholders including policymakers, academia, healthcare providers and the community.

The study followed a cross-sectional design, and it was carried out on two levels, i.e. individual and facility levels. Both qualitative and quantitative approaches were utilized: in-depth interview and pre-defined validated questionnaires, collected on a nine-month interval.

Currently, statistical analyses are ongoing. The findings will be of outmost importance for identifying the key gaps and barriers to the delivery of important aspects of comprehensive SRH services in health emergencies. They also will outline a set of strategies, which can be applied in any setting, to assess health facility and system readiness to optimize the response toward potential future health emergencies.