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Effects of COVID-19 lockdowns on unintended pregnancies among adolescent girls and young women in low- and middle-income countries : a scoping review

Lüdecke, Lara Teresa ; Ekman, Björn LU orcid ; Arunda, Malachi Ochieng LU ; Bulamba, Robert ; Daama, Alex ; Ekström, Anna Mia ; Kyasanku, Emmanuel ; Larsson, Elin C. ; Nkale, James and Sundewall, Jesper LU (2025) In Reproductive Health 22(1).
Abstract

Background: The response to the COVID-19 pandemic involved various lockdown measures, including school closures, which significantly impacted young populations, particularly in low-and middle-income countries (LMICs). Given the well-known protective effect of regular school attendance on sexual and reproductive health and rights (SRHR), reports of disrupted education, compromised SRHR, and an increase in unintended pregnancies among adolescent girls and young women (AGYW 10–24 years) have caused major concerns. We conducted a scoping review to compile the available evidence of the impact of COVID-19 lockdown measures on unintended pregnancies among AGYW aged 10–24 in LMICs. Methods: The scoping review followed the five-stage framework... (More)

Background: The response to the COVID-19 pandemic involved various lockdown measures, including school closures, which significantly impacted young populations, particularly in low-and middle-income countries (LMICs). Given the well-known protective effect of regular school attendance on sexual and reproductive health and rights (SRHR), reports of disrupted education, compromised SRHR, and an increase in unintended pregnancies among adolescent girls and young women (AGYW 10–24 years) have caused major concerns. We conducted a scoping review to compile the available evidence of the impact of COVID-19 lockdown measures on unintended pregnancies among AGYW aged 10–24 in LMICs. Methods: The scoping review followed the five-stage framework by Arksey and O´Malley. A systematic search on two comprehensive databases, using search terms related to COVID-19 and unintended pregnancies, was conducted along with grey literature searches of articles in English language published between 2019 and 2024. The systematic review software Covidence was used for publication screening, selection and data extraction. Results: After deduplication, 241 publications were screened, and 72 full-text publications were assessed for eligibility. 13 publications from the database searches, citation searching and grey literature, were included. The scoping review included seven studies that applied quantitative methods, four that used qualitative approaches and the remaining two mixed methods. Five out of 13 publications were set in Uganda, two in Kenya and two in Nigeria, while six other countries were represented once. All included studies reported increases in pregnancies among AGYW during the COVID-19 period. School dropout among girls following a pregnancy was reported to have increased. Factors associated with unintended pregnancy were school closures, limited access to SRHR services including contraceptives, and increasing sexual encounters. Conclusion: School closures and other lockdown measures during the COVID-19 pandemic led to an increase in unintended pregnancies among AGYW in LMICs. The long-term consequences for these young individuals, their communities and to the broader society are still to be measured and available evidence is limited, few studies have applied robust study designs, and several relied on small sample sizes. Further research is needed to build a stronger evidence base for health and socio-economic impacts of school closures and lockdowns among young people.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adolescent girls, COVID-19, Lockdown, Low- and middle-income countries, School closures, Sexual and reproductive health and rights, Unintended pregnancies, Young women
in
Reproductive Health
volume
22
issue
1
article number
89
publisher
BioMed Central (BMC)
external identifiers
  • scopus:105005795961
  • pmid:40405251
ISSN
1742-4755
DOI
10.1186/s12978-025-02045-7
language
English
LU publication?
yes
id
e9ffce33-658e-4f1b-992b-15335320e409
date added to LUP
2025-07-14 10:32:03
date last changed
2025-07-15 03:00:02
@article{e9ffce33-658e-4f1b-992b-15335320e409,
  abstract     = {{<p>Background: The response to the COVID-19 pandemic involved various lockdown measures, including school closures, which significantly impacted young populations, particularly in low-and middle-income countries (LMICs). Given the well-known protective effect of regular school attendance on sexual and reproductive health and rights (SRHR), reports of disrupted education, compromised SRHR, and an increase in unintended pregnancies among adolescent girls and young women (AGYW 10–24 years) have caused major concerns. We conducted a scoping review to compile the available evidence of the impact of COVID-19 lockdown measures on unintended pregnancies among AGYW aged 10–24 in LMICs. Methods: The scoping review followed the five-stage framework by Arksey and O´Malley. A systematic search on two comprehensive databases, using search terms related to COVID-19 and unintended pregnancies, was conducted along with grey literature searches of articles in English language published between 2019 and 2024. The systematic review software Covidence was used for publication screening, selection and data extraction. Results: After deduplication, 241 publications were screened, and 72 full-text publications were assessed for eligibility. 13 publications from the database searches, citation searching and grey literature, were included. The scoping review included seven studies that applied quantitative methods, four that used qualitative approaches and the remaining two mixed methods. Five out of 13 publications were set in Uganda, two in Kenya and two in Nigeria, while six other countries were represented once. All included studies reported increases in pregnancies among AGYW during the COVID-19 period. School dropout among girls following a pregnancy was reported to have increased. Factors associated with unintended pregnancy were school closures, limited access to SRHR services including contraceptives, and increasing sexual encounters. Conclusion: School closures and other lockdown measures during the COVID-19 pandemic led to an increase in unintended pregnancies among AGYW in LMICs. The long-term consequences for these young individuals, their communities and to the broader society are still to be measured and available evidence is limited, few studies have applied robust study designs, and several relied on small sample sizes. Further research is needed to build a stronger evidence base for health and socio-economic impacts of school closures and lockdowns among young people.</p>}},
  author       = {{Lüdecke, Lara Teresa and Ekman, Björn and Arunda, Malachi Ochieng and Bulamba, Robert and Daama, Alex and Ekström, Anna Mia and Kyasanku, Emmanuel and Larsson, Elin C. and Nkale, James and Sundewall, Jesper}},
  issn         = {{1742-4755}},
  keywords     = {{Adolescent girls; COVID-19; Lockdown; Low- and middle-income countries; School closures; Sexual and reproductive health and rights; Unintended pregnancies; Young women}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Reproductive Health}},
  title        = {{Effects of COVID-19 lockdowns on unintended pregnancies among adolescent girls and young women in low- and middle-income countries : a scoping review}},
  url          = {{http://dx.doi.org/10.1186/s12978-025-02045-7}},
  doi          = {{10.1186/s12978-025-02045-7}},
  volume       = {{22}},
  year         = {{2025}},
}