Disruption in accessing sexual and reproductive health services among border populations during COVID-19 lockdown in Uganda

Background The spread of COVID-19 exposed the inadequacies in-herent in the health care systems of many countries. COVID-19 and the attendant demands for emergency treatment and management put a significant strain on countries' health care systems, includ-ing hitherto strong health systems. In Uganda, as the government strived to contain COVID-19, other essential health care services were either disrupted or completely crowded out. Balancing the provision of COVID-19 treatment and management services and at the same time offering sexual and reproductive health and rights ser-vices (SRHR) proved to be a considerable challenge in these circum-stances. COVID-19 prevention-related travel restrictions and border closures had far-reaching negative consequences on the mobility of individuals to access essential health services in Uganda. The situa-tion may have been worse for cross-border communities that some-times access services across the borders.Methods Using quantitative data from 1521 respondents and quali-tative data (20 key informant interviews and 12 focus group discus-sions), we investigate the disruption in accessing SRHR services for border communities in Uganda during COVID-19.Results Results indicate that females (adjusted odds ratio (aOR) = 1.3; 95% confidence interval CI = 1.08-1.79), those with primary ed-ucation (aOR = 1.47; 95% CI = 1.61-2.57), currently employed (aOR = 2.03; 95% CI = 1.61-2.57) and those with the intention to leave current residence (aOR = 2.09; 95% CI = 1.23-3.55) were more likely to have experienced a disruption in accessing SRHR services. However, respondents aged 35 years, or more were less likely to have experienced a disruption compared to their younger counterparts.Conclusions Results shed light on the disruption of access toSRHR services during pandemics such as COVID-19 among a highly mo-bile population. There is a need to invest in building strong and re-silient health care systems that can guarantee continuous access to essential health services including SRHR provisions among mobile populations during pandemics.