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.