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Protecting Sexual and Reproductive Health and Rights Progress in a Pandemic

By Traci L. Baird

From the moment the World Health Organization declared COVID-19 a global pandemic, EngenderHealth has recognized that our work and the work of our global partners on sexual and reproductive health and rights (SRHR) will be more critical than ever.

Tanzania family

A family outside of a health center in Tanzania. Photo credit: EngenderHealth/Sala Lewis

During public health crises, resources are often pulled away from routine health services even though this is the time when people need them most to prevent pregnancy, address violence, and protect their sexual and reproductive health (SRH).

We have seen in our programs that COVID-19 is amplifying existing gaps and problems—of the unmet need for contraception, lack of choice or quality in health services, lack of access to hotlines and shelters, and lack of availability of services like fistula repair or cancer screening.

A report released by UNFPA has put magnitudes to these gaps. No longer are we only concerned about decreased access to contraception when economic realities mean more people are seeking to delay pregnancy; now, we are anticipating millions of additional women unable to use contraception, even in a best-case-scenario regarding the pandemic.

The report estimates that if the COVID-19-precipitated lockdowns have “medium health service disruption” and last 3 months, 23 million more women will not have access to desired contraception and will experience 600,000 additional unintended pregnancies, above the pre-pandemic levels of unmet need and unintended pregnancy. A 6-month lockdown with medium health system disruption, it estimates, would result in 4 million unintended pregnancies, above baseline levels.

EngenderHealth is working with our partner ministries of health as well as local and international NGOs to ensure that SRH services, including contraception, are considered essential and that they are provided safely. Additionally, we have shared clinical guidance and are working at the country level to support supply-chain efforts, dissemination of information to healthcare providers and communities, and creative options to reduce contact time for contraceptive services while offering a range of methods.

We know that during health and economic crises—especially those that keep people at home when their homes are not safe—there are surges in gender-based violence. UNFPA’s modeling anticipates 15 million additional cases of intimate partner violence (IPV) for every 3 months that countries are locked down due to the pandemic.

At the same time, the projection of a potential 13 million additional child marriages and 2 million additional girls experiencing female genital mutilation (FGM) during the decade that would otherwise not have occurred must stop us in our tracks and prompt us to work with local partners on programs to accelerate our work on gender and rights within the context of comprehensive SRHR.

EngenderHealth staff are confirming which local services for GBV and IPV survivors continue to operate to ensure that referral mechanisms are reaching functional services, and our partners are supporting health facilities in providing emergency care, including emergency contraception and post-exposure prophylaxis for HIV prevention.

We appreciate UNFPA’s leadership in raising awareness of the likely full impact of the pandemic on access to contraception and the risks of GBV, FGM, and child marriage. The projected loss of hard-won progress toward the Sustainable Development Goals related to health, gender equality, education, and reducing inequalities is tragic. But we have faced, endured, and risen above tragedy before.

EngenderHealth commits to joining our partners around the globe to draw on our collective experience to mitigate the impacts of the pandemic, and to develop and apply innovations to reestablish and accelerate progress on SRHR.

Related Links

The Guardian: ‘Calamitous’: domestic violence set to soar by 20% during global lockdown