“The current pandemic is straining human resources, disrupting supply chains and service delivery, and negatively impacting service seeking among women and girls in countries across the globe,” said Sarah Barnes, Project Director of the Wilson Center’s Maternal Health Initiative. She spoke at a recent event, co-hosted by the UN Population Fund (UNFPA), on unintended pregnancies during the COVID-19 pandemic. The increasing rates of unintended pregnancies during the pandemic have exacerbated the vulnerabilities of many women, said Anneka Knutsson, Chief of the Sexual and Reproductive Health Branch at UNFPA.

According to a recent Lancet Global Health study, more than 50 percent of reproductive-age women in low- and middle-income countries want to avoid a pregnancy, said Beth Sully, Senior Research Scientist at the Guttmacher Institute. And one in four of these women have an unmet need for modern contraceptive methods.

What’s more, the pandemic has increased women’s risk of unintended pregnancies due to school closures, limited access to comprehensive sexuality education and contraception, and increased risk of violence against women and girls in low- and middle-income countries, said Barnes.

The pandemic has provided an opportunity for us to see how our sexual and reproductive health services are being treated differently, where we exceptionalize them, and where we do not see them as essential, routine, and normal, said Sully.

COVID-19’s Effect in Low- and Middle-Income Countries

In Nepal, information on sexual and reproductive health is considered taboo, said Lirisha Tuladhar, Secretary of the Youth Coalition for Sexual and Reproductive Rights, Nepal. During the pandemic, school dropout rates increased, which further limited young people’s access to even minimal sexual and reproductive health information. Even so, school sexual education curricula do not cover unintended pregnancy and abortion, exacerbating the intergenerational information gap, she said.

The situation worsened when Nepali men working overseas lost jobs due to the pandemic and returned home. In lockdown, sexual contact increased, resulting in a rise in unintended pregnancies, said Tuladhar.

The lockdown prevented commodities that could help prevent unintended pregnancies from reaching the Democratic Republic of the Congo (DRC), causing supply shortages, said Dr. Jean Claude Mulunda, DRC Country Representative at Ipas.

Pandemic Programming and Initiatives

Although rural communities in Nepal typically don’t have access to digital platforms, COVID-19 has made it mandatory for these communities to be online, said Tuladhar. Telenursing allowed nurses to provide counseling services and sexual health information to individuals who needed it, in collaboration with YoSHAN, she said.

In the DRC, Ipas partnered with Experian to create a smartphone app to improve accessibility to abortion services without internet use, said Dr. Mulunda. During COVID-19, Ipas trained youth champions to help navigate the app and raise awareness in the community, he said.

The Argentinian Ministry of Health allowed access to modern contraceptive methods and voluntary legal interruption or termination of pregnancy, said Valeria Isla, Director of Sexual and Reproductive Health at the Argentina Ministry of Health. Declaring these services essential during COVID-19 established the importance of sexual and reproductive health in all provinces, she said.

“Prior to the pandemic, we used to send sexual health kits to 5,500 health care centers throughout the country in addition to the provincial sexual health areas to meet certain unsatisfied demand,” said Isla. However, despite having enough kits, a major challenge involved having primary health care centers open to provide services, she said.

In Argentina, a national toll-free hotline helped people access contraceptive methods during the pandemic. Direct interventions by the national government and local provinces allowed for individual referrals to healthcare facilities for legal termination of pregnancies, said Isla. The hotline fielded more than 10,000 phone calls in 2020. In addition, the government promoted virtual meetings, digital prescriptions, and delivery of emergency hormone therapy, she said.

The pandemic has given us a lens right now to reflect on our regulatory regimes, on our supply chains, on our standards and provisions of care to determine how and why we treat sexual and reproductive health differently, said Sully.

Cross-Sectoral Solutions & Coalition Building

Collaboration from each and every sector is needed, said Tuladhar. It cannot be solved by just one person or one organization. The most important thing for Nepal is to reduce the stigma associated with sexual and reproductive health and rights. We can work with the older and younger generations in order to make sexual and reproductive health comprehensive, she said.

In the DRC, civil society organizations worked with the Ministry of Health to identify and train youth champions. During COVID-19, these efforts helped us maintain momentum in our efforts to prevent violence against women and improve access to abortion services, said Dr. Mulunda.

An important factor for Argentina was the development of feminist organizations, networks, and movements such as Ni Una Menos (Not One Less), which catalyzed and united campaigners of all ages across the country for sexual and reproductive health justice, said Isla.

By consolidating a budget for sexual health, we ensured supplies could be purchased by the federal government and distributed to the provincial health centers, said Isla. Since teenagers don’t generally go to health centers in Argentina, we have to create mechanisms to reach out to them across sectors and across disciplines, she said.

“We have to continue working together with the civil society organizations and we have to understand that working with the civil society organizations, feminist and trans feminist movements, implies accepting complexity but also diversity,” said Isla. “If we can respect that diversity, we will be able to create a sexual health agenda with the greatest impact and a more comprehensive one,” she said.

The pandemic has taught us the importance of treating sexual and reproductive healthcare as an essential service, said Sully.

Read more:

• Fulfilling contraception needs yields immense benefits.
• How has COVID affected the status of sexual and reproductive rights?
• COVID has devastating effects on adolescent sexual health.