The Effects of COVID-19 on Sexual and Reproductive Health: A Case Study from Six Countries – World


Global responses to the COVID-19 pandemic overlap with pre-existing widespread inequalities in sexual and reproductive health that disproportionately affect vulnerable populations. Although COVID-19 is having serious and, in some cases, devastating effects on health systems around the world, studies show that people whose human rights are least protected – including refugees, displaced persons, conflict-affected populations, indigenous peoples and people living on low incomes Environments – likely to have unique difficulties accessing quality sexual and reproductive health care during a crisis. Studies of previous health crises, particularly the Ebola epidemic in West Africa and the Zika epidemic in South America, also suggest that the indirect mortality effects (including maternal and newborn mortality) of a public health crisis can be as significant as the direct ones Mortality effects. Although there appear to be no direct clinical results in pregnant women due to COVID-19, initial predictions assumed that COVID-19 would inevitably lead to an interruption in health services, with resources and personnel from SRH being involved in an emergency in the public domain Health would be diverted. A disruption in global pharmaceutical and medical supply chains was also forecast, which would lead to shortages and reduced raw materials (including contraceptives, nutritional supplements for pregnancy and sterile medical equipment essential for deliveries). Experts also believed that COVID-19 would have an impact on health-oriented behavior as fears of contracting COVID-19 would prevent women from having access to family planning, prenatal care, skilled obstetrics, and other vital reproductive health products To receive mother and newborn (RMNH.) Services.

This report reviews data from six focus countries – Bangladesh, Burkina Faso, Colombia, Democratic Republic of the Congo (DRC), Nigeria, and Syria to assess the effects of COVID-19 on sexual and reproductive health. Overall, the available data in the six focus countries suggest that access to family planning counseling and access to and use of contraceptives has been restricted in some, if not all, facilities. Family planning was severely affected in Bangladesh (minus 50 percent), as was the access to and use of contraceptives (minus 35 percent). Contraceptive access and use have also been negatively impacted in Colombia due to supply chain disruptions and in the Democratic Republic of the Congo due to barriers to entry. However, contraceptive use in Burkina Faso has increased since the pandemic began – especially among nulliparous women (up 39 percent) – suggesting that women may prefer to postpone a first pregnancy. School closings have contributed to increased rates of child, early and forced marriage (CEFM) and teenage pregnancies – particularly in the Democratic Republic of the Congo, northeastern Nigeria and Syria. As a result, there has been an increase in the demand for safe abortions, which, in particular, does not seem to be met in the Democratic Republic of the Congo.

Overall, there appears to be a critical decline in the availability and use of prenatal care (ANC) in most priority countries, but limited data are available. In Bangladesh, the number of ANC visits has fallen by 31 percent, and in Colombia, border closings are having a serious impact on the access of Venezuelan migrant women and refugee women to the ANC. At the start of the pandemic, qualified delivery rates were initially affected in Nigeria and Syria, but both have improved since then. In Syria, the proportion of births cared for by a healthcare professional is now 95 percent, 4 points higher than before the pandemic. In Bangladesh, the number of skilled obstetrics across the country has decreased by two-thirds, and it appears that number has not fully recovered in 2021. Figures on maternal mortality are available for some contexts; However, it’s not always clear whether the rates reflect all deaths of pregnant women (including those who died from COVID-19) or just deaths from pregnancy complications. Maternal mortality has increased significantly in Colombia and the Democratic Republic of the Congo, but rates in Burkina Faso appear to have improved compared to pre-pandemic numbers.
COVID-19 has created significant barriers to access to health as well as changes in people’s behavior when searching for health. In the six priority countries, one of the dominant barriers to access to health during the pandemic has been the redirection of health resources towards the pandemic and away from SRH services. This has resulted in a lack of adequate health facilities, a lack of medical equipment including PPE and an insufficient number of health professionals to meet the needs of the population. In Bangladesh, 19 percent of people felt that COVID-19 had restricted their access to health care, while 15 percent of people in Colombia felt the same. In Syria, that number rises to 45 percent, suggesting that the ongoing conflict has resulted in very poor health system resilience. In Nigeria, Burkina Faso and Syria, the shortage of skilled workers is particularly pronounced due to illness, burnout and targeted attacks on health services. Other barriers to entry that existed before COVID-19 have been tightened by the pandemic, including travel distance, the cost of health care and transportation to health facilities, and the uncertainty caused by conflict. In the past 18 months, people’s health-conscious behavior has also changed; In many contexts, people seem to avoid going to health care facilities – even for essential care purposes – for fear of contracting COVID19. Access to contraception, ANC visits, safe abortions, and skilled obstetrics are essential forms of health care, and the decline in women using these services is incredibly worrying.

This report also examines the significant gaps in the availability of RMNH data in the six focus countries.
Comprehensive and high quality data is essential for the decision making of RMNH and SRH. Without information about gaps in supply, access barriers and the number of people affected, state health ministries and humanitarian health clusters cannot react meaningfully to the health emergency with targeted strategies and resources. Where the data are contradictory and contradicting, as in Bangladesh and Nigeria, governments and health clusters are unable to assess the true extent of the need for action. In contexts where there is no data, this problem is magnified as it can make the problems completely invisible. For example, good data in Burkina Faso on access to contraception mask a lack of data on ANC coverage, which can lead to the assumption that if not reported, ANC coverage must be good. In Syria, too, where deaths from other causes are reported, maternal mortality can be made invisible.

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