COVID-19 disrupts access to Sexual and Reproductive Health

Kentrade Chairman Suleiman Shahbal tries out one of the PPEs. He handed over 1050 full body kits to the County Government of Mombasa on June 13, 2020. Photo: Sherry Kui.

UNFPA estimates seven million unintended pregnancies likely to occur as the pandemic continues to upturn lives globally.

By Mike Mwaniki

That the dreaded COVID-19 pandemic has caused major disruptions to health services in Kenya, as it has done world over is a glaring reality.

Among the critical health services that have been disrupted is access to Sexual Reproductive Health Services

In Kenya, experts say an estimated 300,000 women undergo abortions annually with 21,000 of these women ending up in hospital with complications due to incomplete or botched procedures. This then, would mean that because of this challenge in accessing Family Planning services, the number of unintended pregnancies will go up, and so is the likelihood of illegal abortions and arising complications.

Ms Mary Njeri, a lawyer and reproductive health specialist, says that 2,600 women lose their lives as result of such procedures.

“Women fear arrest and criminal sanctions as the latter appear to be imposed discriminatorily.

“A majority are also unable to access abortion services in private clinics due to the prohibitive cost. They also face humiliation and berating by medical practitioners especially in public health facilities,” Ms Njeri added.

The United Nations Population Fund (UNFPA) says the ongoing lockdowns and distractions caused by the coronavirus disease-which has caused major disruptions globally-could result in seven million unintended pregnancies in the coming months.

The UN organisation and its partners estimate that the number of women unable to access family planning or facing unintended pregnancies, gender-based violence and other harmful practices, could “skyrocket” by millions due to the crisis.

UNFPA’s Executive director, Dr Natalia Kanem observes: “This new data shows the catastrophic impact that COVID-19 could soon have on women and girls globally.

“The pandemic is deepening inequalities, and millions more women and girls now risk losing the ability to plan their families and protect their bodies and their health.”

In line with the Sustainable Development Goals (SDGs), UNFPA works to serve the unmet need for family planning, and to stamp out gender-based violence and harmful practices such as female genital mutilation (FGM) and child marriage. It also focuses on ending all preventable maternal deaths.

The research was conducted by UNFPA, in collaboration with Avenir Health, Johns Hopkins University in the United States, and Victoria University in Australia.

Experts say COVID-19 is having an enormous impact on women and girls as health systems become overloaded and facilities close, or provide a limited set of services which they need. At the same time, many women and girls also are skipping important medical check-ups for fear of contracting the virus.

Disruptions to global supply chains could lead to significant shortages of contraceptives, the partners said, while gender-based violence – already on the increase due to the pandemic, UN News reported earlier this month—is expected to rise still further as women are trapped at home for prolonged periods.

Globally, around 450 million women across 114 low and middle-income countries use contraceptives, according to UNFPA and partners.

They project that if health services remain disrupted and lockdowns continue for six months, some 47 million in these countries may not be able to access modern contraceptives, resulting in around seven million unintended pregnancies.

There also will be 31 million additional cases of gender-based violence during the same period, with a further 15 million more cases expected for every three months the lockdowns continue.

The pandemic has also affected programmes to prevent female genital mutilation (FGM), and the experts estimate two million FGM cases may occur over the next decade that could have been averted.

Similarly, an additional 13 million child marriages could take place this decade as the crisis has disrupted efforts to stop this practice.

UNFPA is working with governments and partners to prioritise the needs of women and girls of reproductive age during the pandemic.

According to UNFPA estimates (2019), Kenya has 17 million people who are aged between 10 to 24 years.

The Kenya Demographic and Health Survey (2014) shows that a significant proportion of youth aged 15 to 19 years are sexually active.

At 15 years, three out of 100 girls are either pregnant or have given birth to their first child, which rises to 40 out of 100 by age 19, with many of these pregnancies unintended.

“Other examples include new HIV infection rates, number of deaths and injuries as a result of unsafe abortions,” says the report.

According to experts, the youth have been missing from decision making spaces in Kenya as decision makers are mostly middle-aged who can’t know what the youth need.

The National Manpower Survey Basic report published by the Government in 2014 showed that only three out of 10 (29 per cent) employees in the government were aged below 35 years.

Pundits say a good example of public services not meeting that needs of the youth is in sexual and reproductive health services.

According to the Kenya Service Provision Assessment survey (2010), only seven per cent of  public health facilities have the capacity to offer youth-friendly services, yet all data shows the youth are sexually active.

Meanwhile, UNFPA says its focused on strengthening health systems, procuring and delivering essential supplies to protect health workers, ensuring access to sexual and reproductive health and gender-based violence services, and promoting risk communication and community engagement.

The UNFPA chief, Dr Kanem says: “Women’s reproductive health and rights must be safeguarded at all costs…

“The services must continue; the supplies must be delivered; and the vulnerable must be protected and supported,”.

Elsewhere, the World Health Organisation says contraception and family planning information and services are life-saving and important at all times. 

“Sexual activity does not cease with the COVID-19 pandemic, it is therefore crucial to ensure that people are able to access rights-based services and information to initiate and / or continue use of contraception,”. 

By preventing unintended pregnancies, the WHO notes, contraception helps to protect girls and women from the negative health consequences of unintended pregnancies, which can save their lives. Contraception reduces the need for abortion, meaning that women and girls are less at risk of unsafe abortion, which again can be lifesaving.  

At the same time, condoms, when used consistently and correctly, help to prevent both unintended pregnancies and sexually transmitted infections (including HIV).  

“In addition, by preventing the negative health consequences associated with unintended pregnancies, unsafe abortion and sexually transmitted infections (including HIV), contraception can help alleviate additional pressure on already-stretched health systems which are working hard to address COVID-19,” the WHO adds. 



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