Pandemic puts reproductive health care out of reach for millions, new data shows

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A woman wearing protective clothes walks past the entrance to a maternity hospital during the COVID-19 outbreak in Nairobi, Kenya. Photo by: Baz Ratner / Reuters

BARCELONA — Disruptions to reproductive health services since the start of the COVID-19 outbreak could result in more than 1 million unsafe abortions and 900,000 unintended pregnancies, according to Marie Stopes International.

New data released by the organization, based on findings from online surveys of women in the U.K, South Africa, and India with more than 1,000 respondents per country, shows that sexual and reproductive health services have been hit hard during the pandemic. Almost 2 million women and girls have been unable to access MSI’s services in the first six months of 2020, and the organization estimates that this could result in 3,100 additional maternal deaths.

National lockdowns and restrictions on movement, including police roadblocks in some countries, have made it difficult for MSI and other organizations to operate and for women to access services in clinics and products such as contraceptives from pharmacies.

“[But] women’s needs do not suddenly stop or diminish during an emergency – they become greater,” Dr. Rashmi Ardey, director of clinical services for MSI in India, said in a press release.

According to MSI’s data, 13% of the women surveyed in India expressed a need for abortion services during the pandemic. Almost one-third of respondents seeking an abortion in that country, however, reported that their local clinic was closed, while others said they faced long wait times — more than five weeks, in some cases.

“As a doctor I have seen only too often the drastic action that women and girls take when they are unable to access contraception and safe abortion,” Ardey cautioned.

A lack of information on what services were available, and where, further complicated access. Only 43% of the women surveyed in South Africa and 44% of those in India thought that people could access abortion services from a private clinic during the pandemic. In both countries, the perceived availability of abortion services was considerably lower than before the pandemic.

Fear of infection has also been preventing women from leaving the house for contraceptive services or products. About one-third of women in India — 31% — and one-quarter of women in South Africa — 26% — said that this was the case.

Speaking during an online event Wednesday, Anisa Berdellima, MSI’s senior manager of impact and sustainability, said that while the organization’s operations have been affected across regions, Asia is facing the most severe impact. This is, in part, due to the longer and more strict lockdowns, particularly in India, where “75% of the impact that we have incurred has come from,” she said.

Based on the number of women who accessed services between January and June versus the numbers forecast for that period, MSI predicts there will be 1 million unsafe abortions, an additional 650,000 unintended pregnancies, and 2,600 maternal deaths in India alone.

These figures are particularly “scary,” Ardey said during Wednesday’s event. But on top of the lockdown and lack of public transport, the reallocation of public health facilities and personnel for the COVID-19 response and disruptions to drug supply chains have made it particularly difficult for women to access advice and services in India, she said.

“Sexual and reproductive services should be recognized as essential services, which should continue — especially during national emergencies — to protect the health and well-being for vulnerable women,” Ardey said.

“As a doctor I have seen only too often the drastic action that women and girls take when they are unable to access contraception and safe abortion.”

— Dr. Rashmi Ardey, director of clinical services, MSI India

While this data provides a snapshot of the current crisis, MSI anticipates that with a second wave of outbreaks on the horizon, the worst effects of COVID-19 are yet to come. According to CEO Simon Cooke, “there is an opportunity to use this as a catalytic moment to transform services.”

Going forward, MSI is going to explore how telemedicine, which is already being implemented in the U.K., could provide services remotely to women in low-resource settings in India, South Africa, and Nepal.

The organization has already been working with partners and providers over the last months to adapt its services and tailor these to local contexts. In Zimbabwe, family planning has been integrated into local immunization programs to ensure rural women can still access these services. Meanwhile, in Uganda, a pilot project delivers health care products to women at home using a ride-hailing mobile app.

In addition to defining safe abortion and contraception as “essential services” to be included in the basic package of services available, MSI is calling on key players to ensure this is communicated to all stakeholders, particularly at the subnational level.

Cooke also urged donors, partners and the global community to maintain support and funding for sexual and reproductive health and called on them “to learn from the impact we have seen so far.”

Devex, with support from our partner UN Women, is exploring how data is being used to inform policy and advocacy to advance gender equality. Gender data is crucial to make every woman and girl count. Visit the Focus on: Gender Data page for more. Disclaimer: The views in this article do not necessarily represent the views of UN Women.

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  • Emma Smith

    Emma Smith is a Reporter at Devex. She covers all things related to careers and hiring in the global development community as well as mental health within the sector — from tips on supporting humanitarian staff to designing mental health programs for refugees. Emma has reported from key development hubs in Europe and co-produced Devex’s DevProWomen2030 podcast series. She holds a degree in journalism from Glasgow Caledonian University and a master's in media and international conflict. In addition to writing for regional news publications, she has worked with organizations focused on child and women’s rights.