Margit Endler1, Taghreed Al-Haidari2, Chiara Benedetto3, Sameena Chowdhury4, Jan Christilaw5, Faysal El Kak6, Diana Galimberti7, Claudia Garcia-Moreno8, Miguel Gutierrez9, Shaimaa Ibrahim10, Shantha Kumari11, Colleen McNicholas12, Desirée Mostajo Flores13, John Muganda14, Atziri Ramirez-Negrin15, Hemantha Senanayake16, Rubina Sohail17, Marleen Temmerman18, Kristina Gemzell-Danielsson1. 1. Department of Women and Children's Health, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden. 2. Scientific Affairs Unit, Al Kindy College of Medicine, University of Baghdad, Baghdad, Iraq. 3. Department of Gynecology and Obstetrics, Sant´Anna University Hospital, Torino, Italy. 4. Obstetrical and Gynecological Society of Bangladesh, Dhaka, Bangladesh. 5. Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 6. American University of Beirut, Beirut, Lebanon, and International Federation of Obstetricians and Gynecologists, London, UK. 7. University of Buenos Aires, Buenos Aires, Argentina. 8. World Health Organization, Geneva, Switzerland. 9. Instituto de Salud Popular (INSAP), Lima, Peru. 10. UNICEF Iraq, Baghdad, Iraq. 11. Yashoda Hospital, Hyderabad, India. 12. Planned Parenthood, St Louis, MO, USA. 13. The Bolivian Society of Obstetricians and Gynecologists, Santa Cruz de la Sierra La Paz, Bolivia. 14. The Rwanda Society of Obstetricians and Gynecologists, Kigali, Rwanda. 15. Urogynecology Department, Hospital Dr Manuel Gea Gonzalez, Mexico City, Mexico. 16. University of Colombo, Colombo, Sri Lanka. 17. Services Institute of Medical Sciences/Services Hospital, Lahore, Pakistan. 18. Aga Khan University, Nairobi, Kenya and Ghent University, Ghent, Belgium.
Abstract
INTRODUCTION: We aimed to give a global overview of trends in access to sexual and reproductive health and rights (SRHR) during the coronavirus disease 2019 (COVID-19) pandemic and what is being done to mitigate its impact. MATERIAL AND METHODS: We performed a descriptive analysis and content analysis based on an online survey among clinicians, researchers, and organizations. Our data were extracted from multiple-choice questions on access to SRHR services and risk of SRHR violations, and written responses to open-ended questions on threats to access and required response. RESULTS: The survey was answered by 51 people representing 29 countries. Eighty-six percent reported that access to contraceptive services was less or much less because of COVID-19, corresponding figures for surgical and medical abortion were 62% and 46%. The increased risk of gender-based and sexual violence was assessed as moderate or severe by 79%. Among countries with mildly restrictive abortion policies, 69% had implemented changes to facilitate access to abortion during the pandemic, compared with none among countries with severe restrictions (P < .001), 87.5% compared with 46% had implemented changes to facilitate access to contraception (P = .023). The content analysis showed that (a) prioritizations in health service delivery at the expense of SRHR, (b) lack of political will, (c) the detrimental effect of lockdown, and (d) the suspension of sexual education, were threats to SRHR access (theme 1). Requirements to mitigate these threats (theme 2) were (a) political will and support of universal access to SRH services, (b) the sensitization of providers, (c) free public transport, and (d) physical protective equipment. A contrasting third theme was the state of exception of the COVID-19 pandemic as a window of opportunity to push forward women's health and rights. CONCLUSIONS: Many countries have seen decreased access to and increased violations of SRHR during the COVID-19 pandemic. Countries with severe restrictions on abortion seem less likely to have implemented changes to SRHR delivery to mitigate this impact. Political will to support the advancement of SRHR is often lacking, which is fundamental to ensuring both continued access and, in a minority of cases, the solidification of gains made to SRHR during the pandemic.
INTRODUCTION: We aimed to give a global overview of trends in access to sexual and reproductive health and rights (SRHR) during the coronavirus disease 2019 (COVID-19) pandemic and what is being done to mitigate its impact. MATERIAL AND METHODS: We performed a descriptive analysis and content analysis based on an online survey among clinicians, researchers, and organizations. Our data were extracted from multiple-choice questions on access to SRHR services and risk of SRHR violations, and written responses to open-ended questions on threats to access and required response. RESULTS: The survey was answered by 51 people representing 29 countries. Eighty-six percent reported that access to contraceptive services was less or much less because of COVID-19, corresponding figures for surgical and medical abortion were 62% and 46%. The increased risk of gender-based and sexual violence was assessed as moderate or severe by 79%. Among countries with mildly restrictive abortion policies, 69% had implemented changes to facilitate access to abortion during the pandemic, compared with none among countries with severe restrictions (P < .001), 87.5% compared with 46% had implemented changes to facilitate access to contraception (P = .023). The content analysis showed that (a) prioritizations in health service delivery at the expense of SRHR, (b) lack of political will, (c) the detrimental effect of lockdown, and (d) the suspension of sexual education, were threats to SRHR access (theme 1). Requirements to mitigate these threats (theme 2) were (a) political will and support of universal access to SRH services, (b) the sensitization of providers, (c) free public transport, and (d) physical protective equipment. A contrasting third theme was the state of exception of the COVID-19 pandemic as a window of opportunity to push forward women's health and rights. CONCLUSIONS: Many countries have seen decreased access to and increased violations of SRHR during the COVID-19 pandemic. Countries with severe restrictions on abortion seem less likely to have implemented changes to SRHR delivery to mitigate this impact. Political will to support the advancement of SRHR is often lacking, which is fundamental to ensuring both continued access and, in a minority of cases, the solidification of gains made to SRHR during the pandemic.
Authors: Mandikudza Tembo; Jenny Renju; Helen A Weiss; Ethel Dauya; Nancy Gweshe; Precious Ndlovu; Portia Nzombe; Chido Dziva Chikwari; Constancia Vimbayi Mavodza; Constance R S Mackworth-Young; Rashida A Ferrand; Suzanna C Francis Journal: BMC Health Serv Res Date: 2022-03-30 Impact factor: 2.655
Authors: Johanna Rydelius; Mina Edalat; Viola Nyman; Tagrid Jar-Allah; Ian Milsom; Helena Hognert Journal: BMJ Open Date: 2022-02-23 Impact factor: 2.692