Reproductive Health advocates wants state to prioritise RH agenda in Covid-19 guidelines
George Kebaso @Morarak
Reproductive health advocates have appealed to the government to urgently prioritise sexual and reproductive health agenda in the COVID-19 guidelines as maternal deaths in the country spike.
Reflecting on the Kenya Demographic and Health Survey (KDHS), 2014 when the maternal mortality ratio was 362 maternal deaths per 100,000 live births, the advocates have noted that the fatalities due to the current COVID-19 pandemic, are alarmingly rising.
According to the KDHS, maternal mortality accounted for 14 per cent of all deaths to women age 15-49 when the survey was done six years ago.
"Unfortunately, these figures have increased exponentially due to the current COVID- 19 pandemic that has resulted to socio-economic challenges to most households, following government’s directives to impose on partial lockdown," United Nations Population Fund (UNFPA) Kenya Programme Coordinator Dr. Rael Mutai said.
While the significance of addressing the pandemic has taken centre stage, Mutai observed that the grim state of sexual and reproductive healthcare was still prevalent with COVID-19 exacerbating it.
"Lack of access to maternal products, rising cases of Female Genital Mutilation (FGM), child marriages, teenage pregnancies and Gender Based Violence are some of the predominant incidents recounted during this season," she noted during a virtual stakeholders’ forum on the impact of COVID- 19 on sexual and reproductive health rights.
In its publication, United Nations Population Fund UNFPA’s “Reproductive Health for Communities in Crisis” describes how in times of crisis, reproductive health needs are likely to be overlooked.
“Ante-natal and post-natal visits have drastically gone down. Women are no longer visiting hospitals for their check-ups or their children’s for fear of exposure to coronavirus infections. This is a red flag as it could cause maternal and child mortality,” said Mutai.
Mutai said that the disruptions have resulted to maternal health medics reassigned to COVID- 19 response teams. She added that most maternal health clinics have not resumed their normal operations and may only open ahead of curfew time, inconveniencing most women to access the facilities for assistance in contraceptive methods and child’s healthcare.
Inua Dada Founder Janet Mbugua echoed Mutai’s sentiments saying that most women and girls, especially those living in the informal settlements are suffering from ‘period poverty’, a setback that has resulted to young girls engaging in transactional sex for money in order to not only access sanitary products but also to support their families.
“Due to job losses, women no longer get their daily wages and the little they get go to providing food for their families over acquiring sanitary towels.
With schools closed and movement restrictions across counties, vulnerable girls in urban slums and rural areas are really in dire need of financial and menstrual health support,” lamented Mbugua in the webinar facilitated by New Faces New Voices Kenya.
Rising cases of teenage pregnancies was also deliberated especially with the recent report that about 4,000 school-going girls below the age of 19 have been impregnated in the last four months in Machakos County, according to the County’s Children’s Department.
Plan International Gender and Inclusion Specialist Banu Khan said that while these statistics were perturbing, child pregnancy and unsafe abortions continue to intensify, as millions of children continue to spend most of their free time at home unsupervised.
A fact sheet by the World Health Organisation states that at least 10 million unintended pregnancies occur each year among adolescent girls aged 15–19 years in the developing world.
Of the estimated 5.6 million abortions that occur each year, 3.9 million are unsafe, contributing to maternal mortality, morbidity and lasting health problems.
“While schools provided a safe haven from peer support networks and studies that keep children engaged, the long duration closure has brought with it risks of sexual violence from perpetrators close to them.
We must advocate for systems to address this complex issue to protect our children and their future,” said Khan.
Besides Kenya’s struggle with sexual and reproductive healthcare systems, panelists from gender-based organisations in South Africa expressed their views on how the situation is during this pandemic.
Khuluka Foundation’s Josina Machel, an activist and GBV survivor, lamented the recent demise of over 10 women attributed to cases of widespread violence against women in South Africa, in June alone.
These circumstances have caused a public uproar prompting the South African Deputy President David Mabuza to make an appeal to members of parliament,
For us the time to talk on issues of gender-based violence is over, time is of the essence, we need to act now and act decisively in tackling all challenges faced by the women of our country.”
Despite the focus on girl empowerment on matters sexual and reproductive health, Graca Machel Trust Children and Youth advocate Caroline Makumbe pointed out the need to enhance response systems to create safe shelters for all GBV victims.
In South Africa, stigma and cultural beliefs were a major obstacle to offer psychosocial support but with response systems, boys facing sexual violence are gradually gaining confidence to speak out and seek help and justice from the perpetrators.
The panelists, merged in an ongoing webinar series from various organisations, resolved to petition the policy makers in prioritizing sexual and reproductive healthcare agenda in line with the current COVID- 19 response guidelines.
While community health workers have been deployed to various counties to sensitize grassroots on the misconceptions of coronavirus, similar interventions should address the grim state of maternal health in a bid to reduce morbidity and neonatal deaths.
Collaborative partnerships and social-economic mobilisation with non-governmental organisations, community based organisations and private sector will enhance policy implementation towards creating state-run safe facilities and economic empowerment to the vulnerable.
This should not only be enacted during COVID- 19 season, but also a strategized lasting resolution for structured reproductive healthcare systems.