Safeguarding Maternal, Child and Reproductive Health during COVID-19

Tuesday, July 14th, 2020 00:00 |
A Ministry of Health officer performs a mouth swab. Photo/PD/JOHN OCHIENG

Mabingue Ngom

Half way into 2020, since the virus that causes COVID-19 was first diagnosed in China in February 2020, there have been more than 11 million confirmed cases, and over half a million fatalities.

With about 30% of the confirmed cases, the United States of America bear most of the burden of the epidemic followed by Brazil, India, Russia, Peru, Spain, United Kingdom and Italy. 

The epidemic seems to be steadily rising in Africa, as it went from only a few cases in March to over 500 thousand confirmed cases and more than 11 thousand fatalities by the end of June.

Mortality rate from COVID-19 varies greatly within the West and Central region, as it is very high in countries like Chad (8.5%) and Niger (6.3%) and meanwhile, the lowest are Guinea (0.6%), Ghana (0.6%), Cote d’Ivoire (0.7%) and Gabon (0.8%).

Similarly, access to testing within the region fluctuates significantly, ranging from a high of more than 7,000 tests per 1 million population in Ghana, to 162 tests per 1 million population in Mali.

Many West and Central African countries have strained and under-resourced health systems, which makes them unable to quickly scale up their responses to both epidemics and pandemics.

However, thanks to strong leadership and rapid response emergency systems, many countries in the region were able to control the spread of the pandemic.

It is nonetheless crucial to stay the course, while pursuing the strong collaboration in harmony with partners such as World Health Organisation (WHO) and community-based actors.

Previously UNFPA has played an important role in the responses to the West Africa Ebola outbreak, as well as in other past epidemics and uses that rich experience in the response measures to COVID-19.

In addition to providing countries with resources such as personnel protective equipment for Healthcare Workers, UNFPA works directly to ensure that each country's national responses are inspired by the best possible practices available.

This approach is critical, because often response measures have a negative impact on maternal, reproductive and child health services.

Recognizing the manner and extent to which epidemics affect women, children and other vulnerable populations is crucial when creating effective and fair responses.

Moreover, gender adds another layer of susceptibility to infection, as women are reported to be disproportionately exposed to directly transmit infectious diseases due to their traditional roles as caregivers.

In addition, women constitute 70 per cent of the healthcare workforce as they are risking their lives to save others while serving as nurses, and more. 

A recent study commissioned by UNFPA and conducted by Avenir Health, Johns Hopkins University and Victoria University estimate that 7 million unintended pregnancies are expected to occur, if the lockdown measures enacted at the beginning of the pandemic carries on for six months and there are major disruptions to health services. 

Furthermore, the researchers predict that some 47 million women in 114 low- and middle-income countries will be unable to use modern contraceptives if the average lockdown, or COVID-19-related disruption, continues for six months with major disruptions to services.

For every three months the lockdown continues, assuming high levels of disruption, up to 2 million additional women may be unable to use modern contraceptives. 

The undesirable effects of the lockdown measures include a spike in gender-based violence as movement restrictions trap women and girls.

It is estimated that 31 million additional gender-based violence cases can be expected in low and middle-income countries.

For every 3 months the lockdown continues, an additional 15 million extra cases of gender-based violence are expected.  

In order to effectively draw from the lessons learned from the responses to the past epidemics, the West and Central African Regional Office of the UNFPA has performed a documentary review of the major epidemics of the past with an emphasis on how to ensure reproductive, maternal, child and adolescent health services continue effectively during the COVID-19 pandemic.

The review draws out lessons learned from 20 years of major epidemics since 2002, including SARS-CoV, HIV/AIDS, Ebola, Zika and MERS-CoV.

It enables recommendations for our representatives and the different member countries, particularly highlighting three interventions and us to produce a practical guide with sets of lessons learned.

One, to ensure continuity of reproductive, maternal, newborn and adolescent health services, including the protection of health professionals. Two.

Addressing gender-based violence and harmful practices; and three, ensuring the supply of vital reproductive, maternal, newborn and adolescent health products, including modern contraceptives.

It is paramount that we implement measures immediately in order to lessen any disruption to maternal, child, and reproductive health services.

As stated by Dr. Natalia Kanem the UNFPA Executive Director, “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."

Mabingue Ngom is the Regional Director of the UNFPA-West and Central African Regional Office (UNFPA-WCARO). He oversees 23 countries.

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