It is unfortunate that as we observe World Health Day today (April 7) that the world is battling a healthcare emergency in the form of COVID-19. The pandemic has also triggered off an economic crisis that threatens the survival of millions of people across the world.
The COVID-19 pandemic has placed India’s already weak public health systems and infrastructure under tremendous strain. COVID-19 has also exposed the lack of sufficient access for health workers to personal protective equipment and limited reach of quality healthcare information and services. As the world diverts funds to battle the situation, the well-being of vulnerable populations, including women and girls, is at risk of being significantly compromised, as has been witnessed during previous pandemics.
The reproductive health and rights of girls and women is an important public health issue that requires higher attention during pandemics, a phenomenon that has been observed even in developed countries and is not unique to India. According to the United Nations Fund for Population Activities (UNFPA), the emergency response to COVID-19 also means that resources for sexual and reproductive health services may be diverted to deal with the outbreak, contributing to a rise in maternal and newborn mortality, increased unmet need for contraception and increased number of unsafe abortions and sexually transmitted infections. The reduced access to family planning services and maternal health care during the Ebola crisis, for instance, posed a serious risk to the lives of mothers and infants. Similarly, the outbreak of the Middle East Respiratory Syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS) led to adverse pregnancy outcomes including miscarriage, prematurity, foetal growth restriction and maternal death.
This is also the time to prevent a surge in violence against Indian women. WHO cautions us that violence against women tends to increase during every type of emergency, including epidemics. While data are scarce, reports from China, the United Kingdom, the United States, and other countries have suggested an increase in domestic violence cases since the COVID-19 outbreak and the subsequent imposition of lockdowns. Exacerbating the risks of violence for women are increased stress, the disruption of social and protective networks, and decreased access to services. Moreover, the risk of intimate partner violence is likely to increase when social distancing measures are put in place and people are encouraged to stay at home.
Over the decades, India has performed exceptionally well towards improving its health indicators such as maternal and child mortality. In the past year, the government had also intensified its focus on population issues and harnessing the potential of our demographic dividend. We must ensure that the on-going calamity does not hamper the progress we have made and the set momentum is not lost.
Reproductive health and rights of women require greater attention. Six actions can prevent the maternal and reproductive health rights especially of young people from being compromised even as the government intensifies its efforts to cope with COVID 19.
One, sanitary napkins, contraceptives and several other hygiene products should be listed under essential goods and all efforts should be made to ensure adequate supplies. While some states, such as Telangana and Karnataka have done so, the Central government enforce mandatory inclusion of these items as essential goods across the country.
Two, efforts at spreading awareness on how a woman can access to health information and services should be intensified. The battle today is not restricted to COVID-19. We are also fighting misinformation, myths, misconceptions and superstitions.
Three, ASHAs and other community-level health workers should be supported to ensure continued access to family planning services. With close to 30 million women wanting to use contraception but not being able to do so for various reasons, the COVID-19 crisis should not divert attention away from the huge unmet need for family planning in India.
Four, efforts should be intensified to further support initiatives that have been launched to change mindsets and bring about behaviour change agencies should be encouraged to adopt innovative communication strategies that motivate people to observe and imbibe healthy behaviours. For instance, Population Foundation of India, in collaboration with Facebook and the Government of India has begun providing reliable and actionable content for MyGOV’s COVID-19 Content Hub to address improve people’s access to verified, reliable and updated information on COVID 19. Vetted by leading public health experts and epidemiologists, the information is being translated into different languages to reach a wider audience.
Finally, the government should establish a dynamic platform that allows for effective state-NGO interface to deal with the COVID crisis. This can be done by setting up joint task forces at the state/district/sub-district/city/town level comprising of representatives from lead NGOs in health, water, sanitation, and hygiene for health (WASH), and others engaged with social protection for providing necessary support to the state administration.
Also worth considering could be the setting up of dedicated communication and feedback cells for effective communication and interface between government and people regarding measures to control the pandemic. The need of the hour is for the government and civil society organisations to come together and ensure success in this collective endeavour to prevent COVID-19 from causing irreparable damages to people’s lives.
Poonam Muttreja is executive director, Population Foundation of India.