Contraception during the Covid-19 epidemic

When international news began to be flooded with reports of a rising number of coronavirus infections at the beginning of this year, the virus seemed to me like a distant threat that was unlikely to reach Africa. In retrospect, I realize that was very naïve!

South Africa recorded its first case of COVID-19 on March 5—a wakeup call for me and most South Africans. Since then, my family and I have been glued to the news, and we’ve witnessed a surprising amount of interest from different government departments and the presidency in combating the virus and ‘flattening the curve’. Every Sunday, the nation would wait in anticipation for the ‘family meeting’ where the President provided updates and preparations for the coming storm. As I look back on this now, I can’t help but wonder why we don’t pay this much attention to other health issues affecting our nation, including sexual and reproductive health.

This year’s World Contraception Day, observed globally every year on 26 September, feels very unusual to me. The aim of this day is to raise awareness of the variety of contraceptive methods available and enable women to make informed choices about their sexual and reproductive health.

Early on in the pandemic, many health agencies warned that lockdowns and curfew restrictions would have a major negative impact on women, especially young women and girls. They highlighted the vulnerability of women to Gender Based Violence (GBV), a potential spike in unplanned pregnancies, a rise child marriage in exchange for money and the risk of sexual assaults, among others. Months later, reports indeed show an increase in unplanned pregnancies among young women.  

In an attempt to contain the rapid spread of the virus, infection control measures were put in place early on, including lockdowns. Although health services were classified as essential and remained operational during South Africa’s lockdown, accessing services, which involves movements of people, remained a challenge.

At the same time, the COVID-19 epidemic has provided an opportunity to rethink how we approach contraception awareness programs. Online engagement has quickly become the new norm for reaching out to young women in need of information. In line with this new reality, Inside My Purse, via our Facebook page, hosted live chats on topics related to HIV prevention, sexual and reproductive health and GBV. The live chats provided a platform and safe space for young women to connect, support each other, share experiences and learn during lockdown.

Conversations were led by experts and young women representing diverse experiences from South Africa, Kenya, Uganda and Zimbabwe. some young women shared how they were struggling to adhere to their contraception, HIV prevention and treatment plans because they had not disclosed the use of these products to their families. Others told us how they were turned away at healthcare centres as priority was given to COVID-19 related illnesses. When seeking permits to access health care centres from law enforcement, young women would be stopped and ridiculed as contraception was not considered essential. Because of school closures, many young women were ‘idling’ and engaged in unprotected sexual activities. At the same time, school closures significantly exposed young women and girls to sexual assaults and violence by partners, known/close individuals from the community or family.

Limited access to contraception and choice of methods remain a challenge in developing countries—around the world, more than 214 million women who want to avoid pregnancy don’t use modern contraceptives. Prior to COVID-19, South Africa was already facing a massive contraception shortage due to inefficient supply chain management. Regular stockouts deprived women of the opportunity to use contraceptive methods of their choice, increasing the risk of unplanned pregnancy, complications from which are a major contributor to maternal mortality and morbidity. These contraception issues need to be highlighted and addressed not only on World Contraception Day, but also throughout the year.

This year, as women, activists, governments, businesses and communities, let us not lose sight of our commitments to improve women’s sexual and reproductive health and rights. The need for contraception has not stopped because of the pandemic. Instead, COVID-19 has further uncovered disparities in women’s health and further exposed the inefficiencies of healthcare systems that do not meet women needs. Now is the time to think differently about how to ensure that women’s needs, and aspirations are fully met.

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