Bad policies to blame for low contraception during Covid-19

Ms Essy Olang opened up in 2020 on the difficulties she faced trying to access contraceptives in the wake of the Covid-19 crisis.

Ms Olang' told Nation.Africa she was unable to access her choice of contraceptive as supply continued to shrink, exposing her to unwanted pregnancy.

Between May and June 2020, her numerous trips to health facilities in Migosi, Kisumu Central, had borne no fruit.

“The health centre had no contraceptives like implants and pills. I was forced to buy some e-pills (emergency contraceptives) from a pharmacy that cost me Sh150. It’s usually free at the clinic and all public hospitals,” said Ms Olang.

Her sentiments were echoed by the Ministry of Health (MoH), which, last year, admitted that the use of contraceptives had significantly dropped since the onset of Covid-19.

Data released by MoH in September 2021 showed the use of different family planning methods dropped among women of reproductive age from 5.4 million to 5.02 million between 2020 and 2021. Before the virus struck, contraceptives use was on an upward trajectory, growing to 5.4 million in 2019/20, from 4.4 million in 2018/19.

The drop was attributed to fewer women visiting hospitals to get contraceptives and the disruption of the supply chain.

Dr Estella Waiguru, the family planning lead at MOH, told a meeting in Nairobi that the government estimated that in 2021, the use of contraception would avert more than 2.4 million unintended pregnancies and 6,100 maternal deaths.

Unsafe abortion and deaths

A new research finding has indicted African governments for abandoning reproductive health services at the height of the pandemic. A study by Africa Population and Health Research Centre (APHRC) has blamed poor government policies for the surge in unintended pregnancies and unsafe abortion and harrowing maternal and neonatal deaths as Covid-19 took its toll on the continent.

The study, conducted in Kenya, Uganda, Ethiopia, Malawi and Burkina Faso, has also revealed how women and girls from low-income backgrounds faced multiple barriers to accessing sexual and reproductive health (SRH) services at the onset of the contagion.

The report blame the governments’ policies for failing to strike a balance between transmission and addressing reproductive health needs and priorities of women, girls and sexual minorities.

The report, Impact of Covid-19 Pandemic on Sexual and Reproductive Health Services, shows healthcare priorities were mostly redeployed to Covid-19 units and reproductive health supplies deprioritised by the authorities.

The study sought to examine how healthcare providers, women, girls and sexual minorities in the five countries responded to offering and seeking reproductive health services at the height of the pandemic.

Delayed care-seeking

Interviews with 3473 women and girls, and 446 health providers, revealed that care-seeking was often delayed, or even stopped.

In Kenya, the study shows, some health providers in private facilities faced challenges in restocking family planning commodities. Shortages of such commodities were also prevalent in public facilities.

Close to two thirds of the women and girls interviewed in Kenya and Uganda cited restricted movement due to lockdowns and curfews as the main barrier to accessing SRH services.

In some cases, clients were denied services even when they were available. The choice to deny services was closely linked to policies and guidelines related to Covid-19 or due to the fear of being infected.

Ms Evelyne Opondo, senior regional director for Africa at the Centre for Reproductive Rights (CRR), said governments must ensure reproductive health services remain essential at all time.

“The rights of entire population to access sexual reproductive health services, including during the pandemic, remain a key responsibility for every government. Governments must accord the highest protection of reproductive rights for women, girls and sexual minorities,” said Ms Opondo.

Call for policy reviews

Mr Boniface Ushie, a research scientist at APHRC, said government policies in response to health emergencies must be continuously reviewed to effectively respond to evolving trends and developments.

Mr Victor Raugu, executive director at the Network for Adolescents and Youth of Africa (Nata), noted that with fears that Covid-19 could become endemic, countries can no longer ignore essential interventions in other aspects of healthcare.

“Local and national governments must strengthen community health outreach to enhance adolescents and youth access to reproductive health information and services.”

Ms Achieng Akumu, Africa regional director at Planned Parenthood, underscored the need for governments to supply private health facilities with reproductive health commodities to adequately serve vulnerable women, girls and sexual minorities.

The World Population Data Sheet puts Kenya as the fourth country with over 60 per cent use of modern contraceptives in sub-Saharan Africa after Zimbabwe, Eswatini (66 per cent) and Lesotho (65 per cent).