Ensuring universal access to Sexual and Reproductive Health (SRH) services and rights are key UN Sustainable Development targets. However, the current COVID-19 pandemic, along with epidemics of Ebola and Zika, prove that SRH services can be severely disrupted during these times. This disruption can often cause many negative effects for different groups of people, specifically in disempowering individuals (particularly women and girls) and exposing them to preventable health risks.
Reduction in the availability of these services can increase the number of unintended pregnancies from lack of access to family planning, unsafe abortions and complicated deliveries without access to emergency care. In turn, this can result to thousands of maternal and new-born deaths and health problems across the world (WHO, 2020).
Similarly, this reduction can also affect individuals seeking sexual health care, undeniably leading to higher rates of sexually transmitted infections (STI) and diseases. According to the British Association for Sexual Health and HIV (BASHH), in-person services for UK patients seeking STI tests and treatments, HIV testing, medications and HIV pre-exposure prophylaxis (PrEP) have reduced drastically since the COVID-19 pandemic began during March 2020.
STI services are trying to preserve as much capacity as possible so that they can meet patients’ needs by rapidly expanding online and phone services, along with posting out STI and HIV home testing kits for individuals (Aidsmap, 2021). However, the provision of long-acting injectable contraceptives, routine vaccinations and microscopy to confirm STI diagnoses have suffered. For example,
9% of clinics have reported that they have been unable to provide HIV PrEP, while 20% of clinics have reported very limited capacity.
Similarly, out of a survey of 196 doctors, nurses, pharmacists and other health professionals, 53% reported that they were operating less than 20% of their pre-COVID in-person appointments, while 54% reported more than an 80%t shrink in appointments (Aidsmap, 2021) A study by Thomas-Glover et al (2020) has also found that there has been a disproportionately larger reduction in attendances to sexual health services in those aged under 18 years, particularly in semi-rural areas (Thomson-Glover et al., 2020).
The COVID-19 pandemic has also brought further challenges for individuals experiencing sexual violence/gender-based violence. A study by Endler et al (2020) notes that
there has been a 79% increase in risk of violence across 29 different countries during the span of the pandemic
According to UN women (2021), the COVID-19 pandemic, along with previous infectious disease outbreaks, led to an alarming rise in the incidents of gender-based violence, unsurprising given that SRH resources are diverted elsewhere. Similarly, while stay-at-home orders limit the spread of the virus, it can potentially result in dangerous situations for men and women living with violent partners (UN Women, 2020).
There have been multiple suggestions to explain the reason for this increase in domestic violence and gender-based violence during infectious disease outbreaks. Mittal and Singh (2020) note that during such pandemics, women in informal jobs are more likely to become unemployed, and more economic dependence on their male counterparts. Moreover, they state that the economic strain following a global pandemic can increase substance abuse and alcoholism within different groups of people, with reports of a 55% increase of alcoholic consumption in the USA, which has been proven to increase the risk of abusive behaviours. It has also been reported that women experiencing gender-based violence are more likely to experience other forms of gender violence, along with other health conditions, such as PTSD, depression, chronic pain and sexually transmitted diseases (Mittal and Singh, 2020).
The above information shows that many changes have been occurring in SRH healthcare delivery and health-seeking behaviour in response to the COVID-19 pandemic.
Similarly, further priority should be given to geographical locations where SRH services have faced more challenges in the form of budget cuts and closures, in order to ensure that individuals in these areas can still have access to the appropriate services. It should be anticipated by the governments of countries, charities, NGO’s and other actors that suspended and underfunded SRH services should be restored while restrictions are gradually eased, as time passes. The current number of people affected by the lack of access to SRH services is already incredibly high and letting this carry on into the ongoing future could result in more alarming numbers globally.
Moving forward, individuals should be encouraged to continue using SRH services through remote services, while priority of in-person appointments should be given to those at highest risk of health complications relating to abortions and childbirth, STIs, SRH related cancers, those at risk of domestic/gender-based violence and those who cannot rely on
remote consultations and services. While the COVID-19 pandemic should undeniably be given urgent attention, it is vital for governments and politicians to also continue providing funding and the necessary facilities for SRH services in order to ensure better health outcomes for SRH service users.
Contact the author: @panizniz
Disclaimer: the views, thoughts, and opinions expressed in the text belong solely to the author and do not necessarily reflect the official policy or position of Identity International.
Aidsmap, 2021. UK sexual health services are being decimated by COVID-19 [WWW Document]. aidsmap.com. URL https://www.aidsmap.com/news/apr-2020/uk-sexual-health-services-are-being-decimated-covid-19 (accessed 4.9.21).
BASHH, 2021. Home | British Association for Sexual Health and HIV [WWW Document]. URL https://www.bashh.org/ (accessed 4.9.21).
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