Family Planning and Contraception during COVID-19
The COVID-19 pandemic has deepened the cracks that have been existing in our society leaving indirect impacts in family planning and contraception. Sex does not stop during pandemics, therefore, it is important and necessary to enable men and women to be able to seek family planning and contraception services. The restricted movement and lockdowns imposed by the government has disrupted access to many for getting family planning information, products and services. Moreover, manufacturers in Asia have either halted or reduced their production of contraceptives which makes the availability of these products even more difficult. As health systems all over the country are prioritising their response to the COVID-19 pandemic, men and women may find themselves deprived from seeking care. The unpopularity and unavailability of telemedicine This may result in unwanted pregnancies, undesired pregnancy related outcomes and high maternal and neonatal mortality related to unwanted pregnancies.
As of June, the lockdown has been in progress for the last 3 months in Bangladesh, with no certainty on how long it may continue. UNFPA predicts that in Bangladesh, unintended pregnancies will increase due to limited access to family planning and information services during this pandemic situation. Moreover, women and men may hinder themselves from visiting clinics and hospitals due to risks of being exposed to the virus. Any complications that may arise from unintended pregnancies or termination of pregnancy may have a negative impact on the already strained health system.
FIGO presents the following six action points for policy makers, political leader and health system providers:
- Social Distancing and limitations on mobility speaks to an urgent need to expand postpartum family planning services, particularly long-acting reversible contraceptives [LARCS] such as Contraceptive implants, Post-partum IUDs or Injectables
Access to health care has been an issue across many parts of the globe from time immemorial. The increase in prenatal care and institutional births seen over the last 20 years have become incredibly valuable and precious – as a ‘one off’ opportunity to provide women with counselling about contraceptive options and comprehensive and integrated health care. The COVID19 pandemic has led to the partial and sometimes complete close down of sexual and reproductive health services in many parts of the world. Antenatal, delivery, and postnatal care may be the only opportunities women have to access contraception.
To make optimum use of these points of care: – prenatal care and messages must include counselling on birth-spacing – maternity units across the globe must urgently develop postpartum family planning services concentrating particularly on long acting contraceptive methods such as postpartum IUD, which are more effective and reduce the need for return trips for supplies.
– midwives who serve women who may not be able to reach facilities for delivery should work with local health systems to deliver contraception messages and products to facilitate birth spacing, including exclusive breastfeeding and contraceptive methods for women and/or their partners.
- Self-care family planning methods should be promoted and supplied to women and men proactively
Self-care family planning methods include emergency contraceptive pills, injectables, condoms, vaginal rings, and fertility awareness methods and can be used or resupplied safely to users. WHO provides extensive guidance on their correct use. However, given the major role of users themselves and the private sector in their delivery, they are often underutilized within health systems. For example, self-injectable contraceptive methods should be made widely available as well as one-year stocks of the oral contraceptive pill. Given the lockdown experienced in many communities and the increased risk of gender-based violence for women accessing services, having these supplies on hand can help women exercise control over their lives.
2. Barriers to accessing contraception need to be lifted
Some of the problems caused by the barriers to contraception can be mitigated with effective task shifting/sharing between health care providers. In many countries nursing and midwifery education includes contraception advice and provision.
3. Implement telemedicine using mobile phones and social media as an adjunct to improving information and access to contraception
The provision of health services by professionals utilizing technology to exchange information with women should be maximized and expanded rapidly in all areas of health. The use of digital health tools has been explored before but now is the time to capitalize on pilot interventions such as using mobile phone, websites and call centers, which have been shown to work in a range of development contexts. Novel ways of sharing information such as social media could be used to the benefit of women and health care providers should engage with these tools. The delivery of contraceptive products to people’s doorsteps would be a major improvement in access and also free women’s time waiting in crowded health services dealing with ill patients.
4. We need to anticipate and address likely supply chain needs and challenges
The sudden reduction in cross border commerce of materials used in the manufacturing of key contraceptive methods, e.g. active pharmaceutical ingredients, polymers and packaging materials, the limits on transportation within countries as well as the increased bureaucracy with importation of goods across the globe is likely to result in shortages of key contraceptive methods. Governments need to plan ahead for specific supplies and commodities in their supply chains, as well as ensure oversight and logistics requirements to ensure that supplies reach clients and facilities in the last mile. Mitigation strategies addressing the tracking, security, storage and re-supply of products must be developed ahead of time and tested on how their resilience may be affected in conditions associated with the pandemic.
Picture: Johns Hopkins University
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