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Telemedicine for accessing menstrual regulation services during COVID-19 period

The world is still facing the global pandemic of the COVID-19 which has changed the global systems and structures. It is threatening to hinder the progress on rights for many marginalized people including- women and girls of the reproductive age. It has hampered the sexual and reproductive health and rights (SRHR) area the most- which was already a less advanced area before. It has accelerated a range of complex direct and indirect impacts on SRHR access around the world, which impacts both the availability of particular services and supplies, and barriers to access for particular groups of people. Global supply chains have collapsed, many of the health care facilities have closed, contact between health practitioners and patients has drastically reduced, and health-seeking behavior related to the SRHR has declined (Haddad et al., 2021).

Effective contraceptive methods and safe abortion care are nuts and bolts for reproductive health, and sexual and reproductive health and rights (SRHR) are fundamental human rights. The sustainability and development goal (SDG) 3 requires reducing complications due to abortion, which includes ensuring access to family planning, safe abortion services and post-abortion care.

According to United Nations Population Fund (UNFPA), about 7 million unintended pregnancies across the globe will result from the pandemic. Again, a recent study found that there was 10% decline in the usage of contraception and it is predicted that more than 15 million unintended pregnancies were due to reduced contraceptive use (Haddad et al., 2021). This will cause more births, with a growing proportion taking place without proper medical attention or in unsafe conditions.

In Bangladesh we observed for the first time a full lockdown from March, 2020 (Shammi et al., 2021). During this time period, many of the restrictions and interventions enforced pregnant people which was given for controlling virus spread and it has an impact on the MR service seeking among women (Haddad et al., 2021). Due to this lockdown, it became very difficult for the people to seek services from the service centers especially for the pregnant mothers for different family planning services which has increased the maternal mortality and morbidity rates (Ahmed et al., 2021a; Roberton et al., 2020). So, this is high time to think of that issue. In response to COVID-19, different countries have taken different approaches to changing abortion regulations and family planning practices, ranging from imposing restrictions to alleviating certain requirements. New restrictions for new variant, OMICRON will widen inequities in access to contraception and abortion care. Therefore, we must look for the ways of mitigating these effects.

Telemedicine and MR

To mitigate this problem different measures can be taken, such as reduced in-person clinical visits, expanded availability via telemedicine etc. Telemedicine could be an important way for mitigating the risks and increasing the professional health service seeking rate. Today, medical abortion is one of the safest medical procedures and increased access can lead to a decline in maternal morbidity and mortality. The Center for disease control and prevention has given a broad outline on the benefits and the types of services which one can get from the service centers.

According to the CDC the benefits of telemedicine are:

  • Allows for remote monitoring of patients
  • Allows you to send and receive messages from your doctor using chat messaging or email
  • Allows you to talk to your doctor live over the phone or video chat
  • Reduced number of visits to clinic
  • Reduced wait time for services
  • Save on travel time/ transportation costs

(Source: COVID-19: Telemedicine – What does it mean and why should you care? | CDC)

The services which one get through telemedicine are:

  • Screening for COVID-19, testing recommendations, and guidance on isolation or quarantine
  • General health care (this will include family planning services too)
  • Prescriptions for medication (if necessary, then someone can get their necessary medication prescriptions including-MR prescription too)
  • Nutrition counseling
  • Mental health counseling

(Source: COVID-19: Telemedicine – What does it mean and why should you care? | CDC)

So, this could be a very good way to get the MR services during this pandemic situation and many of the NGOs (including Friendship Bangladesh) are working on it.

 

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References:

Ahmed, T., Rahman, A. E., Amole, T. G., Galadanci, H., Matjila, M., Soma-Pillay, P., Gillespie, B. M., el Arifeen, S., & Anumba, D. O. C. (2021). The effect of COVID-19 on maternal newborn and child health (MNCH) services in Bangladesh, Nigeria and South Africa: call for a contextualised pandemic response in LMICs. International Journal for Equity in Health, 20(1). https://doi.org/10.1186/s12939-021-01414-5

Haddad, L. B., RamaRao, S., Hazra, A., Birungi, H., & Sailer, J. (2021). Addressing contraceptive needs exacerbated by COVID-19: A call for increasing choice and access to self-managed methods. In Contraception (Vol. 103, Issue 6, pp. 377–379). Elsevier Inc. https://doi.org/10.1016/j.contraception.2021.03.023

Jones, N., Guglielmi, G., Małachowska, A., Abu Hamad, B., Yadete, W., With Abu Hamad, S., Abu Hamra, E., Alam, F., Alheiwidi, S., Alabbadi, T., Al-Redaisy, N., Amaireh, W., Amdeselassie, T., Banioweda, K., Diab, R., Gebeyehu, Y., Gezahegne, K., Iyasu, A., Qandeel, A., … Workneh, F. (2021). lockdowns in low-and middle-income countries.

Roberton, T., Carter, E. D., Chou, V. B., Stegmuller, A. R., Jackson, B. D., Tam, Y., Sawadogo-Lewis, T., & Walker, N. (2020). Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. The Lancet Global Health, 8(7), e901–e908. https://doi.org/10.1016/S2214-109X(20)30229-1

Shammi, M., Bodrud-Doza, M., Islam, A. R. M. T., & Rahman, M. M. (2021). Strategic assessment of COVID-19 pandemic in Bangladesh: comparative lockdown scenario analysis, public perception, and management for sustainability. Environment, Development and Sustainability, 23(4), 6148–6191. https://doi.org/10.1007/s10668-020-00867-y

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