COVID-19: Activists urge govt to improve sexual and reproductive health services

For the last three months, the Uganda Government has taken a lot of measures including a partial lockdown to tame the spread of coronavirus.

The over 38 first Presidential directives to safeguard against COVID-19 were delivered on March 18, 2020, among others, closing schools, religious and social gatherings.

The measures that followed severed international and domestic travels, both public and private transport were not spared, disrupting production, and service delivery to capacity.

Recently, President Yoweri Museveni eased restrictions on private cars, general merchandise shops, shopping malls, and public transport in the gradual process to lift the country out of the lockdown.

However, the concern of the health activists in all these is the quite little discussion about access to sexual and reproductive health services and goods.

According to the Community Health Rights Network (COHERINET), even without the pandemic, women in Uganda face barriers to accessing sexual and reproductive health (SRH) services.

COVID-19, according to the COHERINET team leader Musa Yiga has placed an extra strain on the services.

"While many services shut down to maintain physical distancing and avoid further infections, women still very much need SRH products and services. Life goes on and sexual interactions continue, even amid the challenges COVID," he said.

Yiga says the reality that products such as family planning pills and injections, condoms, sanitary pads, lubricants, dental dams, among others, remain out of reach was a great concern.

"These deficiencies may further result in unwanted pregnancies that may result in another scourge of unplanned births and unsafe abortions that might lead to increased rates of maternal mortality and morbidity," he said.

According to the data released by UNFPA, the United Nations sexual and reproductive health agency, two months ago, the number of women unable to access family planning, facing unintended pregnancies, gender-based violence, and other harmful practices could skyrocket by millions of cases in the months ahead.

The research reveals the enormous scale of the impact COVID-19 is having on women as health systems become overloaded, facilities close, or only provides a limited set of services to women and girls, and many choose to skip important medical checkups through fear of contracting the virus.

The report also cites that the global supply chain disruptions may also lead to significant shortages of contraceptives and gender-based violence is expected to soar as women are trapped at home for prolonged periods.

It predicts that I47 million women in 114 low and middle-income countries may not be able to access modern contraceptives and seven million unintended pregnancies are expected to occur if the lockdown carries on for six months and there are major disruptions to health services.

For every three months, the lockdown continues, up to an additional two million women may be unable to use modern contraceptives according to the report.

Dorothy Kobugabe, who is an SRH activist, says that there is a need for amplified access to reliable comprehensive sexual reproductive health and rights information and referrals for services during this Covid-19 pandemic.

"We are calling upon our government through the health ministry to further prioritize availability and ease accessibility to comprehensive quality decentralized friendly sexual reproductive health not limited to abortion care services especially at community grass root levels during the Covid-19 pandemic," she said.

The other stakeholders according to Mariam Mirembe who is an outreach officer with COHERINET, asked men to be agents of change. "They should promote and defend the reproductive health rights of women," she said.

She said the number of women seeking SRH services have drastically reduced not only in rural areas but even in Kampala.

"At one facility I know around the city, the 50 women who could visit the facility for SRH services every month have reduced to less than 10," she said.

Dashi Yahaya, a lawyer who officers legal services to the people who push for their health rights said the right to have access to healthcare services, including reproductive health services, is enshrined in the Constitution and that it is not restricted by any disaster.

He, however, said during the Covid-19 period, there will be two things: unwanted pregnancies or unsafe abortions, and yet the legal regime does not allow abortions under Section 141 of the Peno Code.

"This means very many people will end up being criminals. Therefore, to avoid all those, we are calling upon the government and other stakeholders to prioritize the accessibility to comprehensive sexual reproductive health services during Covid-19," he said.

Ibrahim Bale, a police liaison officer at Kalerwe attached to Wandegeya Police Station confirms the increase in unwanted pregnancies in his area of jurisdiction.

He calls on other stakeholders to support police efforts of sensitizing the public on SRH services.