We are in the midst of a global pandemic and the world is turned on its head. The emergency facing us is becoming increasingly uncertain and more and more countries around the world face restrictions and national lockdowns.
Many programmes and team members around the world have been affected by the crisis and are working hard to ensure they can keep delivering for the women and girls who need them, while keeping our clients and team members safe.
With lockdowns leading to curfews and the cancellation of market days, which would usually provide a cover for women wanting to access services discreetly, many women have been unable to reach facilities. In Madagascar, for example, travel restrictions meant women were unable to access maternity hospitals or contraceptive services.
However, some teams have adapted their methods in order to continue to serve women. Teams in Madagascar accessed government permits for their buses to be allowed on the roads. This meant that services could be delivered directly to women in their homes, or that women could be safely transported to health facilities without fear that they would be turned back at road blocks.
On the 20th March, the Government in Uganda responded to the Covid-19 pandemic by imposing a lockdown restricting travel across the country. These restrictions varied between districts, with some imposing stricter and more aggressive penalties than others.
When it became clear that these travel restrictions prevented women from accessing sexual and reproductive health services, the MSI team set up a pilot project, in partnership with UNFPA, to deliver healthcare products using the SafeBoda ride-hailing mobile app.
The project allows women to order reproductive health commodities, including condoms, contraceptive pills, emergency contraception, pregnancy test kits, HIV testing kits, and menstrual health products, through the e-Shop/. The products are packed and given to a boda boda rider, who then delivers the products directly. The service has allowed women in the Kampala and Wakiso districts to order and receive reproductive health commodities at their doorsteps and has the potential to be scaled up across more districts in Uganda.
As some women are cautious of visiting health facilities during during the pandemic, programmes have been building community awareness around Covid-19 prevention through radio shows, Facebook broadcasts and community-based campaigns.
We know from previous health crises that diverting resources away from reproductive healthcare can lead to additional deaths. During the Ebola epidemic, as many, if not more people died in Sierra Leone from increased barriers to maternal and reproductive healthcare than from the virus itself.
“The Ebola crisis led to a spike in the number of teenage pregnancies. People were too afraid to go to hospital or government facilities. If we had stopped providing contraception and post-abortion care, it would have been much worse… People will always need services, irrespective of an epidemic,” said Felix Ikenna, Dr and Quality Assurance Director, MSI, in Sierra Leone
So understandably, the government were keen to prevent a repeat of the spike in teenage pregnancies seen during the Ebola crisis.
The Ministries of Education and Gender collaborated with development partners at district level and through emergency committees to focus on contraceptive access for young people, while publicising sexual health advice and information on youth services via school radio programmes.
Bengaly, a midwife in Burkina Faso is adapting to new challenges in order to continue to provide care to the women and girls who need her. She is able to navigate through quarantines and roadblocks by using her excellent relationships with local healthcare providers who help coordinate her visits, and even uses the quarantine checkpoints as an opportunity to educate the officers in sexual and reproductive health when travelling between villages.
To ensure the safety of herself and her clients, she has implemented the latest guidance to minimise the risk of Covid-19 infection, for example, by ensuring physical distancing in the waiting areas.
Her commitment has meant that she is able to continue to deliver essential contraceptive services to the women in her community. Because, as she says, “even in the most difficult situations, we have to be able to meet the needs of our clients”. — www.msi.com