key: cord-0969362-3kjs0rwx
authors: Townsend, John W.; ten Hoope‐Bender, Petra; Sheffield, Jill
title: In the response to COVID‐19, we can’t forget health system commitments to contraception and family planning
date: 2020-08-07
journal: Int J Gynaecol Obstet
DOI: 10.1002/ijgo.13226
sha: 682bb3f105f6d546d892f7f22ce638aa85c1b12a
doc_id: 969362
cord_uid: 3kjs0rwx

Contraceptive and family planning services and supplies are core components of essential health services, and access to these services is a fundamental human right. This standard must continue to be respected and protected as such by governments prioritizing scarce resources during this COVID-19 pandemic. But with many health systems currently focusing on the response to the pandemic, the provision of basic contraception counselling, the delivery of contraceptive products and services, and the functioning of supply chains have been disrupted.

Contraceptive and family planning services and supplies are core components of essential health services, and access to these services is a fundamental human right. This standard must continue to be respected and protected as such by governments prioritizing scarce resources during this COVID-19 pandemic. But with many health systems currently focusing on the response to the pandemic, the provision of basic contraception counselling, the delivery of contraceptive products and services, and the functioning of supply chains have been disrupted. As a result, women, men, and adolescents are often unable to obtain these services from their regular providers.

The UN Secretary General, António Guterres, recently highlighted the pandemic's devastating consequences on women and girls, which cross every sphere: from health and the economy to security and social protection. 1 Globally, more women and children may die due to the consequences of inaccessible and inadequate health services than will perish from COVID-19 itself. In addition, the Secretary-General reminds us that nearly 70% of frontline health workers are women, who shoulder a disproportionate share of unpaid care work and are critical actors in the sustainable development of all countries. Hence the need to consider our response in a larger context.

There are three perspectives and timeframes that should be kept in mind in planning a response to the pandemic.

The first priority is to understand the contexts in which we work by listening to the voices and understanding the needs of the clients.

Responding to their needs should be foremost and continuous. We must foster integrated responses to contraceptive needs and ensure that the proposed solutions in the short-and long-term are ethical, equitable, and support reproductive justice. Also, our responses need to be integrated, considering the work of physicians as well as the crucial roles of nurses, midwives, and community health workers. The principles of ethics and justice also demand that the public health response focus on those who are most vulnerable, and that solutions proposed are based on evidence.

Given the challenges children and adolescents face for healthy growth and development, we need to consider the impact of schooling disruptions, domestic violence, and loss of opportunities for learning.

The second priority calls for health care systems to continue to respect and plan holistic response strategies to the pandemic, including not labelling basic reproductive health services (contraception/family planning, abortion services, prenatal and postpartum care and breastfeeding support) as 'non-essential' . It is unconscionable to consider these services as anything but essential given both countries' human rights commitments and the well-documented health risks for women and their infants should services be denied. Major investments in health infrastructure and supplies need to consider the Sustainable Development Goals (SDGs), which seek to enhance the wellbeing of families who could be out of work, out of funds, and out of support for some time due to the pandemic. By keeping our focus on people and communities, we can improve efficiency, enhance social and financial risk protection, increase system responsiveness to changing needs and contexts, and above all improve health and equity. The key challenge will be to keep the development of health systems present in our policy planning, investments in human and financial resources, integration of responses across health providers, and ensuring the availability of data on the adequacy of our response. We must keep critical data for decisions in front of the service users, communities, and leaders to whom we are accountable. We expect no less from FIGO and its members at this critical time-never forget that contraceptive and family planning services and supplies are core components of essential health services, and access to these services remains a fundamental human right, now and in the future.

In the words of the UN Secretary General, from this larger perspective of reproductive justice, "gender equality and women's rights are essential to getting through the COVID-19 challenge together, to recovering faster, and to building a better future for everyone". 

Put women and girls at the centre of efforts to recover from COVID-19