COVID-19 Mitigation Efforts Impede Access To Reproductive Health Services

by Amref Health Africa

Study conducted in Kenya, Uganda, Zambia highlights challenges faced by women seeking family planning, antenatal, postnatal and immunization services, as improvements in sanitation and hygiene interventions are recommended for better health outcomes

Nairobi, July 19th, 2021: A study by Amref Health Africa has unearthed the impact of the COVID-19 pandemic on sexual and reproductive health of women in Kenya, Uganda and Zambia.

According to the study, on the Impact of the COVID-19 Pandemic and Response on Reproductive, Maternal, Child And Adolescent Health Service Provision In Kenya, Uganda And Zambia, COVID-19 and its policy response negatively affected provision of, access to and utilization of antenatal care, skilled delivery, family planning services, postpartum care and postnatal services including immunization and child health services.   

There was a 9.2% decline in utilization of short-term family planning methods (such as contraceptive pills and injections) reported in Uganda during the lockdown. In Kenya and Zambia, there was a slight decline in utilization of family planning services, including a drop in the number of new acceptors (first time users) recorded. In the two countries, the number of clients seeking immunization and child welfare services also dropped in the initial months of the pandemic, although in Uganda, the utilization of postnatal and postpartum services appears to have remained constant.

Among the barriers to access and utilization of Reproductive Maternal Child Adolescent Health and Nutrition (RMCAH-N) services listed by the respondents included fear of contracting COVID-19 at health facilities; movement restrictions; loss of income; high costs of transport and cost of seeking services; inadequate infrastructure and supply of health commodities such as drugs and Personal Protective Equipment (PPE); and insufficient and/or dissatisfactory support from health workers, which discouraged clients from seeking services.

“The stigma associated with testing positive for COVID-19 and being quarantined stood out as another barrier to access for respondents in Kenya, while in Uganda, temperature screening was found to be a hindrance as superstitious beliefs surrounding it discouraged some communities from seeking access to services where screening was a requirement,” said Dr. Shiphra Kuria, Regional Program Manager, RMNCAH and Nutrition, Amref Health Africa, during the launch of the study. “Governments therefore need to consider sociocultural beliefs and norms when designing interventions for pandemic response, to ensure that they do not leave anyone behind by failing to deliver contextually relevant solutions to the people they are meant to serve.”

COVID-19 has also impacted the conditions for implementing mother and child health and nutrition programmes at all levels. In many low resource settings for example, supply chains for nutritional products and essential medicines have been disrupted and health facilities are at risk of increasing transmission if the appropriate measures are not put in place.

To ensure uninterrupted access to and utilization of RMCAH-N services are guaranteed for all even while controlling the spread of the pandemic, the study recommends that governments invest in infrastructure to meet the health needs of their populations, complemented by improved staffing and adequately supported health care workers; ensure sufficient and reliable supply of PPE and RMCAH-N commodities such as medicines and contraceptives, and sensitize communities on COVID-19 prevention and health rights.

In addition, while hand hygiene has been put forward as a key mitigation measure against COVID-19, barriers to improved sanitation Sub-Saharan Africa remain. In Kenya for example, a rapid assessment of handwashing stations carried out by Amref Health Africa indicates that constant supply of handwashing commodities (soap and clean water), especially in urban informal settlements, remains a challenge. This poses a considerable threat to vulnerable populations including children, who are most at risk of gastrointestinal diseases like diarrhoea – the leading global killer of children under five – attributed to poor sanitation.

According to the study, while 97% of surveyed handwashing stations distributed by the National Business Compact on Coronavirus (NBCC) had water and 89% had soap, about 25% of them were inaccessible – and therefore not functional.

“We are happy to note that most of the users washed their hands independently with soap and water but some improvements, for example the height of taps and choice of installation points, need to be made. Improving contact-free dispensing of water and soap, enhancing daily operation and maintenance including replenishment of consumables, and increasing the numbers and distribution of handwashing stations, with proper coordination of all actors, would contribute significantly to addressing barriers and improving outcomes,” said Martin Muchangi, Program Director, WASH & NTDS, Amref in Kenya.


Notes to Editors

About Amref Health Africa

Amref Health Africa, headquartered in Kenya, is the largest Africa-based International Non-Governmental Organisation (INGO). With a focus on increasing sustainable health access, Amref runs programmes in over 35 countries in Africa, with lessons learnt over 60 years of engagement with governments, communities and partners. Amref Health Africa also engages in programme development, fundraising, partnership, advocacy, monitoring and evaluation, and has offices in Europe and North America as well as subsidiaries: Amref Flying Doctors, Amref Enterprises and the Amref International University.

For more information contact:

Elizabeth (Lizz) Ntonjira
Global Communication Director
Amref Health Africa
Email:[email protected]

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