News

Because she counts

17 July 2020

By Argentina Matavel Piccin

We begin the decade of action for the Sustainable Development Goals (SDGs) this year in the midst of an unprecedented crisis. The COVID-19 pandemic is taking a massive toll on people’s health and lives, and triggering a global economic recession.

The health impact of the pandemic has dominated our collective mindspace and response efforts. However, following on the heels of this health emergency, are its more long-term socio-economic implications that have a clear gendered impact, which call for urgent and equal attention.

2020 has been momentous in more ways than one. It marks a milestone in the commemoration of landmark international agreements: 40+ years of the Convention on Elimination of All Forms of Discrimination against Women (CEDAW, 1979), 25+ years since the International Conference on Population and Development (ICPD, 1994) and the 25th anniversary of the Beijing Declaration (1995). These agreements strongly underscored the idea that women’s rights are essential to the full realisation of human rights and sustainable development. It is this enduring vision that must remain our touchstone today, as we navigate our way through the crisis we collectively face as a global community.

COVID-19 has exposed the fragility of public health systems the world over, including in the so-called developed world, and exacerbated existing structural, economic and socio-cultural inequalities. And once again, as in past humanitarian situations, the crisis impacts particular disadvantaged groups more adversely than the general population. These disadvantaged groups include women and girls, adolescent girls and boys, sexual and gender minorities, individuals with disabilities, people from low-income and socially marginalised backgrounds, and the elderly who are acutely affected this time.

The scale and severity of the crisis threatens to reverse the gains made towards the SDGs and the three transformative goals that define the work of United Nations Population Fund (UNFPA) around the world and in India — ending unmet need for contraception, ending preventable maternal deaths, and ending gender-based violence (GBV) and harmful practices against women and girls. India has made significant progress in recent years on a number of health and socio-economic indicators, including increase in institutional deliveries, reduction in total fertility rate, reduction in maternal mortality ratio, and a sharp decline in child marriage. COVID-19 could potentially disrupt the pace of progress on these fronts.

As we move ahead, UNFPA refocuses the lens on the vulnerabilities of women and girls, and calls on all to renew our commitment to safeguard the health and rights of women and girls during and beyond this emergency. With health systems under tremendous strain in responding to COVID-19, and the entire health machinery singularly focused on dealing with the emergency, women’s access to sexual and reproductive health services is challenged. Closure of production sites and breakdown of global and local contraceptive supply chains has interrupted the availability of contraceptives and critical life-saving maternal health medicines. Apprehensions around contracting the virus in health facilities, and loss of income may also prevent women from seeking services, and accessing essential medicines.

According to UNFPA’s projections, because of mobility restrictions related to COVID-19 during a period of six months, 47 million women in 114 low-and middle-income countries may lack access to modern contraceptives, resulting in seven million unintended pregnancies worldwide. Continued access to SRH services is critical for a woman or a girl to prevent an unintended pregnancy, and to have control over her fertility and life trajectory. It is also lifesaving for a pregnant woman in case of an emergency during delivery. The UNFPA is partnering with the Ministry of Health and Family Welfare and with the health departments in select states, to ensure that women and girls, especially pregnant and lactating women, and those under quarantine, have timely and uninterrupted access to safe, quality maternal health care, including modern contraceptives to avoid unintended pregnancies.

Anecdotal evidence is already showing that restricted mobility, confinement within the household and lack of social connectivity is increasing the risk of violence faced by women and girls who are already vulnerable to abuse. Continuation of GBV response services during the crisis enables women and girl survivors of violence to seek necessary help and support, and could in extreme instances, save their lives. UNFPA partners with select state governments in India, civil society organisations and other UN agencies to ensure that essential services for survivors of GBV and most at-risk women and girls can continue wherever feasible.

Young people need attention too. Lack of social connectivity and limited social support can increase the risk of stress and mental health issues among young people. Lack of peer contact can hinder development of skills and abilities among adolescents. Young girls and boys are also experiencing difficulties accessing sexual and reproductive health information and services that were usually delivered through school or community health programmes. This may potentially result in the rise of unintended pregnancies and sexually transmitted infections (STIs). Prolonged closure of schools, along with severe economic stress at the household level, may find many girls forced into early and child marriage. Life-skills programmes have played an important role in imparting critical knowledge to young people so that they are able to make informed decisions about their bodies and lives. UNFPA is working through targeted interventions for young people to ensure continuity of these life-skills sessions and support services for the youth.

Elderly people are the hardest hit by the COVID-19 pandemic. Social isolation, limited or no access to non-COVID but critical health services, lack of family and community support even for basic necessities such as food, have compounded their already precarious situation. UNFPA and its partners help ensure critical health mobile services and essential dignity care such as food and hygiene related materials.

This is also a time when we acknowledge and celebrate the courage and sheer hard work of health workers who are at the front lines dealing with this health emergency. As UNFPA’s regional humanitarian advisor, Tomoko Kurokawa said, when a disaster strikes, there are those who run away from it, and there are those who run towards it. Healthcare workers including doctors, nurses, and all the other health support staff who are putting in gruelling hours of work in the current crisis, are people who haven’t hesitated to run straight into the epicentre of a crisis to do their duty, to save lives. That a large proportion of health workers around the world and in India are women, reinforces the gendered nature of the health workforce, and also underlines the increased risk of infection that women healthcare workers face.

In celebrating the hard work and fortitude of our health workers, we need to protect them against stigma and discrimination from family and community members. We must ensure that they have access to psychosocial support to handle the immense stress of providing care to intense, continued suffering, and for the sense of inadequacy and guilt they feel when they lose patients after giving everything to save them.

UNFPA has been involved on several fronts to support frontline workers such as doctors, nurse-midwives, community outreach workers with a) provision of protective kits; b) initiating a helpline to address the mental health and psychosocial needs of health workers; c) capacity building on COVID-19 prevention and management d) involvement in the MoHFW campaign against stigma and discrimination; and d) facilitating task shifting for delivery of sexual and reproductive health services.

What next? We step forward in the decade of action, humbled by the knowledge of our collective vulnerability in the face of this crisis. “We are all in this together” is now a much-used refrain that we must fully embrace. Let us apply this humility to reach out beyond the comfort zones of our socio-economic strata; be more tolerant and compassionate with neighbours and co-workers who contract the virus; express solidarity with those less advantaged; and approach the unfinished agenda with a fresh resolve.

If we have learned anything from this and past humanitarian calamities, it is that sexual and reproductive health needs do not cease to exist during a crisis. And neither do human rights. Twenty-five years ago, the Programme of Action of the International Conference on Population and Development, ICPD, proved that change is possible when we promote sexual and reproductive health and family planning as a human right, especially women’s rights. In working towards a post-COVID-19 world, let’s resolve to Build Back Better, and embrace the vision of a future that is based on social justice and gender equality, to secure rights and choices for all.

Argentina Matavel Piccin is Representative India and Country Director Bhutan, United Nations Population Fund

This opinion piece was first published in Indian Express dated 17th July 2020.