MBALE – The COVID-19 pandemic has substantially strained health systems and transformed the sexual and reproductive health environment in Uganda.
Dr. Moses Walakira, Programme Specialist (Family Planning), UNFPA said COVID-19 has disrupted health systems, health commodity supply chains, and ways of life and that more and more women and girls are now unable to access the family planning information, products, and services they need.
He explained that this will have a direct impact on women and girls’ health and well-being for years to come and that it will also lead to unwanted pregnancies that could put mothers and children at risk of malnutrition, disease, and economic hardship — pushing the most vulnerable deeper into poverty.
“The national lockdowns, inter-district lockdowns, Fear of contracting COVID-19 and transport difficulties due to mobility restrictions have caused people to avoid health care facilities, which has led to a delay in accessing routine health services,” said Dr Walakira.
Dr Walakira was presenting a paper at the World Population Day Media E-Chat on 15 July by Zoom titled; Analysis of the Effect of COVID – 19 on Family Planning Service Delivery in Uganda
He explained that a reduction in availability of essential Sexual reproductive Services [SRH services] has resulted in increased maternal and new-born deaths, unintended pregnancies and unsafe abortions.
He revealed that trends over Q1-4 of 2017, 2018, 2019 and comparison of Q1-3 of 2019 – 2020 across all levels of service delivery by UNFPA indicated that calendar year 2020 had a downward trend in January-April in uptake of Family planning and SRHR services and that the trends increased in May-September in 2020, but no similar observations for earlier years.
This comes at the time of a recent [Global Finance Facility] GFF pulse survey, 8 in 10 GFF countries are reporting declines in demand for essential services, 77% indicate disruptions in the supply of essential health products, and 87% have experienced impacts on the health work force.
Dr Walakira explained the trends in Contraceptive Stock on hand (SoH) 2017 -2020 by Ordering indicated that there was a decline in SOH in 2017-2019, but steady increase 2020 for example April-October, 2020 had higher SOH compared to 2019.
The report by Dr Walakira also says that the annual Couple of years Protection [CYP] Performance Trend (2017-2019) by Family Panning [FP]method showed a steady increase in Implant related methods
The report adds that the effects of the COVID 19 related restrictions were immediate (April 2020) but subsequent months saw improvement in uptake of FP services and reproductive health outcomes.
The report however says that there are factors that may have minimized or averted the adverse outcomes like government mitigations; authorization of continued delivery of essential services, development and roll out of guidelines on continuity of essential health services, availability of stock at the national warehouses, adaptations to service delivery models and resilient commodity delivery system (last mile assurance).
Dr Muhammad Mulongo [Mbale hospital agrees with Dr Walakira that indeed Covid 19 has impacted greatly on Family planning and reproductive health services for women and youths across the country due to restrictions on transport.
He explained that a strategy for ensuring access to family planning in the COVID-19 situation would first require an understanding of impacts on demand, supply, and equitable access adding that for example, the desire to reduce face-to-face contact with a health care provider may result in fewer visits for contraceptive methods which require such contact.
“Women need more than just products — they need access to accurate information and proper communication, they also need support emotionally, physically so we need service delivery redesign for family planning,” Dr Mulongo said.
Dr Patrick Mutono Lodoi also consented COVID-19 is fundamentally changing the contraceptive landscape, and by extension, the ability of national programs to meet women’s immediate needs for contraception.
Dr Mutono, a member of the parliamentary Covid 19 task force says as Uganda battles Covid 10, emerging evidence shows that women and girls are paying the highest price through an increase in gender-based violence during lockdown, a reduction in access to needed sexual and reproductive health services and a lack of social protection.
“Covid 19 outbreak impact on health systems has undoubtedly impacted the sexual and reproductive health of women and girls especially in access to family planning but our government has quickly adapted and responded to curb transmission of the virus and to provide care for the many who have been infected, his should give us hope,” said Dr Mutono, the Butebo County MP.