New data shows that the COVID-19 pandemic has taken a toll on sexual and reproductive health programmes in Nepal. Experts worry that they won’t be able to do much unless there are resources.
The Nepal government’s department of health services has figured out that the use of contraceptives dropped to 39.37 per cent during the COVID-19 pandemic in between 24 March and 21 July 21 of 2020. This has come as a surprise for a country that boasted the highest use of contraceptives, especially condoms, in SouthAsia.
Data analysed by the government body also showed that 134 new mothers and pregnant women lost their lives during the infection in the four months in the same period, when a countrywide lockdown was imposed. However, experts take the official figures of maternal deaths with a pinch of salt as many remote communities remain unreached by health facilities even in the best of times.
The number of women who availed of safe abortion service during the same period was less than 15,000, according to the department. Lack of transportation and qualified health workers, excessive bleeding, abortion and labour complication as well as delivery at home were among the factors that led to their death.
Abortions during the lockdown
COVID-19 locked women in urgent need of antenatal and postnatal services indoors. Health department officials have scanned their records to put the number of women availing safe abortion service during the same period at less than 15,000. The lack of taken-for-granted services like transportation often led to excessive bleeding, abortion and labour complications. Often, even complicated cases of labour had to be attended by midwifes.
“Unwanted pregnancy and unsafe abortion have increased during the pandemic due to lack of access to and unavailability of contraceptives and the lack of safe abortion service in time,” Dr Mahesh Puri, co-director of the Centre for Research on Environment, Health and Population Activities (CREHPA) told local radio. “As a result, sexual and reproductive health service indicators have been affected,” he said.
Even in the best of times, just two out of every five abortions in the Himalayan nation.
A discourse Nepal needs to have
The number of children who died for lack of government services during the COVID-19 lockdown is still unclear. Clarity is also lacking on number of teenage pregnancies during the same time.
There is a consensus among health experts in the government as well as among advocacy groups and the government’s bilateral partners that the COVID-19 pandemic has thrown a huge challenge to the government’s maternal and child health programmes.
But senior bureaucrats think differently. Dr Roshan Pokhrel, secretary of health and population told Radio Nepal that “Sexual and reproductive health service indicators did not get impacted negatively amid the infection.”
He says that health services resumed after a gap of time, even though the health department was overwhelmed with COVID-19.
Health advocacy groups claim to be able to see through the argument. They say that it suits the government to avoid the discussion, because any discussion of the problem will need to be followed up with an allocation of resources. That is a challenge when the country’s economy has taken a beating like all other countries in SouthAsia, they say.
It is a discourse that the government and policy makers need to have with civil society groups, they say.
Image: Wikimedia Commons — Mass-community health teaching in Achham, Nepal