DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20212192

Impact of COVID-19 pandemic on safe abortion and family planning services at a tertiary care women’s hospital in Nepal

Sangeeta Kaushal Mishra, T. Geetha Rana, Shree Prasad Adhikary, Sandesh Paudel, Prabhu Sah

Abstract


Background: The COVID-19pandemic emerged as a major public health crisis, which has affected all dimensions of the health care system. Sexual and reproductive health services were severely affected, leading to a decrease in access and service utilization, affecting the overall health of women.

Methods: A two-year comparative study, before and during the COVID-19 pandemic, on safe abortion services and family planning, was conducted at Paropakar maternity and women's hospital to assess the impact of COVID-19 on service utilization.

Results: Safe abortion services were decreased by 34.4%, and family planning services by 39%, in 2020 as compared to the previous year. Uptake of long-acting reversible contraceptives and permanent methods was most affected. Utilization of services was affected markedly during lockdown, and showed a persistent decline, even after the lockdown was lifted.

Conclusions: The COVID-19 pandemic has seriously affected safe abortion and family planning services in Nepal due to lockdown, travel restriction, home isolation, resource reallocation, health facilities serving only emergencies and confusing messages about COVID-19 control. The decline in these services will create additional demand and pressure on the health care system, resulting from unplanned pregnancies and unsafe abortions. Health care staffs should be reoriented about the essential nature of safe abortion and family planning services during emergencies, and the implications of service disruption, on society and the country. Pragmatic and gender sensitive changes to national policies should be made, to ensure that women's health is safeguarded, and safe abortion and family planning included as essential health care services during emergencies.

 


Keywords


Safe abortion, Contraception, Family planning, COVID-19, Sexual and reproductive health, Nepal

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References


Reproductive, maternal, newborn and adolescent health during pandemics. Available at: https://wcaro.unfpa.org/en/publications/reproductive-maternal-newborn-and-adolescent-health-during-pandemics-lessons-learned. Accessed on 20 February 2021.

Elston JWT, Cartwright C, Petal N. The health impact of 2014-15 Ebola Outbreak. Public Health. 2017;143:60-70

Government of Nepal. Annual Report 2017/72(2014/2015) Kathmandu: Ministry of Health and Population, Department of Health services 2015. Available at: http://dohs.gov.np/wp-content/uploads/ 2016/06/Annual_Report_FY_2071_72.pdf. Accessed on 20 February 2021.

Preventing unsafe abortion. Available at: https://www.who.int/news-room/fact-sheet/detail/preventing-unsafe-abortion. Accessed on 20 February 2021.

Covid-19 Pandemic in Nepal-Wikipedia. Available at: https://en.wikipedia.org> wiki>COVID-19_pand emic_in_ Nepal. Assessed on 15 February 2021.

Karkee R, Morgan A. Providing maternal health services during the Covid-19 pandemic in Nepal. Lancet Glob Health. 2020;8:1243-44.

COVID-19 pandemic cuts access to sexual and reproductive healthcare for women around the world. Available at: https://www.ippf.org/news/covid-19-pandemic-cuts-access-sexual-and-reproductive-healthcare-women-around-world. Accessed on 20 February 2021.

Birgisson NE, Zhao Q, Secura GM, Madden T, Peripert JF. Preventing unintended pregnancy: the contraceptive choice project in review. Women Health. 2015;24(5):349-53

Bayefsky MJ, Watson KL. Abortion during Covid 19 pandemic-ensuring access to an essential health service. N Engl J Med. 2020;382:e47.

Ayadi AM, Sidibe AM. Ebola outbreak on reproductive health services in a rural district of Guinea: an ecological study. Transact Royal Soc Trop Med Hygiene. 2017;111(1):22-9

Sully EA. Adding it up: investing in sexual and reproductive health. Available at: http://www. guttmacher.org/report/adding-it-upinvesting-in-sexual-reproductive-health-2019. Assessed on 20 January 2021.

Assessed impact of the COVID-19 pandemic on sexual and reproductive health in Nepal. Nepal Health Res Counc. 2020;18(47):313-5.

Henderson JT, Puri M, Blum M, Harper CC, Rana A, Gurung G, et al. Effects of abortion legalization in Nepal, 2001-2010. PLOS One. 2013;8(5):e64775.

World Health Factsheet, preventing unsafe abortion, 2020. Available at: https://www.who.int/news-room/fact-sheets/detail/preventing-unsafe-abortion. Accessed on 25 March 2021.

Brown SS, Eisenberg L. The best intentions unintended pregnancy and the well-being of children and families. US: National Academies Press; 1995.