Time for Action: How COVID-19 is Threatening Girls and Young Women’s Sexual and Reproductive Health and Rights

The knock-on effects of COVID-19 on girls and women

Complications from pregnancy and childbirth is the leading cause of death for girls aged 15-19, and is known to increase substantially in crisis settings. Plan International’s Living Under Lockdown report found that when schools were closed during the Ebola crisis, there was a steep increase in unintended teenage pregnancies and a staggering 75% increase in maternal mortality over just 18 months. According to the latest projections, some 47 million women may be unable to use modern contraceptives if the lockdown carries on for six months. This means up to 7 million unintended pregnancies, with thousands of young lives at risk. Also predicted is an increase in female genital mutilation cases by 2 million.

Reports from the ground are already bearing these predictions out. A new study by Plan International, UNFPA and the Institute for Family Health into the situation among Jordan’s refugee populations observed a 10-20% increase in women who have been unable to access family planning services as well as a rise in gender-based violence.

The threat of COVID-19 to existing SRHR services

Yet, far from a global effort to step up lifesaving SRHR services in light of these shocking statistics, the crisis threatens to shrink girls’ and young women’s already limited access to sexual and reproductive health information and services in three major ways.

First, we are seeing resources redirected away from vital SRHR services in favour of other COVID-related responses. We know from past epidemics that a lack of access to essential health services due to a shutdown of services can ultimately cause more deaths than the epidemic itself. Difficulty accessing contraceptives and other essential services such as safe abortion denies millions of girls and women the right to control their bodies and lives.

Second, lockdown measures in response to COVID-19 have closed schools around the world, leaving an estimated 1.54 billion young people out of school, even fewer young people are now receiving vital Comprehensive Sexuality Education. All too often when shifting from offline to online learning, CSE falls by the wayside and isn’t included in learning packages. And even where it is, with connectivity still being a luxury rather than a right and an ever-widening digital gender gap, girls and young women from marginalized, poorer households are the least likely to be able to access this information. Even if they then overcome numerous barriers to get online, girls and young women are so often subject to harassment and abuse, they are less likely to stay online.

Third, as COVID-19 fuels and shapes major political and economic change, there is a concern that more conservative governments will seek to use the crisis to curtail hard-won sexual and reproductive health and rights – for example, by limiting access to safe abortion. There have already been attempts by at least 11 US states (predominantly in the mid-West and South) to delay abortions. In contrast, there have been moves by other countries such as the UK and Ireland to relax requirements and permit telemedicine for abortion for the duration of the crisis – policies that are to be applauded.

Bridging the Gap

The scale of the problem demands concrete actions from our governments.

With disruption to schools, health services and community centres, new ways of providing information and support to children, adolescents and young people need to be established. This can include social media and remote learning, but Comprehensive Sexuality Education must also be included in distant learning packages and considerations made for those who do not have access to digital resources. Policy makers must also make sure that girls are not discouraged from returning to school by being flexible in their approach to education and making it easy for pregnant girls and young mothers, who often face stigma and discriminatory school re-entry laws, to complete their education.

Governments must ensure continued access to SRH services, which means keeping SRH clinics open and using tele-health as an alternative to face-to-face appointments. They must work together with the private sector to ensure continuity in the supply chain of contraceptives and essential medicines for those living with HIV. These services are of paramount importance in humanitarian contexts, where SRH services must be treated as the lifesaving interventions they are.

As the world recovers from this pandemic, we need to rebuild more equitable and resilient health systems founded on the principle of universal health coverage – and sexual and reproductive health and rights services must be a central tenet. Adolescent girls and young women must be at the heart of these policies, and we will not meet their needs unless we listen to their voices. Intergenerational dialogue will be vital to this process – and we are proud to stand side by side as a young advocate and a global CEO to demand change for girls and young women. Sexual and reproductive health and rights are human rights, and SRHR services are lifesaving. Far from side-lining them during a global pandemic, now is the time to prioritise and fully fund them.