Potential Impact of the COVID-19 Pandemic on Sexual and Reproductive Health in Nepal

Puri, Mahesh; Stone, Lucy

doi:10.33314/jnhrc.v18i2.2747

Cited by 11 publications

(10 citation statements)

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“…Other challenges include fear of patients contracting COVID-19 during visits to health facilities, closure of services as some health facilities have been converted to COVID-19 isolation centers, inadequate information on continued provision of essential SRHR services and heavy workloads on the existing health workers. This is compounded by limited capacity and investments to confront the challenges associated with containing the spread of COVID-19 and treating existing cases [15,16].…”

Section: Introductionmentioning

confidence: 99%

Continuity of Essential Sexual and Reproductive Health Services During Covid-19 Pandemic in the Who African Region

Otieno

Ouedraogo

Nkurunziza

et al. 2021

Preprint

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Background: The COVID-19 pandemic has had a major impact on the capacity of health systems to continue the delivery of essential health services. While health systems around the world are being challenged by increasing demand for care of COVID-19 patients, it is critical to all other services including sexual reproductive health services. Countries are expected to ensure optimal balance between fighting the COVID-19 pandemic and maintenance of essential health services like sexual reproductive health. The purpose of this report was to assess and document continuity of sexual and reproductive health services with a focus on safe abortion, post abortion care and family planning services during the COVID -19 pandemic in selected countries of the World Health Organization Africa Region.Methods: A descriptive survey using a simplified and user-friendly virtual web based rapid needs assessment through a questionnaire was filled in by key informants drawn from the ministries of health from 30 countries in July 2020. The questionnaires were filled in by the World Health Organization staff in charge of sexual reproductive health services in collaboration with their counterparts in the ministries of health and uploaded in excel data sheets and categorized in to thematic areas for analysis.Results: Responses were received from 17 countries out of the 30 countries that received the questionnaires. Of the 17 countries, only 2 (12%) countries reported that sexual and reproductive health services are not integrated in the essential health services package. All the sexual reproductive health elements-family planning/contraception and comprehensive abortion care, including post abortion care are integrated in the essential health services package in 12 (80%) of the 15 countries that have sexual reproductive health integrated. Also,14(82%) countries reporting having ongoing awareness raising campaigns/communication messages about family planning, comprehensive abortion care and post abortion care during the COVID pandemic. 9(59%) of the countries reported reduction in the use of family planning services, 6(35%) indicated no changes in the use of family planning services with only 2(12%) countries providing no response. Conclusion: The survey provides information on the weak health systems of the participating member states of the WHO Africa Region and the magnitude of disruptions of sexual reproductive health services in selected countries. Further, strategies adopted by countries to ensure continuity of sexual reproductive health services amidst COVID -19 like communications, Countries finally identified key areas that need to be supported in family planning/contraception, comprehensive abortion care and post abortion care during the COVID-19 pandemic.

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Section: Introductionmentioning

confidence: 99%

Continuity of Essential Sexual and Reproductive Health Services During Covid-19 Pandemic in the Who African Region

Otieno

Ouedraogo

Nkurunziza

et al. 2021

Preprint

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“…Of the 19 studies, 4 were cross sectional studies [1,14,10], 1 was an observational study [15], 1 was a descriptive analytical study [8] and the rest were qualitative studies.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…According to Lalescka in 2021 [9,4], the COVID-19 crisis had an impact on medical and other essential supply chains, negatively affecting the import, availability, and distribution of modern contraceptives, emergency contraception, antiretrovirals for HIV/AIDS, antibiotics to treat STIs, and medications for maternal and neonatal health, among other inputs from national health programmes [9]. In 2020 Mahesh Chandra Puri [8] estimated the annual impact of a 10% proportional decline in short-acting reversible contraceptive use in Nepal caused by reduced access to SRH services resulting in an estimated 131,700 additional women with an unmet need for modern contraceptives and an estimated 19,000 extra unintended pregnancies over a 12-month period. Taylor Riley et al [6] , assumed that the 10% proportional decline would be the same for services for the following modern contraceptive methods: oral contraceptive pills, the injectable, the patch, the ring, emergency contraceptive pills, male and female condoms, the lactational amenorrhea method, fertility awareness-based methods, the IUD, the implant, and other supply methods, such as spermicide foam and diaphragm.…”

Section: Covid-19 and Family Planning Suppliesmentioning

confidence: 99%

Impacts of COVID-19 on Accessibility of Sexual and Reproductive Health Services: Scoping Review

Nkole¹,

Chisotwa²,

Chikumbi³

et al. 2022

Preprint

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Introduction: Since its discovery in late 2019, the novel coronavirus (SARSCOVID-2) that causes COVID-19 has spread fast, prompting the World Health Organization (WHO) to designate the disease a worldwide pandemic on March 11, 2020.The epidemic has profoundly altered the preexisting global sexual and reproductive health landscape .The virus’s load has put ordinary services in jeopardy and harmed other health priorities. This encompasses both the provision and the supply of contraceptives, sexual health, new born and maternal health services. This Scoping review therefore mapped the availability evidence on the impact and effects of the COVID-19 disease outbreak on sexual and reproductive health. Methods: The methodological framework by Arksey and O’Malley guided this scoping review. A literature search was conducted from the following databases: Embase, PubMed, CINAHL, Scopus, WOS, and AJOL. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram and the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) checklist were used to document the review process. The Strobe critical review checklist was used to determine the quality of the included studies. Results:19 studies were reviewed, out of which 4 were cross sectional studies, 1 was an observational study, 1 was a descriptive analytical study and the rest were qualitative studies .Majority of the studies showed evidence on the impact of COVID-19 and family planning service, maternal and child services, and three studies reported on COVID-19 and sexual behaviour. Five of the nineteen included studies reported on the impact of COVID-19 and family planning service. Conclusion: This scoping review has granted the assessment of the impact of novel SARS-CoV-2 on Sexual and reproductive health services with regards to sexual behaviour, family planning and maternal, neonatal and child health. From the 18 articles identified and reviewed, the overall responses stipulated a significant reduction in client’s utilization of services due to challenges experiences in service implementation such as stock outs. In addition, low demand for reproductive health services by clients due to restrictions imposed on the movements of people to curb the spread of the virus. It is therefore important that Governments and relevant stakeholders in Maternal and Sexual Reproductive Health prioritize development of policies and practices that protect women from the impacts of the pandemic. Furthermore, regular audits to detect trends in MSRH are necessary to inform on going mitigation efforts.

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“…Of the estimated 323,200 abortions carried out in Nepal in 2014, over half (58%) were provided illegally [ 14 ]. A recent modelling study found that a 10% shift in abortion from safe to unsafe would result in 14,500 additional unsafe abortions annually in Nepal [ 15 ]. Lack of awareness about the legal provisions for abortion, availability, location, and costs of services, as well as access to transport to approved facilities, prevent many women from accessing obtaining safe and legal abortion services [ 12 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Denial of legal abortion in Nepal

et al. 2023

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Introduction In Nepal, abortion is legal on request through 12 weeks of pregnancy and up to 28 weeks for health and other reasons. Abortion is available at public facilities at no cost and by trained private providers. Yet, over half of abortions are provided outside this legal system. We sought to investigate the extent to which patients are denied an abortion at clinics legally able to provide services and factors associated with presenting late for care, being denied, and receiving an abortion after being denied. Methods We used data from a prospective longitudinal study with 1835 women aged 15–45. Between April 2019 and December 2020, we recruited 1,835 women seeking abortions at 22 sites across Nepal, including those seeking care at any gestational age (n = 537) and then only those seeking care at or after 10 weeks of gestation or do not know their gestational age (n = 1,298). We conducted interviewer-led surveys with these women at the time they were seeking abortion service (n = 1,835), at six weeks after abortion-seeking (n = 1523) and six-month intervals for three years. Using descriptive and multivariable logistic regression models, we examined factors associated with presenting for abortion before versus after 10 weeks gestation, with receiving versus being denied an abortion, and with continuing the pregnancy after being denied care. We also described reasons for the denial of care and how and where participants sought abortion care subsequent to being denied. Mixed-effects models was used to accounting clustering effect at the facility level. Results Among those recruited when eligibility included seeking abortion at any gestational age, four in ten women sought abortion care beyond 10 weeks or did not know their gestation and just over one in ten was denied care. Of the full sample, 73% were at or beyond 10 weeks gestation, 44% were denied care, and 60% of those denied continued to seek care after denial. Nearly three-quarters of those denied care were legally eligible for abortion, based on their gestation and pre-existing conditions. Women with lower socioeconomic status, including those who were younger, less educated, and less wealthy, were more likely to present later for abortion, more likely to be turned away, and more likely to continue the pregnancy after denial of care. Conclusion Denial of legal abortion care in Nepal is common, particularly among those with fewer resources. The majority of those denied in the sample should have been able to obtain care according to Nepal’s abortion law. Abortion denial could have significant potential implications for the health and well-being of women and their families in Nepal.

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Potential Impact of the COVID-19 Pandemic on Sexual and Reproductive Health in Nepal

Cited by 11 publications

References 0 publications

Continuity of Essential Sexual and Reproductive Health Services During Covid-19 Pandemic in the Who African Region

Continuity of Essential Sexual and Reproductive Health Services During Covid-19 Pandemic in the Who African Region

Impacts of COVID-19 on Accessibility of Sexual and Reproductive Health Services: Scoping Review

Denial of legal abortion in Nepal

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