By Emma Sampson, Coordinator, FP2020 Executive Leadership and Rights and Empowerment teams; Varina Winder, Senior Manager, FP2020 Global Partnerships & Strategic Engagement; Shiza Farid, Data Analyst, Avenir Health
As the COVID-19 pandemic makes stay-at-home orders the new normal, the world is seeing another global surge: violence against women and girls. Countries across the globe are experiencing dramatic increases in reports of sexual offenses, calls to helplines, and demand for emergency shelter, leading the United Nations Secretary-General António Guterres to call for a global ceasefire in such violence – and for “peace at home, and in homes, around the world.”
Given that violence against women and girls is typically vastly underreported, and because global lockdowns mean women and girls may be trapped in place with their abusers, this surge in reports indicates that the reality of this crisis is likely far graver. Without health care screenings or school authorities to act as frontline reporters of suspected abuse, and with health, law enforcement, justice, and even emergency shelter services overwhelmed, women and girls have less access to resources than ever before.
But even as headlines have brought needed attention to the hidden epidemic of gender-based violence (GBV), they have not considered the relationship between violence and sexual and reproductive health. GBV increases the risk of unintended or unwanted pregnancies, as well as unsafe abortion. GBV causes other severe maternal health complications, including increased likelihood of miscarriage, stillbirth, and early labor. Unintended pregnancies can also lead to lower educational and employment potential and poverty for both mothers and their children, a cycle that can trap generations.
While the need for family planning does not end in a crisis, access to these essential services, already often under siege, has become even more challenging. The International Planned Parenthood Federation reported closures of more than one in five of member clinics in April, as well as over 5,000 mobile clinics in 64 countries. In Zimbabwe, Marie Stopes International halted all outreach services, which support over half their clients, and saw a 70% decrease in patients at clinics that remain open.
We have seen this before. During the 2014 Ebola outbreak, in Sierra Leone, access to family planning services declined by more than 20% and adolescent pregnancy increased by 65% in some regions. As we have seen in other settings, a shortage of health service services can lead to an increase in maternal and infant mortality, as well as early marriage, putting women and girls at increased risk of violence throughout their lifetimes. Crises disrupt access to health services when women and girls need them most, with lifelong and sometimes fatal consequences.
In his call for a global ceasefire on violence against women and girls, the Secretary General appealed directly to governments to include women at the center of their pandemic response. Specifically, he called for the prevention and redress of violence against women in national COVID-19 response plans, and for investments in essential services such as emergency shelters and judicial response, as well as online and other social services. Separately, he called for contraception to be available without prescription. The United Nations is leading the charge on this: UNFPA and WHO have issued guidelines that addresses both access to family planning and VAW services.
Frontline organizations are already stepping up to deliver integrated family planning services during this crisis. The United Nations Population Fund (UNFPA) is prioritizing sexual and reproductive health and combating GBV, working to deliver family planning resources, disseminate communication materials, and monitor supply levels across the globe. Leaders in humanitarian response, including the Inter-Agency Working Group on Reproductive Health Care in Crisis, who have long confronted both the epidemics of GBV and lack of reproductive health care in crisis settings are working to pull together best practices to strengthen gendered interventions. This integrated response must become systematic, though. For example, the latest WHO COVID-19 strategy update, while acknowledging the rise in GBV, fails to address women’s and girls’ reproductive health needs.
We already know how violence threatens women’s and girls’ reproductive health – and the good news is, we can adapt existing tools for coordinating both GBV and SRHR services in an emergency to fit today’s unprecedented need.
We must recognize and address the complex realities that women and girls face, both daily and within a public health crisis, and FP2020 is doing its part, collating resources, bringing together partners, and directly supporting people working in the field, to ensure that family planning is not only considered essential but available to all women and girls who need it. We are in this together.