The Fight to Uphold Maternal and Reproductive Healthcare Services in Nepal during COVID-19 Pandemic
In March, major hospitals across Nepal were converted into designated COVID-19 centers. Among the reassigned facilities was Seti Province Hospital – the second largest provider of maternity services in the country. Vital maternal and reproductive health services including abortion, contraception, antenatal and postnatal care were immediately stopped, with no defined timeline for reinstatement.
In response to the new policies, a joint statement was released by the Reproductive Health Rights Working Group (RHRWG). White Ribbon Alliance Nepal, known locally as SMNF Nepal, a member of the RHRWG, signed onto the letter calling to uphold Sexual and Reproductive Health and Rights (SRHR) services to protect women and girls’ health during the pandemic. The statement urged the government to protect SRHR services and create an enabling environment for women and girls to receive safe, quality, affordable, accessible and dignified services.
SMNF Nepal also lobbied Dhangadi Province representatives, including the Mayor and COVID Committee, to continue maternity services and designate an ambulance for pregnant women. After five days of advocacy, the hospital resumed all basic health services, including maternal and reproductive health.
Fears of COVID-19 Lead to Uncertainty
Even where services were available, fear, misinformation, and transportation challenges kept women from accessing these services, decreasing institutional births by 50% during the national lockdown. Even more alarming, stillbirths and newborn deaths increased sharply while quality of care declined. These gaps in care leave women and their babies at risk and threaten to reverse decades of progress to reduce maternal and newborn mortality in Nepal. Another report estimates even a 10% decrease in sexual and reproductive health services will impact millions of women, like Sonam Kumari Ram.
For soon-to-be mother Sonam, the challenges accessing care has turned a joyful time into a fearful experience. At seven months pregnant, she is uncomfortable going to the hospital for antenatal check-ups due to COVID-19. Sonam said, “I am afraid to go to the hospital where transmission is possible. I am also reluctant to go for a check-up as many hospitals are restricting the partner and family from going with pregnant women.” She also avoids going to the market to limit her exposure to the virus. To ensure pregnant and lactating women receive nutritious food items during pregnancy or post-partum, SMNF Nepal provided essential items such as rice, lentils, eggs, salt, and soap to Sonam and 600 other women.
Sonam said her pregnancy experience has been filled with anxiety. To ease her fears, she has developed a detailed birth plan. The plan includes who to contact when labor begins, a designated support person in labor and details of hospital restrictions. Despite a thorough plan, Sonam still has concerns and wonders “When I go for delivery, are the hospitals equipped with the right materials to ensure a healthy and safe delivery?” Even in a pandemic, women and newborns need quality maternity care services for a quality birth experience. Health workers must be supported to provide that care – There are no exceptions in times of crisis, even the current COVID-19 pandemic.
Providing PPE for Healthcare Facilities & Supporting Providers
SMNF Nepal is working to give health providers the information and supplies they need, including personal protective equipment (PPE), so they can safely offer maternal and reproductive care during the pandemic. To date, SMNF Nepal has equipped 115 health centers, birthing centers, provincial and central hospitals across the country with reusable PPE sets, sanitizers, gloves, N95 masks, surgical masks, boots, thermal guns, sanitary pads, soaps and other essential items.
At the Birthing Center of Guashala Primary Health Center, the supplies came at a crucial time. Averaging 50 deliveries a month, the Birthing Center had been working with minimal supplies as the lockdown went into effect. The Center’s Chief Sunita Thapa said, “the supplies have come in very handy to us. We were uncertain of when the lockdown would be lifted and how long the facility could go on with the conditions we were in.” Thapa is grateful for SMNF Nepal’s contributions and adds that the supplies will last for a few months more.
SMNF Nepal’s volunteers and staff are dedicated towards fighting for a better quality of life for women and their children. SMNF Nepal is especially committed to improve the status of Nepali women by contributing to safe motherhood, newborn and child health issues through advocacy, awareness creation and by ensuring increased access to qualitative services.