This report reviews the main epidemics since 2003, including SARS-CoV, HIV / AIDS, Ebola, Zika and MERS-CoV. Often, responses to such epidemics have had a negative impact on maternal, reproductive and child health services. Recognizing how and to what extent epidemics affect women, children and other vulnerable populations is crucial if nations are to create effective and equitable responses.
We presented lessons learned from past epidemics, with a focus on how to ensure reproductive, maternal, child and adolescent health services continue effectively during the current COVID-19 pandemic.
Maternal and newborn health
The extent and severity of the Ebola outbreak (2013-2016) meant that countries and health systems were in uncharted territory. The same is true with COVID-19. Here are some lessons learned from the response to the Ebola outbreak and other similar crises:
→ A consistent message is essential. It will help women and their families seek early counseling and make timely decisions.
→ It is also essential to ensure that maternity hospitals are always seen as safe places.
→ Healthcare workers (HCWs) should have appropriate training in infection control and prevention practices, as well as the proper use of personal protective equipment (PPE).
→ Establishing a clear “risk incentive payment” can help increase the number of healthcare workers.
→ In order to provide appropriate follow-up and protection, all pregnant women should be tested regularly as part of their antenatal care.
→ Women who test positive for COVID-19, including those who are breastfeeding, should not be separated from their infants. Instead, they should consider precautions such as wearing masks when feeding their babies.
→ Interventions should be developed to support facilities, midwives and health workers working privately in communities, so that they become safe alternatives for women during crises.
Sexual and reproductive health
The diversion of financial resources and health care providers to help fight the pandemic can lead to a shortage of doctors and other health professionals providing sexual and reproductive health services. It is critical that we take action NOW to reduce this disruption. Therefore:
→ A representative from sexual and reproductive health (SRH) should have a seat at the table of the COVID-19 response coordination teams.
→ Access to contraception must extend beyond routine health facilities.
→ The presence of skilled service providers can increase adolescent uptake of services and help prevent unintended pregnancies.
→ Health promotion campaigns can educate communities about contraception and how to access it.
Gender-based violence and domestic violence
There is a high risk of an increase in gender-based violence during the current pandemic, as movement restrictions trap women and children in their homes. Disease control measures that do not take into account the gender-specific needs and vulnerabilities of women and children can also increase their protection risks and lead to negative coping mechanisms. Therefore:
→ It is important to strengthen the first response systems linked to violence. First responders should anticipate an increase in gender-based violence at the onset of a pandemic epidemic and prepare accordingly, including by increasing staff and resources.
→ We should explore how technology can help quarantined people who need access to GBV services.
→ We need to make sure that GBV is integrated into the responses of health systems. Health care providers should all be trained to identify women and children at risk of violence and be present at all testing and testing locations.
→ We need to collaborate with existing formal and informal social networks such as women’s groups, community groups, civil society organizations and women’s rights organizations.
Another important step in responding to this pandemic, and to ensure that we are well prepared for more of them in the future, is the development of reliable and rapid data collection methods, followed by ‘timely expert analysis and reporting. All of this at the start of a pandemic is crucial to quickly implementing measures to deal with it. In addition, the development of an “App” that can be used within the West and Central Africa region to collect all data related to COVID-19, as well as data specific to RMNAH, would be a welcome contribution in this epic battle.