Francisca Miranda, holder of a PhD in Ethnology and Social Anthropology (EHESS), Senior Technician in the Gender Equality Policies Area of the European Union’s EUROsociAL + programme and Silvina Ramos MSc, Senior Researcher at CEDES Argentina, Technical Coordinator of Argentina’s National Plan for the Prevention of Adolescent Unwanted Pregnancy and EUROsociAL + expert.
The COVID-19 pandemic in Latin America and the Caribbean has erupted in a context of low economic growth, high levels of informal employment, and weak health and social protection systems, which have exacerbated the vulnerability of the region (ECLAC, PAHO, 2020). The crisis will affect women more seriously, because they are overrepresented in the economic activities hardest hit by containment measures and most exposed to infection (Bárcena, 2020).
In this context, the sexual and reproductive health and rights of many women have been affected by the lack of continuity of family planning services, as well as services for maternal health and for victims of violence, due to the diversion of resources towards the health emergency. The pandemic intervenes in a region where the unmet need for family planning reaches 10% among women between 15 and 49 years of age married or living with a partner in Latin America, and 17% in the Caribbean. Moreover, the prevalence rate of contraception of any kind is 74% for Latin America and 61% for the Caribbean (UNFPA, 2020). The adolescent maternity rate is generally above 12% in the countries of the region (GEO, 2020)[1]. It is both a factor in perpetuating poverty and, like maternal mortality, a reflection of socio-economic, ethnic and regional inequalities. It is estimated that in the COVID-19 context, 18 million additional women will lose their access to modern contraceptives (CIM/OAS, 2020).
A weakening of family planning programmes and a reduction in the use of contraception could increase maternal mortality and morbidity, increase adolescent pregnancy rates and the incidence of other sexually transmitted infections including HIV. It can also lead to unsafe and illegal abortions, in a region where there are restrictive laws on the matter. Added to this is the persistent challenge of transforming male-dominated cultural patterns that still constitute barriers to women’s negotiating power on issues relating to sex.
Some countries in the region have expanded adolescents’ access to information, advice and services relating to contraception; such is the case of Peru with the Ministry of Health’s Family Planning Standard, Ecuador with the National Plan for Sexual and Reproductive Health (2017-2021) and Argentina with the Plan for the Prevention of Adolescent Unwanted Pregnancy (2017). Some countries also incorporate Comprehensive Sex Education into their laws, such as Bolivia with Law 342 on Youth; Uruguay, which incorporates sex education into the General Education Law (18.437) (GEO, 2020), and Argentina (Law 26.150 of 2006).
As part of the implementation and consolidation of public policies on sexual and reproductive health aimed at the adolescent population, the EUROsociAL + programme supports several processes providing technical assistance to governments for the design and evaluation of these policies. In Panama, it supported the Ministry of Social Development in the process of regulating and implementing Law 60 on pregnant minors. In Mexico, work is currently under way to strengthen the National Strategy for the Prevention of Pregnancy in Adolescents, with the National Population Council and INMUJERES, the National Institute for Women. In Uruguay work was carried out to strengthen the National and Intersectoral Strategy for the Prevention of Pregnancy in Adolescents to reduce the incidence of unwanted pregnancy and to guarantee rights. In Ecuador, in the context of COVID-19, the programme is collaborating with the Judicial Council on measures to ensure access to services for victims of gender-based violence.
The post-COVID recovery will make it necessary to assess the magnitude of the impact of the pandemic and the lockdown on the health and educational services that serve the adolescent population. It will also require the strengthening of health systems to restore sexual and reproductive health benefits, including attention to gender-based violence and safe abortion following the parameters established by the legislation of each country (United Nations Population Fund 2020). In schools, attention will have to be paid to the recovery of sexual education and to keeping adolescents in school, which, in addition to strengthening the educational trajectory, operates as a protective factor in preventing teenage pregnancies.
And above all will be the challenge of implementing new interfaces of public policies and services with communities in the regions and new ways of attending to the sexual and reproductive health and maternal health of girls, adolescents and adult women, emphasising the community distribution of supplies, active search in the homes of people in situations of high social vulnerability, maternity homes or residences for mothers, the dissemination of information through social and community networks, the actions of health promoters, mobile clinics and telemedicine. It will also be essential to strengthen the authoritative force of public policies by disseminating and strengthening the application of minimum standards of access and quality of care to ensure that health systems are once again ready to guarantee services and rights. It is also to be hoped that adaptation to this unprecedented context has contributed to putting into operation new and better ways of managing and providing services, of which best use should be made in the future.
[1]https://oig.cepal.org/es/indicadores/demanda-insatisfecha-planificacion-familiar
