Covid-19 opportunity to canvass family planning - Dorayi
The new Country Director, Pathfinder International Nigeria, Dr. Amina Aminu Dorayi, has said that the lockdown coupled with the stock-outs of family planning commodities, Nigeria likely to experience an increase in unplanned pregnancies and an upward spike in population in the country. Dorayi expressed these in an interview with The Abuja Inquirer’s Lagos State correspondent, IJEOMA UKAZU. Excerpts:
Global health attention is currently on the coronavirus pandemic. How do you think this can impact family planning efforts in Nigeria?
As we know, the COVID-19 pandemic has had a profound impact on the lives of people across the globe, as well as health and social systems, and economies. This turmoil will also have a profound impact on access to family planning information and services, as well as sexual and reproductive health more broadly.
Currently, the country is working towards expanding the method mix by introducing new contraceptives, but this will likely be impacted by the pandemic.
We expect to see increase in stock outs at the health facilities and a possible post-Covid-19 baby boom because people are locked down and unable to access family planning services.
Since 2019 family planning fund slash, Nigeria has been struggling with funds, now with Covid-19 as the main priority, many are worried that family planning services will be hampered with possible life threatening consequences. For Nigeria to mitigate this, what measures do you think can be put in place?
With plunging oil prices and subsequent revision of the 2020 budget, a 20 percent cut on capital expenditure, a lot of services will be affected including health and family planning service. However, this does not diminish the importance of family planning as sexual activity does not cease with the COVID-19 pandemic. It is therefore crucial to ensure that people are able to access contraceptive information and services when they need them.
This pandemic presents a unique opportunity for advocates to highlight the condition and importance of health services, including family planning services and bring it to the front burner of decision makers.
Advocates must also intensify efforts to ensure that family planning funding is sustained at both State and federal levels, not only through budgetary allocations, but through alternative financing mechanisms like the Basic Health Care Provision Fund, BHCPF.
Advocates also need to promote and advocate for inclusion of family planning as an essential service in COVID -19 risk and response planning; Optimize opportunities for integration with other essential services, including immediate postpartum and post abortion care and immunisation; Increase access to and use of contraceptives which can be used by clients without service providers. For example, Subcutaneous, SC depot medroxyprogesterone acetate, DMPA.
As part of its objective, Pathfinder has continually advocated for increased investment in family planning and perhaps recorded successes. In the face of the ongoing pandemic, what measures have you put in place to sustain the gains made so far?
Despite the lockdown in many locations around the country, including some of Pathfinder focus states, our staffs have been encouraged to work from home and continue to engage both advocates and decision makers in various states to ensure family planning remains prioritised.
We are also revisiting our advocacy approach to take into cognisance, current realities that have emerged due to the lockdown in most states across the country with possible impact on non-COVID related budget releases.
One of such approaches is our media advocacy strategy to promote and sustain visibility for family planning and the importance of maintaining funding to ensure access to services during this period.
Nigeria's deadline to meet the Contraceptive Prevalence Targets draws near, how do you think Government can ensure and safeguard access to essential health care services, including contraception during this period?
Throughout the crisis, government should ensure family planning, and other essential health services, remain a priority in the COVID-19 response plans. Government should deploy creative solutions for service continuity and ensure respectful, client-centred family planning care such as digital health for counseling. And use of community health workers, pharmacies and drug shops to expand access to services within the communities where people live, while also upholding client rights, maintaining safety and privacy as well as addressing community concerns around the virus and service continuity.
Recently the United Nations, UN announced that the world may face condom shortages due to disruption in the supply chain and factory services following the COVID-19 lockdown. Irrespective of this warning, the demand according to a United Nations Population Fund, UNFPA report is increasing. What is the implication of this?
The shortage of a wide variety of contraceptive technologies, including condom, is inevitable in the initial stages of this pandemic because of the impact on global manufacturing factories which have slowed production or even closed down completely in some regions.
On the other hand, there will naturally be increased demand for family planning services during the lockdown, when families are at home with limited external activities and social networking. As a consequence, unplanned pregnancies will be on the increase if stock outs are experienced in service delivery points. This can be averted by strategically distributing all available family planning commodities that are reserved in the federal and state medical stores to health facilities with high client volume and continuously educating the public about all available family planning options and their effectiveness in preventing pregnancies.
As government intensifies the lockdown directive in a bid to curb the spread of Covid-19, there are fears that the country may see a surge in unplanned pregnancies and consequent abortions in some cases. What can be done to avert this?
It is inevitable that this will be a consequent of the lockdown, however we appeal to citizens who do not wish to have children at this time, to take the necessary precautions to practice safer sex in order to curb unintended pregnancies. That said, the current situation provides us the opportunity to promote sexual and reproductive health care - including family planning or contraception as essential services.
If government and policy makers define as well as promote these as essential service, it will allow people desiring the service to go out and access family planning services without any restriction or fear of security or legal consequences.
Also, adopting innovative approaches or models of care such as tele/digital health where clients can interact with providers, get information and book appointments for services, could make for efficient access to modern contraceptive methods. And by reducing contact time at the family planning service delivery point, the risk of contracting Covid-19 will equally be reduced. So, unfettered access to modern contraceptive methods is crucial at this time to avert this catastrophe of unplanned pregnancies post Covid-19 pandemic.
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