Let women's voices lead the way to strengthen health systems

It is joyful for expectant women to leave hospital holding their newborns after successful delivery. FILE | NATION

What you need to know:

  • One of the most important lessons as health systems build back better is to take account of the voices of women and girls which have often gone unheard.
  • It is a simple yet profound idea to ask those who use health services what they most need, and then ensure that their responses help to shape policy development, investment and accountability.

In just six months, the Covid-19 pandemic has profoundly tested the resilience of even the most advanced health systems and causing massive shocks to economies worldwide and deepened systematic and structural racial, ethnic and gender inequities.

And as countries grappled with how best to address the mortality and morbidity caused by the virus, many other primary healthcare services were severely disrupted — among them crucial sexual, reproductive, maternal, newborn, child and adolescent health, as well as mental health.

While women of reproductive age, children, and adolescents are less likely to die from Covid-19, the virus and control measures can compound and exacerbate the many inequities they face. Scarce finances and interrupted supply chains, and social restrictions limiting movement and closing clinics, impede access to services and put hard-won gains in their health at risk.

Some countries could see as much as a 30 per cent increase in maternal mortality while, globally, over a six-month period, 47 million women and adolescent girls could lose access to contraception, leading to seven million unintended pregnancies.

As the world moves into the next phase of the pandemic, the priority must be to ensure the health and rights of women, children and adolescents are not neglected as they so often have been in the wake of other disease outbreaks.

One of the most important lessons as health systems build back better is to take account of the voices of women and girls which have often gone unheard. It is a simple yet profound idea to ask those who use health services what they most need, and then ensure that their responses help to shape policy development, investment and accountability.

In the What Women Want: Demands for Quality Healthcare from Women and Girls campaign, more than 350 partners sought the views of women and girls in 114 countries about their priorities for maternal and reproductive health services in 2018-19. With over 1.2 million participants, this was the largest ever survey of its kind. Their top demands: respectful and dignified care; water, sanitation and hygiene; medicines and supplies, such as blood; more and better supported midwives; and health facilities within reach.

Women and girls are experiencing disruptions in accessing basic services and supplies as limited resources for sexual, reproductive, maternal, child, newborn, and adolescent health are diverted towards the pandemic response.

Midwives who primarily take care of women and girls within communities have to stay home or risk their health and safety. They are among the least prioritised for receiving personal protection equipment and often work in places without running water for hygiene or other preventative measures.

With curfews and restrictions on movement in place, some pregnant women and girls can face obstruction and harassment, sometimes even from social gatekeepers and enforcement agencies, when trying to make their way to distant health centres to deliver safely.

If they arrive, they then often risk experiencing the rollback of fundamental rights to respectful maternity care, including through coerced c-sections, denial of birth companions and unjustified separation from their babies.

All of these concerns, and others, are reflected in the policy demands of a Covid-19 Call to Action by the Partnership for Maternal, Newborn and Child Health (PMNCH), an alliance of over 1,100 organisations from 192 countries.

On Wednesday and Thursday (today), the Partnership, together with CORE Group, has convened Lives in the Balance: A Covid-19 Summit on Women’s, Children’s and Adolescents’ Health and Well-being, an interactive online forum bringing together global leaders in a debate on ways to protect and advance women’s, children’s and adolescents’ health during the Covid-19 response and recovery phases, and to keep their needs to the forefront as health systems and the social fabric of societies are rebuilt after the pandemic.

By listening to women and letting their voices lead the way, we will strengthen health systems and get back on track with reaching critical global health targets. These include reducing maternal mortality and ending preventable deaths of newborns and children under five.

We also need to ensure we meet our commitments under the International Conference on Population and Development’s Programme of Action, accelerating our progress towards universal health coverage.

Women and young people have been telling us for years what they need. Now we must listen.

Ms Helen Clark, PMNCH board chair and former prime minister of New Zealand; Prof Margaret Kobia, Public Service and Gender Cabinet secretary, Kenya; Ms Preeti Sudan, Health and Family Welfare secretary, India; and Dr Nadine F.G. Zylbermann, National Women’s Institute president, Mexico.                            

­First published by the Thomson Reuters Foundation.