Women opted for traditional birth attendants, home delivery during Covid - study

Pregnant women during the Covid-19 pandemic opted for traditional birth attendants or home delivery for fear of contracting the virus or curfews.

A report by African Population and Health Research Centre released on Friday shows others resorted to self-medication using over the counter drugs.

The report, ‘Impact of Covid-19 pandemic on sexual and reproductive health services in Kenya’, was produced in collaboration with Amref Health Africa, Centre for Reproductive Rights, Planned Parenthood Global, Reproductive Health Network Kenya and Network for Adolescent and Youth of Africa.

The study collected data from 1,816 women and girls from across 28 counties as well as from health care providers in 223 health facilities.

The aim was to document the overall impact of the pandemic on the availability of, access to, and utilisation of SRH services to women and adolescent girls in Kenya, Malawi, Burkina Faso, Uganda and Ethiopia.

In-depth interviews were conducted among 42 healthcare providers, six policy makers and 19 representatives from civil society organizations and NGOs.

The report found that women and girls responded to the barriers to accessing sexual and reproductive health services by either delaying seeking the services, visiting alternative providers or failing to seek the services all together.

At least 17 in every 100 did not visit a health facility completely during the Covid-19 period, while 38 per cent delayed seeking the services.

There was a sharp decline in the uptake and utilisation of services during the pandemic period, reflective of the challenges in both the demand and supply of services.

A harsh or negative attitude by health providers was citied among those seeking services regarded as non-essential.

“Health providers influenced the choice of contraceptives by advising women to switch to ‘pandemic friendly’ contraceptive methods, sometimes based on government Covid-19 prevention guidelines,” the report states.

Among women who reported barriers, 20 per cent reported obstacles accessing contraceptives, 18 per cent safe abortion and 17 per cent to HIV/AIDS services.

The most commonly cited barriers were restriction of movements such as curfew at 58 per cent, long distances to health facilities at 21 per cent, high cost of care at 19 per cent while six per cent cited unfriendly health providers.

“Patients could not travel to health facilities due to lockdowns and curfews and lack of public transportation. Stock-outs of SRH commodities forced some patients to seek services in private facilities at higher cost,” Kenneth Juma, a researcher at APHRC, said.

The report notes that despite lockdown being implemented soon after Covid set in, it took time for the government to address the resulting shock it had on the flow of commodities and supplies.

The report, however, notes that despite the challenges brought by Covid-19, health facilities implemented several measures to ensure continuity of services.

For instance, about 71 per cent of health facilities implemented self-care approaches to service delivery to ensure continuity of sexual and reproductive health services, 51 per cent adjusted timings for services, 37 per cent altered referral patterns while 19 per cent implemented telemedicine.

“Responding to public health emergencies may require drastic control measures but the responses adopted need to be balanced against other public health needs and priorities such as SRH,” the report recommends.

Head of legal strategies at the Centre for Reproductive Rights Martin Onyango faulted the government for the manner in which it handled the pandemic response,noting that the response largely depended on law enforcement officers not public health officers.

“The initial response to the Covid outbreak was a public order approach not a public health approach. Government largely depended on law enforcement to deal with a public health pandemic that then aggravated the impact on access to SRH services,” Onyango said.

Edited by Henry Makori