As the world at large continues to lose people to the rising Covid-19 toll, the impact of the pandemic are exacerbated for women and girls. Restrictive social norms and global lockdowns have limited women’s ability to access health services as well as make them more susceptible to health risks and violence, says a population expert, adding that the outbreak will likely not have a major impact on India’s population projections in the next few years.
IANSlife spoke to Poonam Muttreja, Executive Director of Population Foundation of India (PFI), a national NGO that works at the grassroots level with frontline health workers and rural communities on issues pertaining to the sexual health of women, reproductive health of all and use of contraceptives. Excerpts:
Q: Sexual and reproductive health has taken a backseat during the pandemic. With unplanned pregnancies, little maternity facilities and lack of contraception, how will this reflect on population trends of India?
A: Evidence from past epidemics have shown that the emergency response lead to diversion of resources from routine health care services towards containing and responding to the outbreak. These re-allocations constrain already limited access to sexual and reproductive health services, such as clean and safe deliveries, contraceptives, and pre- and post-natal health care.
A similar trend is currently being observed in the aftermath of Covid-19 and lockdown measures. There have been several media reports quoting government sources stating that there have been an almost 40 percent decline in institutional deliveries in several states as a result of the lockdown. This data is however not available in the public domain.
Findings from a five-state study commissioned by Population Foundation of India to assess the impact of Covid-19 on young people, particularly young women and girls, suggest that nearly half (50 per cent) or more of frontline workers (ASHAs and ANMs) reported that women were not accessing ante-natal care services. Results from another three-state study by PFI indicate that young people in UP, Bihar and Rajasthan reported an unmet need for reproductive health services, sanitary pads during the lockdown.
A recent study by FRSHI India estimated that 26 million couples in India will have no access to contraceptives due to the disruption of family planning services due to the lockdown. Another study by IPAS has forewarned that nearly 2 million women will be unable to access abortion services in the near future due to Covid-19.
The long-term implications of limited availability of essential health services, including sexual and reproductive health services could be severe. UNICEF has estimated that India would have the highest number of forecast births, at 20 million, in the nine months span dating from when Covid-19 was declared a pandemic.
Q: India has a fairly young population, which is also a reason why the death toll is less. Is the demographic dividend coming to our aid?
A: It must be noted that mortality rates for those infected amongst the aged in India have also been low. Unlike many developed countries which have reported staggering number of infections in old age homes, older people in India mostly live at home and not in old age homes. This has accounted for lower risk of Covid-19 related mortality along with the fact that we are largely a young nation.
While older people and people with existing comorbidities such as asthma, diabetes, and heart conditions are more susceptible to becoming severely ill with Covid-19, WHO advises people of all ages to take steps to protect themselves as anyone, regardless of their age, can be infected by Covid-19, given the highly contagious nature of the disease.
While the need of the hour is to combat Covid-19, this must not be done at the expense of other essential health priorities. In order to leverage our demographic dividend, we must invest in their health and well-being. There is a need to ensure uninterrupted provision of reproductive health services and step up investments in family planning. Studies from across the globe have revealed that investing in family planning is one of the most cost-effective public health measures and a development “best buy”.
Women form a half of India’s population and policies and public health efforts have not addressed the gendered impact outbreaks in the past. Across every sphere, from health to the economy, the impact of Covid-19 are exacerbated for women and girls. Restrictive social norms and global lockdowns have limited women’s ability to access health services as well as make them more susceptible to health risks and violence. Multiple responsibilities have also put severe strain on their mental health. Going forward, we need effective solutions to ensure that women’s health is adequately prioritized if we truly want to leverage India’s demographic dividend.
Q: At the time of speaking, the death toll is 35K+ for India. How do you see Covid-19 altering India’s population projections for the next few years?
A: According to the WHO, most people who get Covid-19 have mild or moderate symptoms and will recover from it. Therefore, going by the existing evidence, it is highly unlikely that Covid-19 would have a major impact on India’s population projections for the next few years.