Kathmandu- COVID-19 is taking its toll on sexual and reproductive health in the country. The global pandemic has thrown up challenges to the government's goals of reducing maternal and child mortality rate while unwanted pregnancy and unsafe abortion have increased due to lack of access to contraceptives and safe abortion service, according to the Department of Health Services under the Family Welfare Division.
The use of contraceptives has dropped to 39.37 per cent during the pandemic. One hundred thirty four new mothers and pregnant women lost their lives during the infection between March 24 and July 21, 2020 when the country was into lockdown and the number of women who availed of safe abortion service during the same period was less than 15,000, according to the Department. Lack of transportation and qualified health workers, excessive bleeding, abortion and labour complication as well as delivery at home were among the factors that led to their death.
However, there are no data on the death of newborns and children below five years of age during the period.
The Nepal Health Sector Strategy (2016-2021) has aimed to drop maternal mortality rate to 125 per 100,000 live births.
Similarly, the country under the Sustainable Development Goals has aimed to reduce mortality rate of newborn and children below five years of age to 12 and 20 respectively per 1,000 live births. These aims seem to be unachievable on time due to the infection, it has been said.
"Unwanted pregnancy and unsafe abortion have increased during the pandemic due to lack of access to and unavailability of contraceptives and the lack of safe abortion service in time. As a result, sexual and reproductive health service indicators have been affected," said Dr Mahesh Puri, co-director of the Center for Research on Environment, Health and Population Activities (CREHPA).
According to the World Health Organisation, child and maternal mortality rate could be reduced to 10 and 30 per cent respectively in case of expansion of family planning services.
According to a study carried out by the CREHPA, Nepal witnessed 323,000 cases of abortion annually, out of which 42 per cent from registered health institutions and 58 from unregistered ones.
The figure has dropped by one-third during lockdown during the coronavirus infection, it has been said. So far, 530 health institutions have been registered across the country to provide safe abortion service.
Nepal has legalised safe abortion in 2059 BS. The national policy related to safe abortion, 2060 has been implemented. Similarly, the safe maternal and reproduction health right act, 2075, regulations, 2077 and safe abortion service programme management directive, 2078 have also been implemented.
However, secretary at the Ministry of Health and Population Dr Roshan Pokhrel has a different take on the matter. "Sexual and reproductive health service indicators did not get impacted negatively amid the infection."
Health institutions resumed other services after a gap of some period although they focused only on controlling COVID-19 in the beginning, he said. "All health services have returned to their previous states."
Quality family planning service and use of contraceptives would help reduce the rates of unwanted abortion and unsafe abortion, it has been said.