From Argentina to India: The health of young women and girls always matters

by Lourdes Polo Budzovksy, Lawyer, Member of Catholics for the Right to Decide, YANAA Committee Member, and

Shruti Arora, Program Manager at the YP Foundation, YANAA Committee Member

In celebration of 28th May, the International Day of Action for Women’s Health, two of our Committee Members for the Young Activist Network for Abortion Advocacy (YANAA), explain why sexual and reproductive health must be given special attention during this pandemic. Newly elected Lourdes Polo Budzovksy, and Shruti Arora, emphasise that the health of young women, adolescents and girls must be prioritised in their contexts, Argentina and India, during the pandemic and afterwards.

Argentina: We need a new approach towards sexual and reproductive health matters in the time of COVID-19

In Argentina and across the world, the COVID-19 health emergency has shown, with renewed force, that health emergencies impact women – as well as other historically vulnerable groups in a given region – differently to the rest of the population. The lack of thought that goes into planning healthcare provisions in emergency contexts for vulnerable groups often increases the social and economic differences of a population. Young women and girls are particularly at risk of being socially and economically impacted by the current global pandemic, as governments all over the world have implemented either weak, or no, healthcare policies to provide specifically for their needs.

Aware of the potential severity of the virus, Alberto Fernandez, the President of the Republic of Argentina, was quick to use his powers to decree mandatory social distancing in order to mitigate its impact. The President has also emphasised that Argentina must strengthen its public health system as the last few months have revealed the precariousness of it.  These developments are welcome. What is missing from the Government’s strategy, however, is an approach to address the problems female Argentinians – women, adolescents and girls – are facing currently and will face in the future, as a result of this pandemic.

As is happening in most countries of the world, the health services in Argentina have prioritised responding to confirmed positive cases of COVID at the expense of other health services. To date, there have been 13,215 confirmed cases. It is our new reality as Chaco, where I live, is ranked the province with the third highest level of infections. Yet, females of all ages are put at an unfair disadvantage to their male counterparts. Their need for sexual and reproductive health (SRH) services haven’t disappeared because of the pandemic, now they are just unable to access them. Female adolescents and children are doubly affected – not only are their SRH needs being ignored, they are also young and therefore unable (in most cases) to advocate on their own behalf.

For this reason, the Argentinian Government must commit to managing responses with a gender perspective, taking into account the disparity in impact between men and women, both in the short-term and the long-term. Only by guaranteeing access to SRH services during the pandemic can the government hope to lessen the future negative social and economic effect on its female citizens.

Civil society organisations, activists and feminist movements have been doing everything they can to raise attention to this issue. Women’s healthcare professionals in the NEA region –north east of Argentina- have been working with women’s rights organisations to provide ways for women, young women and girls, to access their SRH rights. This activism has sprung up in response to politicians in the NEA provinces using the pandemic to advance their own conservative interests to obstruct access to SRH rights.

Across the country, networks of health professionals and women’s health organisations, such as Catholics for the Right to Decide, have been lobbying the Government to develop specific care protocols for SRH services. The Government must develop and adopt such protocols immediately, as although the Ministry of Health in Argentina has urged the health services, in all provinces, to carry out SRH services, to urge provinces to do something, is not as effective as implementing a nationwide protocol. This must be done to avoid an increase in unsatisfied needs for contraception leading to unwanted pregnancies and unsafe (and currently illegal) abortions.

Although there are serious issues with access to SRH services during lockdown, there is hope for SRH rights in a post-pandemic Argentina. Last week, the President stated that the abortion legalisation bill  is ready to be sent to the National Congress thus responding to the fervent and historic protests of the Green Tide. I am eagerly awaiting the day when I wake up and abortion is finally legal in Argentina.

India: In a country of marginalised young women and girls, it is vital that their health is a priority for the rest of this pandemic

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India is in lockdown until the 31st of May 2020 and the need for the central and state governments to address the needs of the adolescent girls and young women persists. India has the highest population of young people in the world, with about 356 million in the age group of 10 to 24-years-old. There are differences, diversities and huge socio-economic disparities within the people of this age group which are exacerbating challenges introduced by the national lockdown measures.

When the lockdown was announced in March, I was preparing to visit the health facilities in Varanasi, Uttar Pradesh and North-East district, Delhi in order to assess the quality and “youth-friendliness” of the health services there. The lockdown meant the visit was cancelled and the organisation I work for, the YP Foundation, had to organise online sessions with the teams in Varanasi (and other places). Young female students, who we interviewed as part of our assessment, expressed their fear for the uncertainty that the lockdown has created in their lives. As the crisis continues to unfold, the pressure is mounting on many young women to marry.

Early, child or forced marriage is a common phenomenon in emergency situations as marriage is often seen as a way for families to manage the economic impact of the crisis. Like with any crisis, the data on the pandemic’s impact on early marriage will not be available for months after the crisis is over. In spite of the lack of data, the Government must take the short and long-term impact of COVID-19 on the lives of young women and girls seriously, and to make it a focus in its pandemic strategy.

Women’s SRH needs are very far down the list of priorities for the Government, which is concerning. Social stigma discourages women from seeking support and care for their sexual and reproductive health. This puts young women and girls in an even worse position, as they have less power to make decisions for themselves and their needs, within their family and social structures. In many discussions with them, I have heard complaints of irregular menstruation, intermittent access to SRH products such as sanitary towels, increased surveillance by their family members at home with them and the deterioration of their mental health. The risk that these issues escalate and have long-lasting consequences for these young women is increasingly likely. To mitigate the effects of this pandemic on the future health of young women and girls, access to mental health services as well as SRH products and services must be a core component of the government’s COVID-19 strategy.

It is perhaps most important to stress that COVID-19 is not to blame for the SRH challenges young women and girls face in India – the virus has aggravated pre-existing societal problems and structural issues in India’s healthcare system.  Both require long-term structural solutions. Focusing specifically on the latter, the role of local women leaders must be given more emphasis in the administration of SRH services.

Arshi, a 21 year old relief worker with Action India, a women’s rights organisation in Delhi, has been involved in a number of community health projects for women and is an advocate for young women’s sexual and reproductive rights. In a recent conversation with me, she stated, “I have been supporting women in my community according to their needs. There was one woman who delivered a boy last year, [a contraceptive coil] was inserted by a doctor without taking consent or even informing. She was in desperate need to visit a doctor, but many facilities have not been functional so I supported her in speaking with the frontline health worker who followed the case. In another case, I witnessed my neighbour facing domestic violence at the hands of her husband. When the violence happened, nobody stopped. My mother and I intervened and managed the situation.” Integrating local women leaders into the provision of SRH services and amplifying their voices is a potential long-term solution to access barriers.

The Government must invest and make steps towards using community-led health solutions in the near future. Community solutions may very well have a role to play in ensuring access to SRH services in India during this pandemic, but this option cannot be explored if the Government isn’t even acknowledging there are important unmet needs in the first place.

Right now, the Government must make the health needs of young women and girls a priority on their COVID-19 agenda, as a matter of urgency. Their sexual and reproductive health still matters in the midst of a global crisis.