African governments adopt pro-equity strategies for women, children, and adolescents to accelerate COVID-19 recovery

By Adelyn Wangusi

 

COVID-19 pandemic continues to devastate women’s, children’s, and adolescents’ health in Africa, governments leaders from Nigeria,  South Africa, Liberia, Kenya, and Malawi said at today’s Lives in the Balance: Equity in COVID-19 Response and Recovery meeting, more than 1,000 participants from around world.

The two-day Lives in the Balance meeting was organized by PMNCH, together with the CORE Group, the Global Financing Facility for Women, Children, and Adolescents, and Gavi, the Vaccine Alliance. Meeting participants including those from civil society, the UN, academia, the private sector and governments, discussed solutions to mitigate the direct and indirect impacts of the pandemic, including concrete and measurable commitments to investment and policy change.

“COVID-19 has devastated economies and affected social and community life”, said Dr Zweli Lawrence Mkhize, Minister of Health, South Africa. “Women, children, and adolescents have been significantly affected.”

At the summit, the Government of South Africa announced its commitment to review national COVID-19 policies to improve sexual and reproductive health and rights, and to allocate resources to raise youth awareness of these issues, accompanied by investments in youth economic participation, including to improve gender equality.

These commitments respond to rising need. Given that progress toward the UN Sustainable Development Goals (SDGs) related to women’s, children’s, and adolescents’ health was already off track by some 20 per cent before the crisis, the COVID-19 crisis has highlighted the need for dedicated action for the most vulnerable.

In addition to the ongoing and catastrophic direct impact of COVID-19 in many parts of the world, women, children, and adolescents are affected indirectly because of widespread disruptions to essential health, nutrition, and social services under lockdown conditions. This increases the risk of mortality and morbidity, including from treatable and preventable causes, denying the right to protection and care.

For example, UNFPA estimates that, in 2020, twelve million women experienced disruptions in family planning services due to the pandemic, with an estimated 1.4 million unintended pregnancies across 115 low- and middle-income countries.

Additionally, a recent Global Financing Facility review of 36 partner countries showed there has been up to a 25 percent drop in coverage of essential health interventions, hitting women and children the hardest.

One-third of countries report interruptions to routine immunization services due to lockdown conditions. The redeployment of primary health workers to COVID-19 duties; community reluctance to visit health clinics for fear of infection; and income losses have compounded the problem of reduced access.

Yet the needs of women and children are too often invisible in policy responses to COVID-19. Global Health 50/50 reports that more than 80 per cent of all COVID-19 health-related activities implemented by assessed global health institutions have failed to take gender into account in programme design.  Women, who according to WHO make up 70 per cent of the global health and social workforce and bear the largest share of COVID-19 infections among health workers, hold only 25 per cent of senior positions in national COVID-19 response leadership teams.

“Taken together, the direct and indirect effects of COVID-19 have rolled back decades of global effort, and threaten to disrupt the future trajectory for progress and development massively”, said Helen Clark, Board Chair of PMNCH and former Prime Minister of New Zealand. “COVID-19 is deepening and magnifying social inequalities compounded by ethnicity, gender, income, geography, and other factors. We must act now, not just to protect progress previously made, but also to work towards a world that is far more equitable than the one that existed before the pandemic.”

A seven-point Call to Action on COVID-19, backed by PMNCH’s 1,000-member platform, seeks to protect and prioritize the rights and health of women, children, and adolescents during the COVID-19 response and recovery. The Call seeks to strengthen investment, policies, and services for the recovery of health services, as well as protection of rights and future socio-economic resilience.

This week, at the Lives in the Balance meeting, these statements were revisited by senior country leaders from Nigeria, Kenya and Liberia, who updated participants on progress since December 2020.

Nigeria, which had announced a commitment of US$2.3 billion at the December 2020 meeting for strategic interventions across the health sector during 2020-2028, updated participants on the Government’s efforts to protect and support health workers across the country, 70 per cent of which are women.  “We are making sure salaries are paid on time and setting up infection control measures, made compulsory,” said Minister of Health Dr. Osagie Ehanire. “Capacity building continues – people continue to have more training. We ensure that when it is time for leave, that people go on leave, and that connectivity between the states and the federal government  with respect to task-shifting and task-sharing among health workers is being properly managed.”

In a show of growing momentum and commitment, such efforts were echoed in an increasing number of country statements, including from South Africa, Malawi and Panama, announced today.  These countries have committed to strengthening the health workforce and addressing gender disparities, including their effect on sexual and reproductive health and rights and gender-based violence.

Expressing solidarity to the PMNCH Call to Action, Dr Luis Francisco Sucre, Minister of Health of Panama notes: “In the context of COVID-19, we have fulfilled our commitment to ensure that within the first 100 days of 2021, the vaccination of health workers, the elderly, and pregnant women is underway, as part of the declaration of equity of vaccines and a symbol of hope to overcome this pandemic and its inequalities.”

Malawi highlighted a presidential initiative to expand the health workforce during COVID-19; staffing budgets this year have increased by nearly 50 per cent, improving quality of care for women, children and adolescents. “The pandemic has put so much stress on our workforce, especially those working in hospitals,” said Khumbize Kandodo Chiponda, Minister of Health of Malawi.

“Our President, His Excellency Dr Lazarus Chakwera, has made a directive that we should employ 1,380 additional health care workers to support the response. This was an opportunity to increase our numbers, so that we offer quality health care service to our people, especially the women, children and adolescents. In our national budget, we have set aside $US58.3 million (47 billion Kwachas) for personnel, which is a 45 per cent increase from last year.”

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