Notes From the Field: Abortion is Essential Health Care
Notes From the Field: Abortion is Essential Health Care

Notes From the Field: Abortion is Essential Health Care

As resources are directed toward the COVID-19 pandemic, organizations are staying nimble, forging new partnerships, and creating new systems to ensure that essential health services for girls and women— including access to contraception and safe abortion—remain a priority.

As reproductive health and rights advocates, providers and professionals, and as individuals working and living in India, my Ipas Development Foundation (IDF) team is seeing the COVID-19 pandemic first-hand. Our work in India focuses on the implementation of the country’s abortion law, advocating for increased commitment to sexual and reproductive health and rights, and working with partners to strengthen the public health system at all levels to ensure high-quality, comprehensive contraception and abortion care is accessible to all who need it. This work is even more urgent as the country faces the growing pandemic. 

On 25 March, the Government of India announced a 21-day nationwide lockdown – the most expansive in the world – asking 1.3 billion people to stay indoors and maintain physical distancing to curb the transmission of COVID-19.  Everyone, except those working in essential services, has been prohibited from leaving their houses, and all airports and interstate road borders are closed to private vehicles. In addition to the lockdown, the government has implemented emergency health precautions.  

In anticipation of a huge surge in COVID-19 patients, public and private health facilities have been repurposed and, in some areas, hospital operating theaters have been converted into isolation wards. There has also been a significant redeployment of various cadres of health workers, including doctors, nurses, auxiliary nurse midwives, and community health workers across the country. The Government’s clinical staff are on stand-by for managing COVID-19 patients and field workers have been assigned to raising community awareness about the pandemic and screening activities to ensure the safety of communities.  

While the government’s efforts to curtail the spread of COVID-19 are commendable, the fact that many outpatient services have been cancelled will inevitably have an impact on sexual and reproductive health services, including abortion. Women will unnecessarily suffer due lack of access to safe abortion services and, for that reason, IDF is working with partners to advocate for abortion to be treated as essential health care and adapt innovative ways of delivering abortion care, like tele-medicine.

We’ve made some headway. The government invited us to contribute suggestions to inform operational guidelines for reproductive health during the COVID-19 pandemic. IDF recommended the guidelines articulate the government’s intent to ensure that women’s sexual and reproductive health and rights – including access to contraception and safe abortion – continue to remain a priority during the pandemic.   

We are also working with the Pratigya Campaign, a network of individuals and organizations working to protect and advance women’s rights and access to safe abortion care, to continue advocating for the Ministry of Health to recognize abortion as  time-sensitive, essential health care. We’ve asked the Ministry to ensure both public and private health care facilities continue to provide comprehensive abortion care and that states and district health authorities ensure that medical abortion pills continue to be available in public sector facilities and at pharmacies across the country. We also urge health care providers to give contraceptives for up to three months. 

The way we work normally is changing too. Because IDF field staff can’t travel right now, we are collaborating virtually with local stakeholders to strengthen the technical capacity of the community-based organizations to provide information on COVID-19 and on referral systems for individuals who seek treatment 

These are unprecedented times and leaders from non-governmental organization should not hesitate to forge new partnerships with decision-makers from governments to health systems to community-based organizations in order to create an ongoing mutual learning and support system.  We need to work together, not only to mitigate the immediate impact of COVID-19 on women, communities, organizations and public health systems, but also as a way to reinvent ourselves to best meet our commitments to stakeholders, and, in the case of IDF, to our organisational mission of ensuring all women have access to contraception and safe and legal abortion. 

Read all the latest on our COVID-19 response page.