The COVID-19 pandemic has wreaked havoc on systems, supply chains, and technologies around the world, making it more difficult for people to access the potentially life-saving medical supplies they need. And while organisations, governments, and businesses are finding new and creative ways to meet these challenges, some systems will take longer to recover. The crippling effect of COVID-19 on the reproductive and sexual health supply chain is one of those systems.

The Reproductive Health Supplies Coalition (RHSC), of which Palladium’s Sara Stratton is a co-chair for the Advocacy and Accountability Working Group, recently published recommendations for sexual and reproductive health supply chain resiliency in an advocacy brief.

According to Stratton, there’s a misconception that reproductive health supplies are simply contraceptives when, in reality, it encompasses much more than that. “Reproductive health also includes drugs like oxytocin and magnesium sulphate that are used in deliveries and can prevent death, and menstrual health supplies, among others,” she explains. “So, half the population is affected by how well the supply chain functions.”

Beyond Contraception

Whether in a stable or crisis-affected country, women, girls, and other marginalised groups need access to quality life-saving sexual and reproductive health services. But as COVID-19 forced countries around the world to go into lockdowns, not only did the supply chain break down, but women were unable to get to facilities to receive treatments.

“Family planning services weren’t necessarily considered essential services in some places, which meant that many clinics were closed,” says Stratton.

The World Health Organization recently updated guidelines to ensure family planning is deemed essential. However, Stratton reports that she is still hearing about delays in women receiving treatment or services as countries are in different phases of lockdown and people are apprehensive or unsure of the safety of going to the clinic.

Across 37 countries worldwide, nearly two million fewer women received sexual and reproductive health services between January and June than in the same period in 2019. Coupled with disruptions to the supply chain and contraceptive access, reports estimate that this could result in potentially millions of unintended pregnancies and thousands of maternal deaths worldwide.

The pandemic has only served to highlight the vulnerabilities of global and national supply chains. Still, Stratton explains that this is a crucial point for advocates and policymakers to step in and work to create a more resilient health system and supply chain for sexual and reproductive health supplies, and as she says, “build more equilibrium into the system.”

A More Resilient Reproductive Health System

As RHSC and the broader community begin the work of building back better, she notes there will be plenty of hurdles before reaching the finish line. A significant one will be the COVID-19 vaccine.

“If all the countries have to mobilise their supply chains to get the COVID vaccine out to the last mile, it may take up truck space, HR time, and government budgets instead of ensuring that sexual and reproductive health supplies get to health facilities.” Stratton notes that this is where the need to maintain and advocate for a holistic health system is critical – one that does not prioritise some supplies to the point of the exclusion of others.

According to RHSC’s advocacy brief, collaboration between governments, donors, partners, and the private sector is necessary to build resilient systems that can withstand shocks and ensure continuous, universal access to sexual and reproductive health supplies.

“Part of what led to breakdowns in the supply chains is that none of us were planning for this pandemic,” Stratton notes. “So now, thinking longer term, we have to figure out how we can preposition certain kinds and types of health commodities at particular points along the supply chain so that if one area goes into crisis, you can mobilise another part to respond immediately.”

As the crisis evolves, the sexual and reproductive health community will be focussing on strengthening the system on the back end of the COVID-19 pandemic and finding ways to safely transition so that women can not only deliver babies safely in facilities again, but ensure that the supplies needed are already there and at the ready.

With a focus on collaboration between humanitarian and development organisations, Stratton explains that the work on this brief and RHSC’s response to COVID-19 has brought together humanitarian and development professionals to solve this pressing global problem.

She notes that the collaboration has been one of the silver linings of the pandemic. “Humanitarian professionals have very specialised skillsets in understanding how a crisis is evolving and what types of resources to mobilise,” she says. “I think we [RHSC] have a better understanding now of how humanitarian crises unfold and how to better think about and plan for them from a sexual and reproductive health standpoint.”

It’s imperative that women and girls around the world continue to receive sexual and reproductive health services and supplies both during and after the COVID-19 crisis. Enacting more supportive policies and advocating for improved health supply chains throughout the humanitarian-development continuum will serve to strengthen universal health care and achieve the United Nation’s Sustainable Development Goals.

To learn more about the Inter-Agency Working Group on Reproductive Health in Crises visit: https://iawg.net/. For more information, contact info@thepalladiumgroup.com