COVID-19: A Gender Lens - Protecting Sexual and Reproductive Health and Rights, and Promoting Gender Equality

"Disease outbreaks affect women and men differently, and pandemics make existing inequalities for women and girls and discrimination of other marginalized groups such as persons with disabilities and those in extreme poverty, worse."

This technical brief from the United Nations Population Fund (UNFPA) sheds light on the fact that a disease outbreak can have different impacts on women and men and that women, due to existing factors such as social norms and the division of labour, are most vulnerable. It stresses that sexual and reproductive health and rights are particularly affected in a crisis situation, and they require high attention during the COVID-19 pandemic.

A number of impacts related to sexual and reproductive health and gender are discussed in the brief. These include:

• Women represent 70% of the health and social sector workforce globally and are therefore more exposed to health risks associated with a disease outbreak.
• Women can be less likely than men to have power in decision making around the outbreak; as a consequence, their general and sexual and reproductive health needs may go largely unmet.
• Emergency response to the COVID-19 outbreak means that resources for sexual and reproductive health services may be diverted, possibly contributing to a rise in maternal and newborn mortality, increased unmet need for contraception, and increased number of unsafe abortions and sexually transmitted infections (STIs).
• In times of crisis, increased household tensions can increase the risk of domestic violence. At the same time, the systems for protecting women and girls may weaken or break down.

However, the brief makes the point that, due to their proximity to the community and the healthcare system, women are well placed to positively influence the design and implementation of prevention activities and community engagement. Yet social norms and gender inequality often prevent them from participating in decision-making and planning around outbreak responses. As stated in the report, "Many times, there is also an inadequate level of women's representation in pandemic planning and response, which can already be seen in some of the national and global COVID-19 responses."

The brief offers a list of recommendations that, overall, stress the need to attend closely to sexual and reproductive health and rights and gender during the COVID-19 response. For example:

• Adhere to strict guidance for infection prevention for safe pregnancies and childbirth, among other measures.
• Ensure policies and interventions around response speak to everyone's needs.
• Examine how these needs may differ among groups of women and men, particularly those most excluded and those who face intersecting and multiple forms of discrimination, such as those living in poverty, persons with disabilities, indigenous people, internally displaced persons (IDPs) or refugees, and lesbian, gay, bisexual, transgender/transsexual, intersex and queer/questioning (LGBTIQ) individuals.
• Consider how the quarantine experience can be different for women and men, such as whether women's and men's different physical, cultural, security, and sanitary needs are being met. Recognise that the home may not be a safe place for some women and may indeed increase exposure to intimate partner violence.
• Ensure the response to COVID-19 does not reproduce or perpetuate harmful gender norms, discriminatory practices, and inequalities. It is important to recognise that social, culture and gender norms, roles, and relations influence women's and men's vulnerability to infection, exposure, and treatment.

In particular, the brief offers the following recommendations related to the participation of women in decision-making:

• Prioritise women's participation, as their roles within communities typically place them in a good position to positively influence the design and implementation of prevention activities. Given their proximity to the local level, their surveillance and insights can help signal the start of an outbreak and improve the overall health situation.
• Include women in decision making for outbreak preparedness and response, and ensure women's representation in national and local COVID-19 policy spaces.
• Incorporate the voices of women on the front lines of the response, including healthcare workers, and of those most affected by the disease within preparedness and response policies or practices going forward.
• Support meaningful engagement of women and girls at the community level, including their networks and organisations, to ensure efforts and response do not further discriminate and exclude those most at risk.

In terms of UNFPA's role, the brief notes that "UNFPA will work closely with governments, WHO [World Health Organization], other agencies working on health (H6 - [Editor's note: click here to read about the Global Health Partnership H6]), and national partners to ensure that accurate information is provided to women, including those of reproductive age and pregnant women, on infection prevention, potential risks and how to seek timely medical care, as well as protection from gender based violence."