The COVID-19 pandemic is having a major impact on the delivery of sexual and reproductive healthcare around the world, according to a survey of its national members conducted by the International Planned Parenthood Federation (IPPF).

5,633 static and mobile clinics and community-based care outlets have already closed because of the outbreak, across 64 countries. They make up 14 % of the total service delivery points IPPF members ran in 2018. 

For static clinics – which provided 114 million services to clients in 2018 – the figure is even worse. More than one in five has already closed – 546 in total.

The survey is the largest global set of data available so far on how organizations delivering sexual and reproductive healthcare have been hit by COVID-19. It found:

• IPPF’s South Asia region has seen the largest number of closures overall, with more than 1,872 clinics and other service outlets closed 
• The Africa region has seen the largest number of mobile clinics closed, with 447 shut  
• 971 mobile clinics and community-based care outlets in the Federation’s Western Hemisphere region have been shut down by the pandemic
• IPPF’s Europe region has seen 208 static clinics close
• The East and South East Asia and Oceania region has seen 334 mobile clinics close
• IPPF’s Arab World region has seen 56 static clinics close.

Countries particularly affected by closures include Pakistan, El Salvador, Zambia, Sudan, Colombia, Malaysia, Uganda, Ghana, Germany, Zimbabwe and Sri Lanka. All have reported more than 100 closures of clinics and/or community-based service outlets.

Dozens of IPPF’s members say they have been forced to cut sexual and reproductive healthcare services as a result of COVID-19 restrictions. 

• 44 national members report scaling down HIV testing
• 41 national members say they have scaled down contraceptive care services
• 36 national members are scaling down services on gender-based violence
• 23 national members reported reduced availability of abortion care.

Many national members are also reporting struggles to get hold of key commodities and supplies. 59 say they are facing delays in moving goods within countries. 29 say they are facing a shortage of contraceptives. 16 have reported shortages of HIV-related medicines.

IPPF Director-General Dr Alvaro Bermejo said: 

“The COVID-19 pandemic is a health crisis across every setting, and that includes sexual and reproductive healthcare.

These figures show that millions of women and girls across the world now face an even greater challenge in trying to take care of their own health and bodies. They have needs that cannot wait, but they are facing a lack of time, lack of choice and lack of access to essential sexual and reproductive health services. If these losses can’t be course-corrected the consequences for women and girls will be catastrophic; resulting in loss of health, autonomy and life.

Static clinics have been the biggest providers of sexual and reproductive healthcare across our Federation. The closure of hundreds of them is a devastating blow to the people we serve. And the loss of mobile clinics and community-based provision is particularly hard for poorer and underserved groups, who are often harder to reach and rely on services coming to them.

Some of these closures will be due to government orders or social distancing needs. Ensuring access to critical sexual and reproductive healthcare like contraception, safe abortion and STI testing and treatment, including HIV and AIDS care, is vital.

We have to make sure that women and girls, who will experience the greatest care burden and increased levels of interpersonal violence, can get the care they need. Their rights and safety must be respected. Doing that whilst ensuring the safety of our providers is a priority.

Without access to personal protective equipment (PPE) and a secure supply of vital commodities like contraceptives, members will not be able to reopen lost service points, and more will close. The longer they stay closed, the greater the cost to the lives of women and girls.”

IPPF has established an emergency fund to provide PPE to members in need and is coordinating a Federation-wide response through a COVID-19 Taskforce.

Dr Bermejo added:

“We will do everything we can within our Federation to maintain and restart services. But we also need to see action from national governments. Where technology exists and can be used, our members are working on providing virtual services that minimise physical contact. But without political will, and additional resources such as PPE, face to face services cannot be delivered safely during this pandemic.

We need governments to make pragmatic and sensible changes to policies and legal frameworks making it easier for women to access care and obtain medication virtually. Access to telemedicine and the ability to take medicines in their own homes, such as medical abortion medication, already have a strong evidence base and should become standard.

This will help deliver the care women and girls need urgently and lift some pressure from over-stretched public health services.”