Teenage Pregnancy During a Pandemic

Background

Covid-19 and lockdown have put a strain on all aspects of life, including the economic and social climate and challenges of ac-cessing essential services. Many non-essential health services had to be limited. In some instances, the fear of contracting the dis-ease at the facility level results in many patients being denied or having delayed access to primary health services. COVID-19 was prioritized over other conditions, and all these factors saw a de-cline in patients’ health-seeking behavior for essential and primary healthcare. A reduction of movement was required, which led to reductions in the acquiring of antenatal or postnatal care. Reduced access to maternal healthcare was observed during lockdowns, in¬cluding limited access to antenatal care resources, limited social support and other uncertainties. The ongoing lockdowns left many women without access to time-sensitive maternal and reproduc¬tive health care, from routine gynaecological check-ups to prenatal care to abortion. The unfortunate by-product of this shift is the de-prioritization of other essential health care services, such as ac- cess to contraception [2,3].

Teenage Pregnancy During a Pandemic

Several reports depict that lockdown measures during a pandemic cause a rise in teenage pregnancy. Past epidemics indicated that health resources are often diverted from routine health services, which further reduces access to reproductive health services and maternal, newborn and child health services (Plan International) [4,5]. Studies have reported that the Ebola outbreak in West Afri¬ca gave rise to an increase in teenage pregnancy. The Ebola out¬break in Sierra Leone saw an increase in teenage pregnancy by as high as 65 percent, due to non-pharmaceutical interventions such as school closures (Save the Children, World Vision International, Plan International and UNICEF) [6,7]. Other commentators argue against this phenomenon in that even before the Ebola outbreak, teenage pregnancy rates in Sierra Leone were high (Amnesty) [8]. The table below depicts evidence from other countries on the im¬pact of COVID-19 on adolescent pregnancy.

                                            Table 1: Evidence Linking the COVID-19 Pandemic to Unintended Pregnancies

Proposed Solutions

More significantly, rural areas seem to be areas where people are not aware of the free maternal health services available, leading to less utilization of maternal benefits. Therefore, other means to let communities know must be implemented and involve social media pages used by people in those areas. Lastly, girls’ and women’s sexual and reproductive health and rights must continue to be pri¬oritized, funded and recognized as lifesaving, and must include:

• access to modern contraception,

• menstrual health and hygiene management,

• antenatal and postnatal care,

• clean and safe delivery,

• access to safe and legal abortion facilities, and

• and provisions for the clinical management of rape.

Disruption of schools as a non-pharmaceutical intervention to ar-rest the pandemic has been depicted as a contributing factor to increased teenage pregnancy rates during the pandemic. Access to primary health services and community-level centers should still be operational during the lockdown. Innovation on how these ser¬vices is offered is required, including continuing information shar¬ing, communication, and supporting adolescents. Technology and other virtual platforms have also been used to assist young girls and boys during the pandemic. Sierra Leone experienced pandemics such as Ebola and saw the effect of the pandemic surge employed innovative measures such as developing an interactive game app for boys and girls that provides reliable information on sexual health and how to stay safe from coronavirus [16]. Undoubtedly, social media platforms such as social media and telehealth could be exploited as tools to educate young girls and boys (Plan Inter¬national, 2020). These could include programs to keep young boys and girls busy during school closures during a pandemic, to help them make sound decisions and empower them. Support structures for young girls exposed to gender-based violence should be activat¬ed to provide immediate access. These could be community-based types of systems. Government and Business need to be visible in terms of support programs and initiatives, and these should be pro-active in nature rather than reactive. Partnerships with donors and other civil societies, community leaders and church leaders could be agents of change when curbing increased teenage pregnancy. Lastly, greater confidence in the justice system and the police need to be instilled. However, this can only be achieved if these struc¬tures are adequately capacitated and have trained personnel to deal with Gender-Based Violence and other related cases.

References

1. Policy Research and Monitoring, Council for Medical Schemes, Pretoria, South Africa.
2. Nuamah GB, Baffour PA, Mensah KA, Daniel Boateng, Dan Yedu Quansah, et al. (2019) Access and utilization of maternal healthcare in a rural district in the forest belt of Ghana. BMC 19: 6.
3. Aly J, Haeger KO, Christy AY (2020) Contraceptive access during the COVID-19 pandemic. Contraceptive and Repro­ductive Medicine. BMC 5: 17.
4. Plan International (2020) Covid 19 Lockdown Linked High Number Unintended Teen Pregnancies Kenya.
5. Plan International (2020) Living under lockdown girls and COVID-19.
6. World Vision (2020) COVID-19 Aftershocks. Access denied: teenage pregnancy threatens to block a million girls from re­turning to school.
7. Save the Children, World Vision International, Plan Inter­national and UNICEF (2015) Children’s Ebola Recovery Assessment: Sierra Leone. Center for Global Development (2020). Pandemics and Violence against Women and Chil­dren. World Bank Group (2020). Simulating the Potential Im­pacts of COVID-19 School Closures on Schooling and Learn­ing Outcomes: A Set of Global Estimates.
8. https://www.amnesty.org/download/Documents/ AFR5126952015ENGLISH.PDF
9. Global Citizen (2020) Rise in Teenage Pregnancies in Kenya Linked to COVID-19 Lockdown.
10. World Vision International Homepage (2020) Sexual ex­ploitation during lockdown in Ghana.
11. Edwards, Jess (2020) Protect a Generation: The Impact of COVID-19 on Children’s Lives. London: Save the Children.
12. Davies, Pascale (2020) Teen Pregnancies Rise in Malawi Amid Coronavirus Pandemic. Africa News.
13. Africa (2021) Feature: Teen pregnancies increase in Zimba­bwe as pandemic forces school closures.
14. United Nations (2020) COVID-19 could lead to millions of unintended pregnancies, new UN-backed data reveals.
15. UNDP and Government of Ireland (2015) ‘Assessing Sexual and Gender Based Violence during the Ebola Crisis in Sierra Leone’.
16. Save the Children (2020) Sierra Leone: Innovative Sexual Health App to Help Prevent Surge in Teenage Pregnancy Due to Covid-19.