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On 11 March 2020, the World Health Organization classified COVID-19 as a pandemic. Disease outbreaks affect women, girls, men, boys, and persons of all genders differently, at this time when nations across the world are implementing “keep calm and stay at home" measures, the outbreak has disrupted access to sexual and reproductive health and gender-based violence services. "Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unfair acceptance that the fight is over, leading to unnecessary suffering and death." There is a high risk that all forms of gender-based violence (GBV) will increase during the COVID-19 pandemic, creating more demand and greater need for services. Women’s rights activists globally reported that domestic violence cases have risen dramatically as people across much of the country have been quarantined, potentially with abusers, during the coronavirus outbreak. Rising tensions due to economic losses could lead to a spike in domestic violence behind closed doors increasing early, child marriages at this time of restricted movement, poor visibility and weakened protection system.

Family planning and Sexual reproductive health services and commodities are often overlooked in times of crisis, which indeed hit financial crisis, further more economic instability, placing severe pressure on natural resources, including land and water, health and social services, food shortage and increasing the gap between food availability and food demand. As we all are much aware of the fact that forty-one percent of the world's pregnancies are unintended. Enabling individuals to choose the number and spacing of their children and to space pregnancies at healthier intervals will help to mitigate these problems and reduce the gaps projected between demand for food and crops produced. Expanded access to and use of family planning can play a major role in reducing population growth, hunger, and malnutrition, but a big question mark during ordinary days if this was the status, how the government is responding during this frustrated worrying time for women who are pregnant and are at higher risk and in need of routine health services not only in health units but they also need access to reliable information and quality care Pregnant women with suspected, probable, or confirmed COVID-19, including women who may need to spend time in isolation, should have access to timely woman-centered, respectful, and skilled care. This should include obstetric, fetal medicine, and neonatal care, as well as mental health and psychosocial support with readiness to care for maternal and neonatal complications.

What our government needs to do, they really at this point need to review their strategies urges policymakers to include women’s perspectives in pandemic planning and decision-making. Government's focus is on curtailing the epidemic but they also need to realize the importance of continuing the essential health services. Lack of structured assessment of policy gaps at various levels (supply, demand, service delivery, post service delivery) in the current emergency context. There are no such guidelines for FP and SRH during this situation, though guidelines are available for home quarantine, social distances, clinical management, but major sector FP/SRH missing in GOP guidelines. Policymakers, providers and advocates must be aware of the broad links between the global outbreak response and sexual and reproductive health and rights in order to prepare to mitigate the impact. In addition, Support two-way, community-based risk communication and accountability approaches that is Leverage the capacities of community groups, particularly women’s groups, to support two-way risk communication approaches in order to dispel myths and misinformation about COVID-19. Where feasible, engage them to support local surveillance systems. Ensure decision-making bodies are gender-balanced and inclusive, with attention paid to experts like gender specialists and sexual and reproductive health specialists. They should involve CSO who are already working in it from ages like Rahnuma FPAP and creating an impact not in the society but with the help of other developing partners are helping in addressing these sensitive issues.

In countries like Pakistan where employees do not have health benefits, paid sick leave, or support for child and/or family care, COVID-19 will affect personal and household income, as well as the ability to travel to and/or pay for healthcare, including Sexual and Reproductive Health and Rights (SRHR).As governments encourage social distancing, government social welfare systems and public transport may be suspended, meaning that people may be less able to access health services. In this deadly pandemic time when the country is suffering from 90,000 plus COVID cases and smart, relax, strict lockdowns with no one seriously following the protocols the country will sum up with severe economic lockdown .This economic downturn will likely have a large impact on poverty levels in low-income countries like Pakistan where child marriage is most widespread. Because poverty is a key driver of child marriage, these economic impacts are anticipated to increase rates of child marriage in vulnerable communities. While the ultimate size of the economic impact is still impossible to predict, a paper published by the United Nations University has placed the reduction in GDP per capita in the range of 5 to 20 per cent. Should the reduction in GDP per capita be 10 per cent, then an estimated 5.6 million additional child marriages are likely to take place between 2020 and 2030. The total effect of the COVID-19 pandemic is therefore projected to result in 13 million additional child marriage.

The COVID-19 pandemic unquestionably presents an era-defining challenge to public health and the global economy and where we stand right now as Pakistan ;where coming months will be acutely dangerous and risky. With devastating and dramatic economic slowdown which has already under way has upset trade flows food shortage, collapse of energy crisis, business forced to be shutdown, travel restriction, create unemployment that will do damage at levels that are hard to forecast and grim to contemplate. A recession could take a particularly heavy toll on fragile states where there is greatest potential for unrest and conflict. Well said, “that the disease’s catastrophic economic impact could well sow the seeds of future disorder.”

Saima Murtaza

Saima Murtaza is Director Advocacy & Communication, Rahnuma Family Planning Association of Pakistan

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