By Dr Jameel Zamir – Director of Programmes and COVID-19 Task Force Member
Dear Friends,
The COVID-19 pandemic has been challenging, and it has put immense pressure on our integrated service delivery system. Nevertheless, healthcare providers, mostly female workers, continue to deliver essential SRH services through IPPF members. We are humbled by their invaluable dedication, commitment and unwavering efforts to meet the SRH needs of underserved people in our region.
The situation is changing slowly. A majority of countries have shown a “flattening the curve” of coronavirus infections and the number of new cases continue to remain low in our region, with the exception of countries such as Indonesia and Philippines. In addition, more than half of the countries in South East Asia and the Pacific are vulnerable to humanitarian crisis.
Impact on SRH services: In March, we saw significant close down of service delivery points (SDPs) and scale down of services either by decreased hours, decreased sites, only attending to clients with appointments and/or decreasing the number of service providers working. Two months later there was major improvements with majority of the SDPs (Static clinics 97%; Mobile Units 77%; Associated Health Facility 100% and CBDs 99%) resuming their operations, but the uptake of services remains low due to movement restrictions and clients’ safety concerns on seeking services during the pandemic.
While it is true that COVID-19 has severely affected member programmes and services, it is undeniable also that members have played a pivotal role in their respective countries in ensuring that SRH services remain as essential services and the most vulnerable population is not left behind. We take pride that IPPF members have been part of shaping the #NewNormal and the future with their amazing and innovative work.
Expanding telemedicine: Eight members (Australia, Indonesia, Malaysia, Mongolia, New Zealand, Philippines, Thailand and Vietnam) have either expanded or started using telemedicine to deliver clinical services. Our Indonesia member, which is one of the countries with the highest number of COVID-19 related deaths in Southeast Asia, has been providing a wide range of SRH services via telemedicine from its static clinic in Jakarta. Services include tele-counselling on unintended pregnancies, HIV, adolescent health, safe abortion, contraceptives, SGBV and reproductive health, tele-consultation on STIs (syndromic diagnosis and treatment) and other services such as pap smear results reading and post-abortion follow-up.
Two members (New Zealand and Indonesia) have also been prescribing drugs via telemedicine channels. In Indonesia, member service providers use an Apps known as Halodoc to prescribe clients with the necessary drugs and the drugs will be directly delivered to clients’ preferred addresses.
Using media to spread awareness on SRH: In the Pacific, members have traditionally delivered services via mobile clinics and outreach sessions, to serve their widely dispersed populations across dozens of atolls and island groups. COVID-19 has made these modes of service deliveries impossible and worsen what was already a challenging task in terms of delivering health care. Two members, Fiji and Samoa, have been using television and radio channels to deliver information on SRH. Samoa has partnered with a local television channel to deliver SRHR information on every alternate Thursdays until September, and during the first session of this television series they discussed teenage pregnancy.
Digital CSE: The disruptions in schools and lockdowns have affected the provisions of sexuality education and SRH services among young people. COVID-19 does not stop the sexual thoughts and feelings of young people. Young people need information and services to protect themselves, including contraception and where to get help when they experienced violence.
Members such as Australia, Cambodia, China, Hong Kong, Indonesia, Malaysia, Mongolia, Philippines and Thailand have adapted ways to use their existing sexuality education materials for online CSE delivery. The Hong Kong FPA has maximized the use of its website to reach young people, parents, and youth workers in their local community. Members such as Hong Kong, Indonesia, and Mongolia have also carried out their training and CSE single sessions using the Zoom or Google platform.
Reaching out to the vulnerable people: Whilst everyone is vulnerable to the COVID-19 impacts, those who already faced the highest risk and degree of social and economic marginalization will be the most impacted – at-risk women and girls, People Living with HIV (PLHIV), refugees, migrants, people living with disability, sex workers, LGBTQI+ people and indigenous populations.
With the limited resources and restricted movement, ESEAOR members ensure that the most vulnerable groups are provided with the necessary services. Our Mongolian member signed a memorandum of understanding with the National Centre Against Violence to provide services to the survivors of sexual violence free of charge during COVID-19. The services are currently being continued despite the stable COVID-19 situation in the country.
In the Philippines, indigent clients are followed-up vigorously via hotlines for re-supply of contraceptives and drugs and other SRH needs. Our Philippines member also continues to provide services for PLHIVs at its treatment hubs.
In Tuvalu, our member works in partnership with the Ministry of Health’s (MOH) STI unit to reach out to the transgender group for HIV and STI testing. IPPF’s Kiribati member intensified its mobile clinic services to the sites of a vulnerable group. New Zealand has been providing services free of charge to all its clients
In Malaysia, with the nationwide closure of government family planning clinics, IPPF’s member has partnered with the local police department to deliver contraceptive services to women and girls living in longhousesin some remote parts of the country.
Networking and Partnerships: IPPF’s member in Thailand collaborated with UNAIDS, WHO and other local CSOs to conduct a rapid assessment of the impact of COVID-19 on female sex workers and their access to SRHR information and services. Feedback was provided to local and national authorities to ensure vulnerable and hard to reach populations have access to SRHR information and services.
Our Tongan member works with the MOH to document the number of unintended pregnancies in the country because of COVID-19 measures.
Lockdowns due to coronavirus have made men’s violence against women more visible and even more urgent. There is a brief guide titled Six Steps for Men to prevent Domestic Violence to help men better manage their behaviours and feelings during times of heightened tension because of Covid-19 lockdown restrictions.
Advancing Advocacy: Four IPPF members (Samoa, Vanuatu, Tuvalu and Tonga) are members of their government-led COVID-19 taskforces. Our Samoan member is a member of the national Health Planning Advisory Committee (HPAC) advocated to the Government for inclusion of SRH in national plans.
IPPF’s member in China, CFPA, successfully advocated to the National Health Commission to lay emphasis on family health promotion work during the pandemic. Due to its great work in COVID-19 prevention, China’s Deputy Minister mentioned that the CFPA’s role is significant and irreplaceable.
IPPF’s member in Thailand, PPAT, advocated to provincial governments to allow individuals who need SRH services, especially safe abortion care, to cross provincial borders to receive them from its clinics. PPAT worked with the Referral System for Safe Abortion (RSA) to ensure that the Thai Government included safe abortion care into the essential health care services during the pandemic.
Regional Coordination: Since early April, ESEAOR have been hosting a bi-weekly webinar series with the executive directors of members, to touch base on their work and provide a platform to share their responses, concerns and resources and reflect on our collective action. We are bringing-in expertise from outside our network to help expand our approach.
Women on Web, a telemedicine platform providing medical abortion, was invited to speak on safe abortion care during COVID-19 and the role of telemedicine in improving access to safe abortion services. We also presented IPPF’s response to the pandemic in the two Global Webinar organised by WHO IBP Network and also joined the CNS news panel to speak about our work on addressing SRHR during pandemic.
ESEAOR has also organized a series of webinars with young volunteers and youth staff on increasing SRH information, products and services to young people and have shared and discussed the use of alternative digital platforms for sexuality education during this pandemic. The webinars also provided an opportunity to share how young volunteers are involved in the work of the members during the emergency. The Regional Office has conducted interviews with youth members in China and the Philippines on how young people in their community were affected by the COVID-19 pandemic and what their member did to respond to the situation.
Several communication tools such as advocacy briefs, blogposts, social media messages, posters and videos on youth engagement and periodic regional updates were developed and disseminated widely. For more information and updates from the region, please visit our web and Facebook pages.
The IPPF COVID-19 Taskforce is setting a new benchmark of collective decision making and actions to contribute to the vision of a Unified Secretariat. Its Microsite and Slack channel have been invaluable to share news throughout the Federation. Please do continue to engage with each other and the Taskforce through them.
And you can stay up to date on the work of the Taskforce through the actions and decisions page here: Actions and decisions from the COVID-19 Taskforce
In solidarity,
Dr Jameel Zamir
COVID-19 Taskforce
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