As husbands and wives spend longer periods together during the lockdown, women — specifically those living in areas without health posts nearby — have found themselves at the risk of unplanned pregnancies and unsafe abortions.
Even before the pandemic, there was a huge unmet need for contraceptives in Nepal. Despite an improvement in the contraceptive prevalence rate, nearly half the women still do not use contraceptives because of entrenched patriarchy and lack of access to devices. The lockdown has made things worse.
“Many families have run out of contraceptives, and I get calls every day from women worried about unplanned pregnancies”, says Anju Acharya, deputy mayor of Dupcheswor village municipality in Nuwakot.
In many rural families, the men are back from the cities during the lockdown and this means couples are spending more time together at a time when contraceptives are in short supply. Demographers are predicting a baby boom later this year as a result.
In Bakaiya of Makwanpur, local authorities estimate that there is a 20% increase in demand for contraceptives, and health posts have run out of them.
The Family Welfare Division of the Ministry of Health had anticipated the shortage and had instructed provincial and district health offices to keep at least three month’s worth of prophylactics.
Semma Kumari Chhetri the mayor of Putlibazar Municipality of Syangja heeded that call, and stocked up on contraceptives and says there is no shortage in her district. What has been helpful is that most deputy mayors in Nepal’s nearly 800 municipalities are women, and understand how the problem affects women in their constituencies.
But there are some who have not received requested supplies. Sarala Bolke of Bakaiya village in Makwanpur says: “Contraceptives are an absolute necessity, but unfortunately we have run out of them.”
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In a recent conference call with deputy mayors from various parts of the country women admitted that lack of contraceptives was one of the problems they faced during the lockdown, but mainly it was the lack of earnings.
“Most of our dicussions revolve around the shortage of food, dal, rice, salt,” says gender activist Renu Adhikari who conducted the discussion. “Their main worry for their families during the lockdown is how to stave off hunger.”
If the lockdown is to be extended to three months, the World Health Organization (WHO) and UN Population Fund (UNFPA) warn that more than 13 million women worldwide are at the risk of being deprived of contraceptives.
A further extension of six months could affect 47 million women in 114 low and middle income countries, losing their access to contraceptives. And estimated seven million women may have unwanted pregnancies.
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Confined within their homes, there is anecdotal evidence that many husbands in rural Nepal are now refusing to use contraceptives altogether, leading to predictions of a spike in births by December and into next year.
Deputy mayors in the conference calls also reported a rise in incidence of domestic violence caused by husbands and wives quarrelling over contraceptive use, and women being abused for refusing intercourse.
Gender activist Adhikari also worries about women whose husbands are stuck overseas, and will start returning in large numbers very soon, leading to a big increase in demand for contraceptives.
“If the men and women returnees are not tested properly, they could spread the disease to their families,” she says. “We are tring to tell the health authorities that returnees in quarantines be sent home with a supply of contracpetives.”