Urgent needs and participation of women must be prioritized in Ebola response

7 October 2014

The Ebola outbreak has already claimed thousands of lives, including health workers, undermining human development and all sectors of society. A concerted response is underway to respond to the needs of all people who are affected. And we cannot forget the needs of women and mothers.

It is estimated that more than 600,000 women in the three hardest-hit countries of Guinea, Liberia and Sierra Leone will give birth during the next 12 months. In addition, more than 1 million women who were using modern contraception can no longer receive these services.

As the world ramps up its response to the escalating Ebola crisis, women are being disproportionately affected, and their needs and participation should be prioritized in the response. Because women are caring for, feeding and bathing loved ones who are infected, working as front-line health workers, preparing bodies for burial and in need of reproductive health services, they are exposed to and infected by Ebola at higher rates than men.

A pregnant woman walks through an empty maternity ward in Monrovia, where many facilities have been abandoned or closed. Photo by: UNFPA Liberia

The combination of overwhelmed and collapsing health systems, widespread panic, and quarantine have left pregnant women and women seeking family planning with nowhere to turn. Pregnant women are faced with the double fear of dying from Ebola and during childbirth.

Gains made over the past few years in maternal and reproductive health are being reversed. And innovative ways are needed to protect every individual’s right to health. In Guinea, Liberia and Sierra Leone, doctors report an increase in pregnant women dying from preventable causes, including antepartum and postpartum hemorrhage, ruptured uterus, and hypertensive disease.

According to preliminary data in Liberia, the percentage of deliveries assisted by skilled birth attendants has gone from bad to worse. Figures from May through August show that only 38 percent of pregnant women sought skilled birth attendance, down from 52 percent in 2013. Only 25 percent of mothers received postnatal care compared with 43 percent in 2012, and 40 percent of mothers received the recommended four antenatal care visits before delivery, down from 65 percent of pregnant women last year.

In the most affected district in Guinea, delivery assistance has been reduced by one-third, antenatal consultations have declined by half and the use of family planning has dropped by 88 percent over the past year, putting women in jeopardy and increasing the likelihood of unintended pregnancy at a time of distress and catastrophe. The utilization of health services further declined in September as the disease continued to spread.

As of Sept. 25, at least 2,909 people had died of Ebola in Guinea, Liberia and Sierra Leone from 6,242 cases reported by health ministries, according to the World Health Organization’s latest report. Nigeria and Senegal have recorded a total of eight fatalities and 21 infections.

Advance teams of the newly formed U.N. Mission for Ebola Emergency Response, the first-ever public health U.N. mission, recently arrived in West Africa. Other teams are expected to follow soon. A dedicated trust fund is also set up to ensure a coherent U.N. system contribution to the overall response.

Philderald Pratt, assistant representative for UNFPA Liberia, hands over a shipment of reproductive health kits to Caullau Jabbeh-Howe, the family health director of the Ministry of Health and Social Welfare. Photo by: UNFPA Liberia

UNFPA is supplying emergency reproductive health kits, including clean delivery kits, to pregnant women who cannot get to clinics; drugs and equipment are also brought to health facilities, midwives and communities. These kits contain the medical supplies required to manage safe deliveries and to address possible complications. Since health facilities are overstretched or abandoned, we are mobilizing retired midwives for delivery care at the community level and sending shipments of condoms to prevent unintended pregnancy, sexually transmitted infections and the transmission of Ebola. We have delivered protective equipment such as medical gloves to facilitate safe delivery while protecting health workers from possible infection, disinfectants, heavy-duty aprons, as well as hand-washing equipment.

While immediate action is required to save lives, long-term investment is needed to significantly strengthen health systems and rapid response systems at all levels, with the full participation of women, men and youth to deal with the increasingly frequent and devastating emergencies that characterize our time.

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