COVID-19: Why Policymakers Need A Gender-focused Approach for Health and Economic Recovery

As originally published by The Seep Network on April 2, 2020

As the COVID-19 pandemic continues to engulf the world, questions of post-disaster recovery must be at the forefront of the conversation. We’re still far from understanding the full impact from the spread of the novel coronavirus in developing countries, but international health and economic crises have taught us that although they disproportionately burden women, policymakers seldom prioritize gender-based implications during recovery. Now is the time for development advocates to push for governments and policymakers to ensure it’s different this time – and to address gendered inequalities that could both enhance well-being, such as universal healthcare and social protection, and help economies become more resilient to future crises.

Based on the evidence thus far, the global pandemic has the potential to deal a one-two punch: a major global health crisis and a global economic crisis that will persist well after the slowing down of the immediate health emergency. While these shocks affect everyone, women – who comprise 1.5 billion of the world’s low-wage workers and twice as many of its carers – may be particularly vulnerable to the economic and health crises that unfold in the wake of COVID-19.

Gender roles and norms determine men’s and women’s caregiving duties, mobility, livelihoods, and access to economic opportunities and education. Women the world over are subject to these norms, but for our low-income neighbors, particularly in developing country contexts, these roles place them at higher risk.

Health Impact

Higher Risk of Exposure

During epidemics, women and girls are more vulnerable to certain pathways of infectious disease transmission. They are less likely to be treated or have their concerns about symptoms taken seriously and are often at higher risk for negative secondary effects of epidemics, such as loss of access to general preventive care. The care duties that women undertake at home make them true ‘first responders’, increasing their exposure to all diseases. In the case of Ebola, which spread through contact with bodily fluids, women were also at higher risk of exposure as their caring duties extended to preparing the dead for funerals. Pregnancy during a health crisis also increases risks of secondary complications for women as they try to access overburdened healthcare systems or avoid accessing care for fear of disease transmission.

Dwindling Access to Healthcare

Reproductive health outcomes are jeopardized both in the short and long-term by events like the current pandemic. At the peak of the HIV crisis, for example, it became clear that gender inequity increased women’s risk of infection, not only through women’s care duties, but also their frequent inability to negotiate consistent safe sex or safe spaces. Both issues are compounded by poverty and limited access to social or physical resources. Control over protected sex is often a woman’s burden in a heterosexual couple. This control is compromised if reproductive health services such as provision of condoms and other contraceptives are not prioritized and protected as essential healthcare. Individuals who are covertly accessing contraceptives including unmarried girls, individuals living with HIV, or women whose partners do not know they are avoiding pregnancy will be less likely to go out and seek essential care during a shelter-in-place order. This results in a lapse in continuous coverage and thus in a variety of unwanted sexual and reproductive outcomes. In the long term, unwanted pregnancy predicts increases in both maternal and infant mortality, as does loss of quality of antenatal care.

Increased Risk of Violence

The potential impact of domestic and intimate partner violence of being sheltered in place with a physically or sexually abusive partner is also under scrutiny. About one in three women is a victim of some form of domestic violence; the frequency of experiences of violence victimization (including coercive sexual experiences) is likely to increase when women cannot take themselves or their children away to locations that have traditionally been safe for them. Increased economic distress, an inevitable outcome of this crisis, is associated with increased perpetration of violence.

What Governments Need to Do

In preparation for long-lasting effects of the current crisis on public health and women’s access to reproductive control, governments and international actors around the world should be investing in

1. Efforts to maintain access to primary healthcare and specialized reproductive services for women, including infectious disease vaccination, prevention and treatment programming for women and children, and
2. Evidence-based practices to prevent violence against women and girls as well as violence response programs.

Failure to do so will set women and communities back in terms of progress towards sexual and reproductive health justice and their individual and community goals for economic growth if unplanned pregnancies and births increase due to loss of access to services.