Covid-19: Pandemic puts sexual health and rights under pressure

Corona is a global health crisis that affects everyone. It affects us in our daily lives and has a major impact on our individual functioning. We depend on experts and crisis teams, and politicians to implement adapted laws and regulations. This leads to measures that contribute to curbing the crisis (flatten the curve), but unfortunately there are also a negative spin-offs.

In some countries, political leaders are taking advantage of the corona crisis to reduce human rights in the area of Sexual Reproductive Health and Rights (SRHR). This particularly affects women and people in marginalised groups. There are also concerns in the Netherlands. People need more factual information (there is a lot of 'fake news' going around). As a knowledge institute and organisation that operates internationally in the field of Sexual Reproductive Health and Rights, we have mapped out what is currently happening on a number of important themes, both in the Netherlands and worldwide.

Sex education: home schooling and extra focus on safe online contact

In the Netherlands

All schools in the Netherlands have been closed since 16 March. This date would actually have been the start of the annual Week of Spring Fever. This project focuses on primary and special needs education and helps schools to structurally include sexuality education in their school plan. Just because schools have closed their doors does not mean that falling in love, flirting, courtship and curiosity about sex among children and adolescents have also gone on 'lockdown'. Attention to sexuality education remains necessary, even in times of corona. Now that young people spend more time indoors at their computers and on their phones, it is important that parents pay extra attention to safe online interaction, to prevent their children from becoming victims of unwanted sexting, bullying or other transgressive behaviour.

International

By closing schools, sexuality education is receiving less or no attention throughout in the world. If there is an opportunity to take classes online at home, sex ed is often not a priority. The partners with whom Rutgers works on this topic in various countries fear that it will not be a priority after the schools are reopened either. Then the emphasis will be on catching up on missed (exam) material. Meanwhile, major inequalities are revealed between those who have access to devices for home education and those who don’t. Normally, Rutgers and partners continually advocate for sexuality education with governments, for example in Indonesia. However, this work cannot now take place and it is feared that education budgets will be redistributed.

What are Rutgers and partners doing?

In the Netherlands

To ensure that children in the Netherlands maintain their access to sexuality education, the Lentekriebels lessons (for children aged 0-12 years) [Spring Fever lessons] have been converted to home-school lessons. There are five lessons available per group, divided into four themes: Physical development and self-image, reproduction and family formation, social and emotional development and sexual resilience. Home lessons are also available for young people in secondary education and MBO (secondary vocational education). In addition, on sense.info additional information for young people aged 12-25 years can be found: about sexual contact in times of corona, use of contraception and access to care in case of unintended pregnancy. Information is also available (online) on crossing sexual boundaries, violence and help.

International

Rutgers, and partners working in the field of sexuality education have made an inventory of what is still possible and are trying to keep the subject on the agenda at schools and (local) governments. We are deciding which plans can still be implemented. A positive side effect is that innovation in sexuality education is now getting a clear boost. For example, a team of students from Delft University of Technology is currently working on an interactive tool that facilitates the discussion of sensitive topics between teacher and pupils. More research is also being done into the impact of the crisis on sexual health.

Contraception and abortion: access and rights are under pressure

In the Netherlands

There is currently no restricted access to contraception in the Netherlands. For people who are sexually active and do not want to become pregnant, it is advisable, as always, to arrange contraception in good time. General practitioners can be contacted for contraception consultations by telephone, can send prescriptions to the pharmacy or, if necessary, schedule an appointment in the practice. Patients who cannot come to the practice because they are ill themselves or live in the house with someone with corona symptoms, but who need a new IUD, can call the doctor for a consultation. All IUDs and contraceptive implants have a built-in reserve of hormones or copper. This means that the method can possibly be used for a few months longer than normal. The quality and continuity of abortion care in the Netherlands is also guaranteed. Abortion clinics and hospitals continue to provide care to people who need it. However, it is currently no longer permitted to bring someone along for support. Intakes and consultations are conducted as much as possible by telephone, video or online. Clients must physically visit the clinic at least once for proper abortion care. In the case of an early-stage unwanted pregnancy, it is not yet possible to obtain the emergency contraceptive pill (ECP) for pregnancy termination without visiting an abortion clinic or a licensed hospital. In distressing situations, e.g. when someone has become infected with corona and is unable to leave home, the best solution is sought in consultation with the doctor.

International

Worldwide, however, access to safe abortion and contraception is under pressure. Not only is abortion regularly considered "non-essential healthcare", the pressure on service providers is also increasing enormously. We see that in Kenya, for example, service providers do not have sufficient protective equipment to provide good care to (potentially) infected patients. Moreover, because of the (partial) lockdown, many women are unable to visit clinics. Finally, there is a great threat of shortage of contraceptives and safe abortion products due to disruptions in the distribution chains

What are Rutgers and partners doing?

In the Netherlands

To support people in choosing a contraceptive method, Rutgers has developed an online tool. In addition, an online morning-after test is available that helps determine whether there is question of a possible (unwanted) pregnancy after unprotected sexual contact.

International

Together with our partners in our international Dream Fund programme She Makes Her Safe Choice’, we are mapping the impact of Covid-19 on safe abortion, especially taking note of what is possible. Our partner DKT International is trying to stock as many products as possible, and DKT WomanCare Global is providing information on how safe abortion can still take place. At the same time DKT is drawing attention to the imminent shortage of contraceptive and safe-abortion products. Rutgers is supporting all partners in the programme by setting up more online activities, e.g. for service providers and pharmacists, and by integrating Covid-19 messages into their various information channels. Our partner Shujaaz Inc. is very proactive in Covid-19 prevention and has launched a special campaign, #LindaFam. This campaign reaches 7.5 million young people in Kenya and Tanzania with information about the virus and encourages them to become positive actors of change in their community.

Sexual and gender-based violence: quarantine leading to serious concerns about increase

In the Netherlands

There is concern and increasing attention being given to domestic violence as a result of the increasing tensions caused by quarantine. People experiencing violence currently have no escape in the form of school or work. Reports to Childline [Kindertelefoon] are increasing. Children who are victims of abuse at home have no way out. It is important that professionals try to stay in contact with these children. Posters are also being distributed alerting people to be vigilant and if violence is suspected to ask social services for help.

International

Research shows that during major crises the risk of sexual and gender-based violence increases. The Covid-19 pandemic is no exception and in the countries where Rutgers works we see the consequences of this. If family members have to stay at home as much as possible, there is a greater chance of partner violence. This is because people are living close together; there is more stress and financial uncertainties to deal with. Moreover, we see that the social safety net is largely disappearing: survivors are stuck with the perpetrators of violence and have less contact with family or friends. At the same time, we see internationally that possible help is scaled back in many situations: telephone emergency services, social-care centres, refuges for victims of domestic violence and legal aid centres are closed or have limited access. It is more difficult for women, and other survivors of violence, to escape their violent situation.

What are Rutgers and partners doing?

In the Netherlands

Rutgers has expanded the information on Pubergids.nl for young children (9-12 years) with vlogs from Iva Bicanic about sexual abuse. For children aged 10 - 14, two extra home lessons on sexual violence and abuse have been made available for primary and secondary school pupils. Primary school and secondary school teachers can contact us for information on identifying and dealing with sexual abuse in times of corona ('How to deal with it?'). In compiling this information, we collaborated with, among others, Centrum Seksueel Geweld (Centre for Sexual Violence) and the Kindertelefoon (Childline). The focus is: identifying & intervening (teachers) and recognizing & seeking help (students) in cases of sexual transgressive behaviour and abuse, both at home and online.

International

It goes without saying that we are very concerned about the increasing number of violent incidents around the world. It is becoming even more difficult to provide adequate help to people experiencing violence, because survivors and perpetrators of violence are isolating in the same space. People experiencing violence are therefore less able to call for help and incidents are often not reported. Within our Prevention+ programme, Rutgers and our partners are working through existing structures to counter the increased number of violent incidents. We are also looking for new ways to reach survivors and perpetrators of violence: for example, through e-counselling and referrals. It is very important that this is done carefully, because there is often little or no privacy.

Sexual rights: Leave no one behind

In the Netherlands

There are concerns about people currently unable to go to abortion clinics because they are in quarantine (with another person) with corona symptoms, or because of an unsafe home situation. It is currently not permitted by law to provide the abortion pill outside the clinic so that it can be used elsewhere with the appropriate instructions. Via the courts and politicians, various organisations and (social) media are asking for this to be addressed. It is important that the right to freedom of choice is also maintained during the corona crisis. The rights of LGBTI persons will not be put under pressure in the Netherlands; something we do see happening internationally. However, trans people do have to deal with postponement of operations and consultations. It is important to pay attention to the psychological consequences for this vulnerable group. 

International

The various countries in which Rutgers works with partners show different situations. The degree of lockdown, the impact on the economy, food supply and healthcare vary enormously. In some countries our activists work more and more online, in others we see that the basic necessities of life are under direct pressure. Not everyone has the privilege of being safe at home, having access to the internet or high-quality healthcare systems. Some countries, including Poland and some states in the US, even want to ban abortion care during the corona crisis, despite the fact that the WHO has identified this as essential care. Several vulnerable groups such as LGBTI people are affected by a multitude of factors. They are sometimes discriminated against in the distribution of food and lose their jobs sooner. In Uganda LGBTI people were arrested in a shelter under the guise of corona measures. 

What are Rutgers and partners doing?

In the Netherlands

Rutgers is following the developments in easily accessible, safe and good abortion care. We continue to advocate that medical treatment should also be provided through the family doctor. This is effective and safe and can be provided under good quality conditions.

International

Rutgers and partners advocate internationally towards governments for the preservation of comprehensive Sexual Reproductive Health and Rights and the protection of already vulnerable groups, under the principle 'leave no one behind'. We are concerned about the impact this pandemic could have on countries that were already unstable, on groups that were already discriminated against and about possible gaps in sexual and reproductive healthcare. Politicians should be aware of these possible consequences and act with emergency aid wherever possible. We also see how important it is that the Netherlands stands up for these rights and that we continue our efforts to strengthen healthcare systems in developing countries.

Sexual rights and reproductive healthcare: especially now!

The measures taken to combat COVID-19 are aimed at protecting vulnerable older people and their health. This is a very important group, but we must be vigilant to ensure that the health of young people also continues to receive attention. The impact of COVID-19 on their sexual and reproductive health is significant, especially internationally. Sexual and Reproductive Health and Rights should not be side-lined in the fight against corona.

It is important that society, care and education professionals, but also politicians, continue to pay attention to this subject and the related needs of people, in the Netherlands and abroad. Sexuality is an essential part of people's identity and a basic necessity of life, even in times of crisis. During the coming months, Rutgers will regularly publish content in order to provide input from our position as a knowledge institute for the social debate and the necessary political decision-making on the themes in which we are active. As an organisation we work on Sexual Reproductive Health and Rights in over 20 countries worldwide. In doing so, we put more than 50 years of knowledge and experience to good use. Everyone has the right to information and care, especially now. That is what we stand for.

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