Governments and international organisations are focused on COVID-19 crisis decision-making. As a result, global and national health governance contexts are changing dramatically, as are the social and political determinants of sexual and reproductive health and rights (SRHR). Various gender dimensions of the pandemic are clear. While initial data suggest that men are more vulnerable to COVID-19 related mortality, in many high, middle, and low-income countries, the “essential workers” and informal workers who are disproportionately exposed are disproportionately lower social status women. 1,2 Intersecting injustices mean that certain disadvantaged groups are particularly hard hit. 3 They are left to reconcile the often-incompatible demands of precarious jobs, potential exposure to COVID-19, the stress of caring responsibilities under lockdown and, particularly for women, increased isolation exacerbating Gender-Based Violence (GBV). 4,5 In addition, they now face seriously disrupted health care services for SRH care.
In 2019, we authored a review regarding accountability ecosystems for SRHR. 6 The term accountability describes “the processes by which government actors are responsible and answerable for the provision of high-quality and non-discriminatory goods and services (including the regulation of private providers) and the enforcement of sanctions and remedies for failures to meet these obligations”. 6 In the review we identified key cross-cutting considerations for fostering accountability for SRHR, including:
macro-level politics and ruling ideologies,
health system responsiveness, and,
the complexity of health systems.
We build on those considerations here, to describe the implications of the COVID-19 pandemic for accountability for SRHR, and propose ways to promote greater accountability.
Schaaf M, Boydell V, Van Belle S, Brinkerhoff DW, George A. Accountability for SRHR in the context of the COVID-19 pandemic. Sex Reprod Health Matters. 2020 Dec;28(1):1779634. doi: 10.1080/26410397.2020.1779634. PMID: 32552593.