Reports Show Health Crises Worsen Reproductive Healthcare Access: Is there anything we can do?
A recent report by health experts highlights that over the past year, the COVID-19 pandemic has exacerbated challenges with providing access to reproductive healthcare. The article mentions a 10% decline in use of short term AND long term contraceptives and alluded to decreased access to contraception—including for those who were previously receiving these services. To put some of this into context, the Guttmacher Institute estimates that the decreased use and access to contraceptives over the past year puts an additional 48 million women at risk of pregnancy from unmet contraceptive needs and 15 million women will experience an unintended pregnancy. Unfortunately, similar trends in contraceptive use and access were noted during the Ebola outbreak indicating that acute health crises increase reproductive healthcare challenges.
There are a number of reasons why health crises are related to decreased use of contraception. Health experts note that during COVID-19, restrictions to in-person consultations, social distancing, travel restrictions, work burden for frontline healthcare workers, an overwhelmed healthcare system, and fears of viral exposure from health facilities have heightened barriers to access. All of this points to a key question—how can we improve contraceptive access in a way that is resilient to health crises?
The COVID-19 pandemic has provided a unique opportunity to evaluate and explore new innovative ways we provide contraceptive services. As the authors of the report note, one area of improvement is to demedicalize contraception. To frame it another way, when we consider the fact that contraception services are primarily accessed through in-person healthcare facilities (e.g. visiting doctor’s offices or hospitals for consultations or insertions/removals, or picking-up contraceptive pills at pharmacies), removing and reducing the need to go to these facilities for consultations or contraceptive removal, replacement, or refills could reduce the risk of contraception inaccessibility in times of health crises when healthcare facilities are inaccessible or high-risk environments.
The challenge with many contraceptives—such as pills, injectable hormones, and vaginal rings—is that most are effective for relatively short term periods (i.e. one to three months). This means patients need frequent follow-ups with their doctor or pharmacies to maintain the effectiveness of their contraceptive regimen. Biodegradable contraceptive implants could help address these issues: such implants could be used for longer term periods—in some cases one year or longer, which would help alleviate the need for any short term follow-ups. And, the biodegradability of such implants would mean they would not have to be removed, reducing the frequency patients would need to go to healthcare facilities. And internationally, such implants could make contraceptives more accessible since biodegradable implants would both be discrete and self-managing, and pop-up clinics could be more scalable. If you are interested in learning more about the possibilities of biodegradable contraceptive implants, such as Hera Health Solutions’s Eucontra, please feel free to reach out.