COVID-19 as a Threat to Sexual and Reproductive Health

Dear Editor-in-Chief

Sexual and reproductive health was the focus of the International Conference on Population and Development (ICPD) in Cairo, with reference to the full physical, mental, emotional, and social well-being of individuals as it relates to the reproductive system. The conference was intended to obtain insights into how people can have a healthy and satisfying sex life, develop the ability to reproduce, and enjoy the freedom to make decisions about the timing and distancing of childbearing. Sexual and reproductive health is a broad concept that encompasses health and well-being specifically in connection to sex, pregnancy, childbirth, and other most private aspects of one’s life (1).

In the meantime, the 2019 coronavirus disease (COVID-19) outbreak that began in Wuhan, China in 2019 has now spread to most parts of the world, thus stimulating its declaration as a pandemic by WHO (2). Globally, about 3.4% of reported COVID-19 cases have died (3). This disaster affects the sexual and reproductive health of an entire community, rendering the provision of relevant services difficult and adversely affecting women and developing countries in particular (4).

Sexual health is defined in the ICPD 1994 Action Plan as a component of reproductive health and regarded in the WHO 1975 Technical Report as an aspect that enriches one’s personality and promotes communication and love (5). The WHO provides universal access to sexual and reproductive health services, including prevention, diagnosis, prenatal care and treatment, and services aimed at aiding birth and infant care, as well as family planning services, such as the provision of infertility and contraceptive interventions and the elimination of unsafe abortions. The organization also spearheads the prevention and treatment of the acquired immunodeficiency syndrome, human immunodeficiency virus infection, other sexually transmitted diseases, and cervical cancer as part of efforts to promote reproductive and sexual health (6).

As previously stated, disasters give rise to reproductive and sexual health problems, including inadequate access to medical services, insufficient nutrition and hygiene, and an increase in sexually transmitted diseases (4,7). Other important issues that require serious attention are out-of-hospital problem management, the insufficient assessment of physical and psychological needs, the lack of resources and facilities, the variety of anticipated medical problems, insecurity, and serious injuries (8,9). During disasters, as well, people may experience the death of a fetus, infant, spouse, or other relative. Complicated post-mortem complexity is a unique phenomenon associated with disability and the loss of self-esteem; the lack of understanding and support from other family members, friends, and health workers and the deficient comprehension of psychological consequences mean that some people grapple with these challenges in silence and isolation (9).

After going through a disaster, people are confronted with psychological problems, such as anxiety, depression, suicide, and post-traumatic stress disorder, which makes it difficult to return to normal life. The economic and social challenges that follow likewise have negative effects on reproductive and sexual health (10). Although we do not know exactly how the COVID-19 pandemic affects reproductive and sexual health, evidence of racial abuse, violence, and gender discrimination has been documented. Health systems and health workers must empower women during such crises and provide resources for psychosocial counseling, care and treatment.

Now, more than ever, the world needs to espouse perspectives free of race, religion, ethnicity, and gender to help countries come together for the sake of the health of all populations. We need to revisit principles of human rights. Community participation, attention to sexual and reproductive health across all age groups, non-discrimination, access to quality services and information, and collaboration will advance the achievement of excellent health.