Table 3.

Comparing the impact of COVID-19 in key areas of SDG5 targets in five selected upper-middle and high-income countries.

Substance*	Impact of COVID-19 in SDG5 targets, selected countries
Maternity care/reproductive health
Summary	Broadly similar trends in maternity care with overall moderate biomedical restrictions but reduced non-medical and social support services; strong limitations in reproductive health services with high regional variation constrain reproductive rights, but relevant differences between countries—US makes the worst case with abortion ban, while Australia and, to a lesser degree the UK took action to protect access to early abortion
Maternity care	Essential maternity care services were largely kept open or transformed into digital services; prevention and social support services were significantly limited or suspended
Reproductive health services	Strong limitations in all areas of non-essential services, especially through side-effects of lockdown policies and re-allocation of staff due to prioritization of COVID-19 care; relevant differences in policy responses with some support in Australia and UK and worsening in Brazil and the US
Reproductive rights	No prioritization of reproductive health and abortion rights, but little legal restrictions except in the US
Care for pregnant women/vaccination	Some prioritization of pregnant and breast-feeding women in vaccination programs but often too late
Health labor market and employment	Human resources for health were not used effectively; increased COVID-19 risk for HCWs; protection of pregnant HCWs varied between countries; HCW shortage exacerbates
Social inequalities	Intersecting gender inequalities increased, disadvantaging ethnic minorities/migrants/refugees and more generally vulnerable groups
Gender-based violence
Summary	Strong increase in violence but lack of monitoring and reliable data; strong restrictions in access to services; lack of effective violence prevention and protection of women but relevant differences between countries: Australia introduced new programs and increased budget to scale up support and prevention, while action was poor or lacking in other countries
Access to services	Strong restrictions and suspension of services coupled with strong increase in demand and need; digital provision of some services; relevant differences between countries: Australian Government took some action to respond to growing demand, marginal governmental support also in the UK and US, in Brazil and Germany mainly limited to NGOs and municipalities
Scaling-up/new programs and training programs	Overall little attention to quantitative and qualitative changes in demand for services and a need for improving sensitivity; action mainly taken by feminist actors and NGOs, but new governmental support programs and increased budgets in Australia
Access of HCWs to help-lines	In some countries “yes” but overall very little attention to the problem and lack of support with relevant variation between countries
Social inequalities	Lack of data but some evidence of reinforced social inequalities with strong intersectional effects, especially connected to digital provision
Gender equality/leadership
Summary	Gender equality issues were largely absent from pandemic policies; SDG5 goals and gender mainstreaming policies were ignored; poor participation of women and lack of female leadership in decision-making; lack of attention to reinforced gender-based disadvantages, especially for mothers
Participation/leadership in pandemic policy	Overall poor participation of women in all areas of pandemic policy and across all levels and actors (except NGOs) involved in governance, including the media and lack of female leadership
Gender equality goals in pandemic policy	Largely absent from pandemic policy and key decisions, like lockdowns; no country applied gender mainstreaming; no prioritization of gender equality and reproductive rights
Gender equality goals in research	Largely absent, no country applied gender mainstreaming guidelines; some mandatory guidelines, especially in vaccine testing; some variation between countries
Access to childcare	Strongly restricted; closures during first lockdowns except in Australia, but some availability to HCWs; strong variation in duration of closures and access of HCWs ranging from very little restrictions in Australia to possible loss of childcare in the US
Access to schools	Strongly restricted; closures during first lockdowns, but some digital schooling and some on-side services for HCWs; strong variation in access of HCWs and duration of closures
Social inequalities	Lack of monitoring but evidence of strong increases, also worsening intersecting inequalities

^*Items are abbreviated (for details, see Table 2).

Source: Authors' table based on country case reports (Tables S1–S5 in Supplementary Appendix).