The Youth Coalition for Sexual and Reproductive Rights (YCSRR) has been advocating internationally on all areas impacting on young people’s sexual and reproductive health and rights (SRHR). We have a history of advocating for meaningful youth participation and youth friendly sexual and reproductive health (SRH) services on the national, regional, and international levels, including at events such as ICPD+25 and the 64th Commission on the Status of Women. We are a diverse group of young people, all under 30 years old, from 20 different countries, who are experts by experience in youth SRHR.
From our advocacy work on issues that impact young people’s SRHR in developing countries, we are presenting our expert-by-experience view of the importance of continuing SRH services in developing countries during the pandemic. There are over 1.8 billion young people in the world, with over 1 billion of these living in the developing world . If targeted youth services are not supported to operate during the COVID-19 pandemic, YCSRR believes that young people will be disproportionately impacted in terms of their SRHR.
Young LGBTQ+ People and Young People Living with HIV
Young people are disproportionately impacted by HIV and make up the majority of new HIV diagnoses . Poor sexual health and HIV knowledge is one of the main barriers to HIV prevention. With the closing of schools and other formal education settings, young people are missing out on key opportunities to gain knowledge to reduce their chance of becoming infected SRHR services and information tend to be forgotten during emergencies , however these are the key times when young people are more at risk of poor SRH, and young women tend to be disproportionately affected by this. There is already clear evidence being reported that domestic, sexual, and gender-based violence is on the increase, and with that comes increased risks to SRH. In areas of the developing world where SRH services were already difficult to access, it must be a priority to ensure that young people are able to access specialised services so that efforts to end new HIV transmissions by 2030 are not set back.
Efforts must also be made to support young LGBTQ+ people during a time where they may be forced to spend weeks or months on end with family who are not supportive of their identity. Intersections of being young and LGBTQ+ add to the SRHR risks faced by the community, particularly where there are either no protective laws or laws that actively discriminate against LGBTQ+ individuals. Data on young LGBTQ+ in developing countries is difficult to find, however there has been a trend of continuing violence and discrimination against young LGBTQ+ people around the world .
With SRHR already not being seen as a priority during humanitarian emergencies and crises, with young women particularly suffering as a result of this, YCSRR believes that the addition of the COVID-19 pandemic on top of current humanitarian settings will further push SRHR to the back of the agenda, which have an overwhelmingly negative impact on young people’s health, and put young people at greater risk of exploitation.
Access to abortion and contraceptive services
During emergencies, contraceptive services tend to be one of the first health services increasing the likelihood that women in developing countries will experience unwanted pregnancies. expanding vulnerability to women that experience unwanted pregnancies. Emergency contraceptives and oral contraception seem to be the most widely and adaptable elements to use in light of COVID 19
Abortion personnel shortage is also an issue since most of the health workforce is put on the frontlines of the COVID response, leaving abortion healthcare services understaffed and putting these at a lower priority level. The IWHA call for a conscientisation and spread of awareness about self-managed abortion .
The ongoing health emergency must not mean that SRH is neglected as evidence points to these services clearly being essential. Pressures on the healthcare system can lead to a lack of attention to SRH leading to lack of screening for STIs, lack of access to contraception and abortion, and reduced opportunity for safeguarding against domestic violence and sexual exploitation. During the 2016 Ebola epidemic, maternal and infant mortality rates increased due to the lack of access to sexual and reproductive health services . Evidence from past epidemics shows that SRH cannot be ignored and must be supported to continue service provision, albeit altered in line with social distancing guidance.
The Youth Coalition for Sexual and Reproductive Rights Recommends:
HIV medication, testing services, PEP, and PrEP, through programmes supported by DFID funding, should be made available to young people for free through postal services and others that will minimise contact with people during the COVID-19 pandemic.
Local LGBTQ+ led organisations should be assisted in offering support to this vulnerable population during this emergency, including emergency accommodation for LGBTQ+ young people who are suffering from violence and abuse where needed.
Contraception and abortion services must be declared essential services to ensure that women and girls are not disproportionately impacted by the pandemic as has happened in the past. Telemedicine for abortion provision should be used where possible. Abortion rights in particular must be protected.
SRHR cannot be neglected during emergencies, and in particular during the COVID-19 pandemic. Services and programmes must change the way they are operating so that young people can still access the services they need, and vulnerable young people are protected from violence and exploitation.