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Overcoming difficulties in SRH services amid COVID-19 pandemic

Anabeth Legaspo, a public health nurse, inserts a contraceptive implant under the skin of a patient participating in the Family Planning Service Provision Outreach in Cagwait, Surigao del Norte. The event is part of the Global Affairs Canada-funded Sexual Health and Empowerment (SHE) project implemented by Oxfam Pilipinas with Sibog Katawhan Alang sa Paglambo (SIKAP). (Erwin Mascarinas/Oxfam)

Nurse Anabeth Legaspo has been providing prenatal care to pregnant women in Cagwait town, Surigao del Sur for several years.

However, when the COVID-19 pandemic forced many towns into lockdown in March 2020, women stopped going to the health center for their regular check-ups with Nurse Anabeth.

Due to movement restrictions during the lockdown, health workers had to think of creative ways to continue delivering sexual and reproductive health services (SRH).

“Since the pregnant women were not allowed to go outside their residence as stipulated in the omnibus guidelines of the community quarantine, we’ve had a hard time providing the necessary services,” explained Melodina Mancao, another nurse from the Cagwait Rural Health Unit.

“That’s why we’ve come up with an alternative way which is to administer the prenatal care directly to their homes,” she added.

Nurse Anabeth Legaspo shows a sample of a contraceptive implant at a Family Planning Service Provision Outreach in Cagwait, Surigao del Sur. (Erwin Mascarinas/Oxfam)

Some of the nurses in the province had to learn how to drive motorcycles just to visit their patients since the government did not allow motorcycles with two or more people onboard.

However, they still did not have enough people to cover the 11 villages of Cagwait, many of which were far from the main road and can only be accessed through muddy unpaved roads. Going to the villages was time-consuming and challenging for the town’s 9 nurses and 6 midwives.

The town’s regular seminars on family planning were also affected.

“As much as we wanted to conduct training and seminars, we’re not able to do it because of the restrictions. There may be some circumstances where we are allowed to hold limited face-to-face seminars but it’s still hard because we can’t reach the number of target participants,” said Criselda Garrido, a barangay health worker from the village of Bacolod.

Criselda believes that despite the pandemic, education and awareness campaigns should be prioritized since it keeps families healthy by informing its members of proper health choices.

Based on the recent COVID-19 Rapid Gender Assessment Regional Highlights published by Oxfam Pilipinas in December 2020, almost 50% of women respondents in all regions outside Metro Manila said they found it difficult to access prenatal and birthing services.

The report revealed that while birth centers were open during the peak of the pandemic, people had difficulty because of the lack of and affordability of public transportation.

“Furthermore, individuals with pre-existing medical conditions may not be able to access specific medical treatments that compromise their recovery during the pandemic given the limited access to specialized clinics,” the study added.

Nurse Melodina Mancao gives contraceptive pills to one of the participants of the Family Planning Service Provision Outreach of the (SHE) Project in Cagwait, Surigao del Sur. (Erwin Mascarinas/Oxfam)

A helping hand

Delivering sexual and reproductive health services during the pandemic was extremely challenging for health care workers, but those in Cagwait said it was made somehow bearable because of the Global Affairs Canada-funded Sexual Health and Empowerment (SHE) Project implemented by Oxfam Pilipinas through Sibog Katawhan Alang sa Paglambo (SIKAP).

“Since the barangay health workers have been trained by SIKAP, it helped ease the problem, as the nurses and barangay health workers (BHW) improved their coordination based on the needs of the villagers,” Melodina said.

SIKAP had also helped the rural health unit of Cagwait to lobby for medical supplies especially for family planning whenever the supplies ran low.

“We all know that in these trying times, our SHR have been deprioritized and disrupted. Our medical health workers are focusing more on vaccination roll out, assisting COVID-19 patients and keeping the health of our citizens afloat amid pandemic. That is why, we’ve come to intervene so that at least the SHR services will continue to reach the community by capacitating the barangay health workers since they are the next in line who are capable to deliver the needed assistance,” said Christine Ampon, Executive Director of SIKAP.

Anabeth said she was very grateful for everything that the SHE project has done for their town.

“Thanks to SHE, we were able to provide uninterrupted family planning services to women of reproductive age,” she said, adding that SIKAP and Oxfam have always supported them during their outreach programs for women and youth.

Since 2018, the project was able to train a total of 93 village health workers across Cagwait town. These workers have been in the frontline under the primary health care approach by rendering primary care services such as first aid, maternal and community-based interventions in Cagwait.

Participants listen to nurses from the Rural Health Unit of Cagwait, Surigao del Sur during a Family Planning Service Provision Outreach where different methods of family planning are discussed. (Erwin Mascarinas/Oxfam)