Health workers in West Africa “in daily danger” while providing reproductive health services

A midwife holds up a flip chart showing a family as she speaks about family planning to a room of women.
A midwife speaks about family planning at a family planning “open house” at a health centre in Assahoun, Togo. © UNFPA Togo/Rita Gbodui
GODOMEY, Benin/ASSAHOUN, Togo/CONAKRY, Guinea

As the COVID-19 pandemic continues to spread, health workers in West Africa say it has been challenging to prevent the spread of the virus while providing life-saving sexual and reproductive health services.

“As midwives, we are constantly struggling to ensure that we protect ourselves and our patients who come for maternal care services,” said Eyamou, a midwife in Guinea. “We need protective equipment. We just don’t have any. But we’re still here and still helping to save lives of women who are giving life.”

This has been a concern in Benin, as well: “We are left to ourselves at the maternity ward.”

“Masks are not available,” said a midwife in the Galilee Health Center.

“We have no choice. Even our patients are not protected,” she added. “Our lives, and that of our loved ones and our patients, are in daily danger from COVID-19.”

UNFPA has with partnered Takeda Pharmaceutical Company Limited to reach countries in West Africa with under-resourced reproductive health services. In May, Takeda announced a $4.6 million contribution to support UNFPA’s work. The funds will go towards supporting maternal and newborn health services in Benin, Guinea and Togo. At least 350,000 women and newborns will be reached with care.

A woman in a pink face mask speaks to a nurse wearing a mask and hair covering.
Hariel Medegan attends an antenatal check up at the Bethesda Zone hospital in Benin. © UNFPA Benin/Nadine Azifan

The funds will also help provide essential supplies and personal protective equipment (PPE) to front-line health workers there.

“We need masks”

Women seeking health services are also highlighting the need for protective equipment and infection control measures.

“We need masks,” said Hariel, who is pregnant.

She said she obtained a face mask to wear while receiving maternal health services at the Bethesda Zone hospital in Benin, a country that has seen over 1,100 confirmed cases of COVID-19. “I put this on because they make us wear it before we go into the hospital, but I don’t feel protected enough.”

Health workers are also raising red flags over the need for infection control measures and supplies.

“We receive up to 90 women per day for prenatal consultations, but the number of seats available does not allow us to respect women’s distance from each other,” said Nouatin, a midwife at the maternity ward at Godomey Health Centre.

Experts worry that women could even grow wary of seeking health services. This could put their health and lives in danger should serious health problems arise.

Protective gear, mobile services enable continued reproductive health care in West Africa

UNFPA is working closely with health systems throughout the region to deploy midwives and strengthen capacity for health care delivery. UNFPA is also distributing PPE and other critical support. These efforts are critical for maintaining operations in maternity wards and other reproductive health facilities.

A young woman in a blue face mask raises her arm to show a bandage covering the back of her upper arm.
Akofa shows the arm where she received a contraceptive implant, which will help her continue her vocational training. © UNFPA Togo/Rita Gbodui

There are more than 600 cases of the virus in Togo. UNFPA is providing PPE and hand-washing facilities to neonatal and maternity units, among other efforts.

Earlier this week, women gathered at a health clinic in Assahoun, Togo, for a family planning “open house.” The open house was an information session about family planning services available free of charge through a UNFPA-supported program.

“We have the necessary protective and working materials to ensure the continuity of reproductive health and family planning services,” said a midwife responsible for the maternity facility.

She is glad to be able to continue providing care. “We feel protected and useful to our communities,” she said.

Women in the community also expressed relief that these services remain available. “I am a seamstress trainee,” 24-year-old Akofa told UNFPA at the Assahoun clinic, where she received a contraceptive implant. “I came to get a three-year implant to avoid getting pregnant during my apprenticeship. We have received the products free of charge, and I believe that is a good thing.”

Coronavirus infects healthcare workers

In Guinea, more than 5,300 cases of COVID-19 have been confirmed, with many infections among health personnel. As fears of the pandemic have intensified, women and children have stopped receiving healthcare. To address this, UNFPA is supporting mobile health services, bringing maternal health care to women’s doorsteps.

“Before, I was scared to go to the health centre,” Fatoumata told UNFPA. “But now I trust the midwife. I know she is giving me good advice for me and my family.”

A youth group raises awareness about COVID-19 at a market in Conakry, Guinea. © UNFPA Guinea/Afiwa Mata Ahouadjogbé

Ramping up care for mothers and newborns

However, more efforts are needed to ensure continuity of essential sexual and reproductive health services in West Africa. This is even more important as the spread of the virus appears to be accelerating on the continent as a whole. It took 98 days for the caseload in Africa to reach 100,000. It only took 18 days to reach 200,000, the World Health Organization announced on 11 June.

In Benin, the partnership with Takeda Pharmaceutical Company Limited will support COVID-19 screening capacity and the emergency transport of women with obstetric and newborn complications, among other efforts. The partnership will focus on infection control measures and the procurement of maternal health medicines and equipment in Togo, along with other health system support. In Guinea, the partnership will support mobile reproductive and maternal health care services, train midwives and nurses in infection control, and improve data management to measure impact of the pandemic on use of health services.

Unfpa.org originally published a version of this article on June 29, 2020.

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