Sign-on: Ensure availability and equitable access to essential SRH services in Covid-19 Response

We express our utmost concern and grief over the preventable death of Katherine Bulatao, 26 years old, who was unjustly refused emergency care by six hospitals. To avoid being infected with COVID-19, she decided to give birth at home with the help of a midwife. However due to complications, she needed to be referred to a hospital that could provide her life-saving care. The unjust refusals to provide the emergency treatment Katherine needed led to her unnecessary death. Based on news reports, she was denied for reasons ranging from the lack of adequate medical capabilities in the hospital to the inability of Katherine to make a deposit or advance payment to the hospital. Katherine’s fundamental rights to life, health, equality and non-discrimination, and to be free from torture and ill-treatment among others have been blatantly violated. She was exposed to unnecessary physical and mental suffering due to denial of life-saving care that only a pregnant person needed and which eventually led to her death.

Katherine’s avoidable death clearly reflects how the government’s response to the pandemic has overlooked the availability and accessibility of quality life-saving reproductive health services. While we recognize that our health system is overburdened with responding to the direct consequences of COVID-19, this does not justify the deprioritization of essential reproductive health services for those who are already in vulnerable situations. Katherine’s death highlights an urgent and time-sensitive need for better maternal and childbirth information and services in the context of the pandemic and the need for adequate supply of life-saving commodities for maternal health. It also underscores the need to address systemic weaknesses in our health care system which failed to enforce the government’s legal and policy guarantees on women’s right to reproductive health and the continuity of provision of essential health services including antenatal and post-partum care services and both basic and comprehensive emergency obstetric and newborn care, essential intrapartum and newborn care, and sexual and reproductive health services in general in the context of COVID-19.[1] Katherine’s death stresses the lack of adequate health facilities and service providers, and how for-profit healthcare neglects and denies women their right to life and health.

Before the pandemic, it was estimated that 2,400 women and girls die every year in the Philippines from preventable causes related to pregnancy and childbirth. There is a high probability that these preventable deaths would only increase with diminished health system resources, lack of immediate access to accurate reproductive health information and services, inadequate transportation facilities, and decreased or total loss of income and employment opportunities in a COVID-19 response that fails to take into account the specific needs of women’s reproductive health and rights.

As financial, technological, and human resources are diverted to directly respond to the COVID-19 pandemic, particular threats to women from marginalized groups including those from lower socioeconomic status or those who already lack access to adequate health and social services are exacerbated. We call on the government to ensure the inclusion and prioritization of essential sexual and reproductive health information and services in its overall COVID-19 response and intervention to minimize the impact of the outbreak on the most vulnerable sectors of our society.

Clear mechanisms to ensure the availability, accessibility, acceptability and quality of reproductive health information and services must be put in place. In particular, we urge the government to:

1. Comply with the Minimum Initial Services Package for Reproductive Health which should include obstetric, prenatal, and postnatal care; contraceptive information and services, including emergency contraception; and post abortion care and post-rape care;

2. Appropriate adequate funding for the continuation of essential reproductive health services to ensure that these services remain affordable for all particularly among socially disadvantaged groups;

3. Ensure that reproductive health facilities are able to operate and continue provision of essential services;

4. Widely disseminate up to date information on the continued availability of reproductive health services i.e. type of services available, and where to avail them, to ensure that women and girls are able to make informed decisions about their health and well-being;

5. Ensure the supply of and access to essential and life-saving medicines as provided under the World Health Organization’s List of Essential Medicine;

6. Guarantee access to quality, respectful maternal health care to ensure freedom from abuse, discrimination, coercion, or violence;

7. Monitor provision and utilization of essential reproductive health services including documentation of cases of delays or outright denials on the provision of these services for improved accountability;

8. Develop task-shifting and -sharing strategies to ensure the efficient use of health care providers currently available;

9.Adopt alternative approaches on the provision of essential reproductive health information and services including the mental health aspect through the use of telehealth and virtual or electronic platforms for screening, consultations, and follow-up.

We extend our deepest sympathies to Katherine’s bereaved family. We will continue to demand for justice and will honor her life by making our calls and feminist solidarity stronger for the recognition that women’s health is essential during this critical period and in the ‘new normal.’ #

[1]Department of Health, Department Circular No. 2020-0167, Continuous Provision of Essential Health Services during the COVID-19 Epidemic available at https://dmas.doh.gov.ph:8083/Rest/GetFile?id=652841. See also Republic Act 10354, Responsible Parenthood and Reproductive Health Act of 2012 (2012); Republic Act 9710, Magna Carta of Women, sec. 17 (2009); Republic Act 10932, Act Strengthening the Anti-Hospital Deposit Law (2017).