Lockdown as Amplifier

The Amplification of Challenges to Sexual and Reproductive Healthcare Provision during Nepal’s COVID-19 Pandemic Response and Lockdown in 2020

Abstract

This article explores the amplification of challenges to sexual and reproductive healthcare provision during Nepal’s COVID-19 pandemic response and lockdown in 2020. In Nepal, the provision of essential primary healthcare is compromised by systemic weaknesses, infrastructure, and the economy. This includes healthcare and services supporting women’s sexual and reproductive health and rights (SRHR). During the pandemic, the government instituted a lockdown to control the spread of COVID-19. The government’s focus on controlling the disease, or on ‘pandemic preparedness’, amplified the pre-existing vulnerabilities in the healthcare system. Policy triage caused SRHR to be under-prioritized, widened the pre-existing gaps in the healthcare infrastructure, and compelled healthcare providers to rely more on improvisation. The article concludes by calling for a re-imagination of ‘pandemic preparedness’ as ‘lockdown preparedness’. In Nepal and in other low- and middle-income countries, ‘lockdown preparedness’ should inform pandemic responses and secure the prioritization of essential primary healthcare. Furthermore, ‘lockdown preparedness’ should direct political attention and priority towards decreasing systemic weaknesses and social inequalities, to counteract their amplification during future lockdowns.