GODOMEY, Benin, ASSAHOUN, Togo, CONAKRY, Guinea — As the COVID-19 pandemic continues to spread, health workers in several West African countries 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 Kadiatou, 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 Ms. Sinzogan, a midwife in the Galilee Health Centre.
"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 is working with partner Takeda Pharmaceutical Company Limited to reach countries 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, reaching at least 350,000 women and newborns.
The funds will also help provide essential supplies and personal protective equipment (PPE) to front-line health workers in all three countries.
"We need masks"
Women seeking health services are also highlighting the need for protective equipment and infection control measures.
"We need masks," said Hariel Medegan, 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 Vivianne, a midwife at the maternity ward at Godomey Health Centre.
Experts worry that women could even grow wary of seeking health services, which could put their health and lives in danger should serious health problems arise.
Protective gear, mobile services enable continued care
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.
In Togo, which has seen more than 600 cases of the virus, 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" - an information session about family planning services available free of charge through a UNFPA-supported programme.
"We have the necessary protective and working materials to ensure the continuity of reproductive health and family planning services," said Ms. Ekpai, 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 had come for 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."
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 spread, there has been a precipitous decline in use of health care, especially among women and children. 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 Barry told UNFPA. "But now I trust the midwife. I know she is giving me good advice for me and my family."
Ramping up care for mothers and newborns
More efforts are needed, however, to ensure continuity of essential sexual and reproductive health services, particularly as the pandemic's pace of spread appears to be accelerating on the continent. It took 98 days for the caseload in Africa to reach 100,000, but only 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. In Togo, the partnership will focus on infection control measures and the procurement of maternal health medicines and equipment, as well as 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.