The life of nearly every citizen in the world has been affected by COVID-19. Yet the long-term consequences of the pandemic will be felt most acutely by women and girls, especially those from countries where already challenging economic conditions are being compounded by poor health, disease and gender inequities. In places where women and girls often struggle to access basic needs such as good nutrition, education, clean water, and sexual and reproductive health services, these needs are being pushed further out of reach.

Women and girls are already hit hardest by malnutrition, being twice as likely to be malnourished as men. Although they harvest the food and cook the meals, they often eat last and least, after male family members have been served due to social norms that may not equally value or prioritize their interests. Particularly for pregnant women and adolescent girls, both of whom have unique and increased micronutrient requirements, malnutrition can have devastating consequences.

The impact of the pandemic on women and girls already suffering from, or at risk of, malnutrition, is severe, largely because it has become much more difficult for them to access necessary and routine health services. In India, where most health workers have had to turn their attention solely to the treatment of COVID-19, the country suspended its Pradhan Mantri Surakshit Matritva Abhiyan campaign, which ensures free monthly checkups for pregnant women. In Nepal, a countrywide lockdown and public transportation closures have left most pregnant women unable to travel for antenatal and postnatal checkups. This has required many to give birth at home rather than at a health facility, risking the lives of both mother and baby.

As they are forced to forego the basic services they need to maintain adequate health and nutrition, women have seen their workload increase both in and out of the home. School closures have left women to take on the role of educators and full-time caregivers, on top of the other roles they occupy. In addition, women comprise 70% of the global health force, shouldering the highest burden of care and increasing their exposure to the disease, making it more likely that they will become ill. Whether as doctors, nurses, community health workers or primary caregivers within their households, women are on the front lines of the global pandemic. Their commitment to go beyond the call of duty is demonstrated in health workers like Rubina Babar in Pakistan, who has served the people in the Jamshoro district for years. To alleviate some concerns about the growing threat of the coronavirus, she took it upon herself to sew homemade masks and distribute them to the most vulnerable in her community.

What does this mean? As the world seeks to stem the damage from the coronavirus, women and girls’ need for continued access to essential health and nutrition services is critical. While restrictions and social distancing guidelines have temporarily put a stop to or delayed some interventions, including weekly iron and folic acid supplementation (WIFAS) distributed through school systems and national vitamin A campaigns, our team is finding new and innovative opportunities to continue delivering as many services as possible to mitigate the impacts of the current health crisis and ensure it doesn’t leave women and girls further behind.

In many places around the world, schools serve as the delivery platform for food and nutrition programs. But with ongoing global closures, these services are coming to a halt and jeopardizing the health of 1.5 billion children and youth. Adolescent girls in developing countries, who often receive school meals, WIFAS and nutrition education in school, are now not only missing out on their classes, but facing an increased risk of anaemia at a time when energy and a strong immune system are paramount.  Preliminary data from the field is showing there is an increase in the number of unintended adolescent pregnancies as the pandemic has unfolded. These adolescent girls are now confronted with even more obstacles to obtain quality and necessary antenatal care, and the risk they may never return to school is higher than ever.

Throughout the crisis, we are doing what we can to protect the health and nutrition of women and girls: In Kenya, we are devoting resources to the purchase of facemasks for midwives and health extension workers, to ensure they can continue outreach and safely deliver critical services to the community. In Uttar Pradesh and Gujarat, India, auxiliary nurse midwives are continuing outreach work, bringing iron and folic acid supplements to pregnant women and WIFAS to adolescent girls in their homes. In Uttar Pradesh, school-going adolescent girls are receiving their WIFAS tablets and nutrition counselling during Village Health and Nutrition Days. We are continuing to support delivery, diverting WIFAS supplies from schools to outreach workers, while developing behaviour change materials that can be delivered through home visits, or virtually through text messages and other platforms. In communities where the technology allows for it, pushing services online, through virtual counselling or information sessions, is vital for them to remain available and ensure the health and safety of women and their babies.

As attention and resources are devoted to stemming the damage of COVID-19, the world cannot overlook the impact on women and girls.  Coronavirus has exacerbated the steep barriers they already face to access basic services. Helping them overcome these barriers, and addressing the wider issue of gender equality, is essential to ensuring they – and we – come out of this global pandemic stronger, more resilient and ready to build a better future for all.

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