Effect of COVID-19 pandemic on home delivery of contraceptives by community health workers in India: Time to (re) evaluate and innovate.

The World Health Organization (WHO) declared COVID-19 a global health emergency in January 2020, leading to a nationwide lockdown in India. It has been an experience from other outbreaks that governments cannot maintain the essential health services and guarantee health services. Due to COVID-19-related case management, all health schemes, including FP services, have been disrupted globally regarding availability, accessibility, appropriateness of service delivery, adequacy, and continuity of care. The impact of the pandemic on FP services listed includes disruptions in supply chain management, enhanced gender inequity, communication barriers, fear of going outside and buying contraceptives, discontinuity of ASHA capacity building, increased time spent with all family members, reverse migration of workers, and increased need of contraceptive commodities. Evidence shows the consequence of non-supply of logistics, social distancing, inadequate human resources, and inability to access services might result in 26 million couples in unmet need for contraception, resulting in 2.4 million unintended pregnancies and 1.45 million abortions, which may lead to unsafe abortions. Potential solutions to these problems include telephonic service delivery, maintaining a record, using video communication and other technological solutions using a smartphone, combining routine immunization with FP services, and installing self-dispensing machines for contraceptives at accessible places. The limitation of this work is that this is wholly experienced-based work and not based on primary findings from the field level data. These findings highlight the importance of reproductive health needs during the pandemic and guide policymakers.