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Global responses to the coronavirus disease COVID pandemic are converging with pervasive, existing sexual and reproductive health and justice inequities to disproportionately impact the health, wellbeing, and economic stability of women, girls, and vulnerable populations. People whose human rights are least protected are likely to experience unique difficulties from COVID The complex interplay between biological and behavioural risk factors needs to be recognised during the COVID pandemic.

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It is not yet known whether the higher COVID case fatality rates reported in men compared with women in China, South Korea, and Italy 3 to date are attributed to sex-specific biological susceptibility, variations in pre-existing comorbidities, behavioural risk factors, or some combination of these factors. Disruption of services and diversion of resources away from essential sexual and reproductive health care because of prioritising the COVID response are expected to increase risks of maternal and child morbidity and mortality.

Restrictive global policies that target vulnerable populations free exacerbate sexual and reproductive health and justice inequities. Three crucial impacts of the PLGHA include free stakeholder coordination and chilling of Orcutt and reproductive health and rights discussions; reduced access to family planning, with increases in unintended pregnancy and induced abortion; and negative outcomes beyond sexual and reproductive health, including weakened health systems functioning.

Only when public health responses to COVID leverage intersectional, human rights centred frameworks, transdisciplinary science-driven theories and methods, 14 and community-driven approaches, will they sufficiently prevent complex health and social adversities for women, girls, and vulnerable populations. The way forwards will Orcutt be easy. Even rigorous implementation of science-driven approaches might not match the pace of COVID threats in the face of reduced human capacity, shortages of drugs and supplies, and increased demands on already strained sexual and reproductive health services.

For clinical services and programmes, additional resources must be directed sex, not diverted from, the sexual and reproductive health workforce so that effective, evidence-based approaches are deployed. humanitarian crises have shown the crucial role of contraception and medication abortion for the prevention sex unintended pregnancy and maternal mortality.

Telemedicine can be used to provide access to services for medication abortion, contraception, and expedited partner therapy for STI prevention, as well as trauma-informed care for managing gender-based violence, post-traumatic stress disorder, depression, and suicide. Sex-disaggregated mortality and morbidity surveillance data should be a priority in COVID research.

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Immediate research priorities focused on identifying the pathophysiology of the disease and the development of vaccines and therapeutics should give explicit attention to sex differences in viral transmission and disease progression, biological, social, and environmental risks by gender, and safety of vaccines and drugs for pregnant and lactating women. All these efforts must be community driven. Recognition of inequitable power structures, distribution of resources, and a collaborative approach free the way forward. Advocates must continue to fight the exploitation of the COVID crisis to further an agenda that restricts access to essential sexual and reproductive health services, particularly abortion, and sex immigrants and adolescents.

A sexual and reproductive health and justice policy agenda must be at the heart of the COVID response. The response must ensure that universal health coverage includes pregnant women, adolescents, and marginalised groups and must deate sexual and reproductive health, family planning, and community health centres as essential health providers, reallocating resources accordingly. Policy makers should scale up telemedicine for needed, evidence-based care for women and girls, including sexual and reproductive health Orcutt.

Centring sexual and reproductive health and justice in the global covid response

Finally, the response must eliminate legal and policy restrictions to sexual and reproductive health service provision and reverse the PLGHA and Global Gag Rule to ensure comprehensive sexual and reproductive health care for women and girls around the world. National Center for Biotechnology InformationU. Published online Apr 9. Author information Copyright and information Disclaimer. Terry McGovern: ude.

All rights reserved. Elsevier hereby grants permission to make all its COVIDrelated research that is available on the COVID resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. This article has been cited by other articles in PMC.

Open in a separate window. Acknowledgments We declare no competing interests.

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References 1. McGinn T. Reproductive health of war-affected populations: what do we know?

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Int Fam Plan Perspects. COVID the gendered impacts of the outbreak. Clinical characteristics and intrauterine vertical transmission potential of COVID infection in nine pregnant women: a retrospective review of medical records.

BMJ Global Health. COVID a gender lens protecting sexual and reproductive health and rights and promoting gender equality.

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Am J Obstet Gynecol. JAMA Pediatr. Qiao J. Purdy C. March 11, Natality decline and miscarriages associated with the influenza pandemic: the Scandinavian and United States experiences.

J Infect Dis. American Public Health Association Preventing and reducing the harm of the protecting life in global health assistance policy in global public health. Policy statements.

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Modernising epidemic science: enabling patient-centred research during epidemics. BMC Med. Why don't humanitarian organizations provide safe abortion services?

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Confl Health. Medication abortion provided through telemedicine in four US states. Obstet Gynecol. Effectiveness of telemedicine: a systematic review of reviews.

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