COVID-19 and the impact on women

The COVID-19 pandemic has left women in a vulnerable position. The University of Cape Town’s (UCT) Hannah Simba and Silindile Ngcobo look at what is needed to assist women.

Is the ongoing Covid-19 pandemic gender neutral? No.

We believe that surviving the current pandemic for women means more than just surviving the disease, as there are threats beyond the risk of infection.

The differences in how women fare during a pandemic compared to men are largely due to long-existing inequalities and social disparities, which are exacerbated by the pandemic, rather than biology.

Inequalities created and compounded by outbreaks leave women in a more vulnerable position. To put it into perspective, globally, women form 70% of the healthcare and social services workforce. This automatically puts them at the frontline during a pandemic response, and thus at a greater risk of infection.

In a study investigating mental health outcomes of frontline healthcare workers in China, women and nurses were far more likely to suffer from depression, anxiety, insomnia, and distress. 

It is true that during crises, epidemics and pandemics, women tend to take up more caregiver responsibilities than usual, often at the expense of their health. Particularly in the Covid-19 crisis, wherein some instances families have to stay at home while self-isolating or during movement restrictions, women can be overworked and overstretched as they take on more domestic care. This increasing burden of care can also take time away from paid work. The responsibility of taking care of the sick at home also often falls more on the women. In some cases, they have a double-barrel role of being the caregivers both at work and at home.

We've seen news reports about how women are also at greater risk of more violence and abuse during the pandemic.

Higher risk

The lockdown and isolation policies implemented in many countries put women at a higher risk of domestic and sexual abuse as they are likely to spend more time with their abusers. The United Nations Entity for Gender Equality and the Empowerment of Women, also known as UN Women, even talked about this violence as a shadow pandemic. The need for protection of women against abuse is therefore heightened during the pandemic. Studies looking into the surveillance and evaluation of effective interventions for those at risk of domestic violence during the pandemic are still lacking.

The Covid-19 crisis also poses a threat to women's reproductive rights. Sexual and reproductive health services remain important even during pandemics. In some countries, however, these become overlooked as funding becomes diverted to pandemic responses. This has dire health (including mental health) consequences for women needing these services. It is projected that due to Covid-19, millions of women and girls may be deprived of family planning services.

As if this is not enough, women and girls are also more likely to become or remain food insecure.

According to the World Food Programme, the number of people who will face a food crisis is expected to double because of Covid-19. It warned of a hunger pandemic. For women and girls, this could have even worse implications as they already constitute 60% of those facing a food crisis.

One thing we shouldn't forget is that the current pandemic is not unique when it comes to women's issues being overlooked. Past outbreaks such as the Zika virus (ZKV), Ebola Virus Disease (EBV), and the 1918–1919 Influenza Pandemic, have shown how gender norms, unprepared health systems, inaccessible healthcare services, and power dynamics can increase women's vulnerabilities during a crisis.

For example, in the ZKV outbreak, power dynamics favoured women's exclusion in decision-making, resulting in their autonomy being infringed and their sexual and reproductive health rights undermined.

In the EVD outbreak, gender roles exposed women to a high risk of infection through caregiving and burial activities. The low-resilient health systems led to women not being able to access healthcare services timely. During the Influenza pandemic, public health officials implemented response strategies such as isolation and quarantine, to curb transmission, which meant more responsibility for women with caregiving roles at home and thus a greater risk of infection.

Responses and strategies

So, what Covid-19 public health responses and strategies are needed to make women less vulnerable during the pandemic?

A good starting point would be to recognise the extent to which the pandemic affects women. A next step would be to address gender norms and the need for shared responsibilities at home and in the workplace. The relevant authorities should prioritise frontline workers' health, including mental health for all women.

They need to integrate sexual reproductive health rights for all women, put in place monitoring strategies, and provide accurate and accessible family planning education and all the necessary healthcare services that women need.

What would also be important is to incorporate and keep surveillance and protection systems for victims of gender-based violence. There must also be clear plans of action to assist women in the informal labour sector when there are movement restrictions with economic repercussions.

One aspect that would make responses and strategies more effective would be the appointment of women in leadership and management positions for national task teams and global organisations.

The time has come for governments to put their money where the mouths are and start prioritising, supporting and funding ongoing scientific research and collaboration on the issues mentioned in this article.

These recommendations could go a long way in helping us achieve Goal 5 of the Sustainable Development Goals which aims to achieve gender equality and the empowerment of women by 2030.

- Hannah Simba is a doctoral student in the Department of Global Health at Faculty of Medicine and Health Sciences at Stellenbosch University. Silindile Ngcobo is a doctoral student at the University of Cape Town. This article is a revised version of their recent paper in Frontiers in Global Women’s Health.