‘What are you doing here?’: (mis)trust, COVID-19 pandemic, and sexual reproductive health rights

Abstract: We explore how the government’s messaging on COVID-19 pandemic response perpetuated mistrust and impeded people’s ability to access and utilise sexual and reproductive health (SRH) services. While the need for SRH information increased, public health messages fostered mistrust in sexual and reproductive health services. We draw on in-depth interviews and focus group discussions conducted among women, girls, and healthcare providers in five African countries (Burkina Faso, Ethiopia, Kenya, Malawi, and Uganda) between May and October 2021. We show how trust was largely eroded through preventive measures, such as stay-at-home directives, social distancing, curfews, and lockdowns. We argue that, on one hand, while state-led epidemic preparedness and response were geared towards the common good, i.e., controlling the virus, on the other hand, de-prioritisation of much-needed services for sexual and reproductive health and rights (SRHR), as well as a lack of transparency among some of the service providers, bred mistrust in healthcare. We conclude that ambiguity in communication and implementation of COVID-19 prevention measures further compromised access to and utilisation of sexual and reproductive health services.

Keywords: COVID-19, pandemic response, (mis)trust, access, healthcare, sexual and reproductive health and rights, Africa

Article posted to the Journal of the British Academy, volume 11, supplementary issue 6 (Exploring Medical Mistrust: From Clinic to Community)