Experiences with Contraceptive Services Among Up-Country Tea Estate Tamil Women During the COVID-19 Pandemic in Sri Lanka

In Sri Lanka, women from rural and Up-Country areas rely predominantly on public health services. Those seeking reproductive health services must access the nearest government hospital or maternity clinic to receive the relevant services free of charge. After the World Health Organization (WHO) declared the COVID-19 pandemic, Sri Lanka faced extended lockdowns during multiple periods during 2020 and 2021 in different parts of the country, which prevented women from going to maternity clinics and accessing reproductive health services. Accessing contraceptives and reproductive health services was delayed. Many Up-Country Tamil women work in tea estates, which are located far away from state-led maternity clinics. This chapter describes the impacts of COVID-19 on Up-Country tea estate Tamil women’s access to contraceptives and other reproductive health services. The focus is on Ragala and Nuwara Eliya Divisional Secretariats in the Nuwara Eliya district, where the highest number of Up-Country tea estate Tamil women reside. Up-Country Tamil tea estate women in Sri Lanka were adversely affected due to the COVID-19 pandemic in terms of accessing all types of contraceptives, doing pregnancy tests, accessing pregnancy-related counseling, ambulance services to travel to hospital for delivery, accessing medicines, and attending monthly clinics and post-abortion care when compared to women from other communities. Going forward, the government may consider building estate-specific maternity clinics that are adequately staffed and supplied with the necessary medications and equipment so that Up-Country Tamil women do not need to travel long distances to access reproductive health services.