AUGUST 4 ― Malaysia has reached a critical juncture in the quest to overcome the pandemic as July 31 marked 500 days of since Malaysia’s first movement control order (MCO) was implemented. Since then, Malaysians have been in various stages of limited economic and social activity for 16 months and counting.
Despite a commendable and increasingly inclusive acceleration of the National Covid-19 Immunisation Plan, cumulative cases now stand at more than 1.15 million. Last week also marked the first time the country’s daily Covid-19 fatalities breached the 200-mark, amid global concerns of the Delta variant spread.
Co-ordinated immunisation efforts like the successful Operation Surge Capacity and achieving herd immunity will aid in abetting the worst of the virus’ impacts. Concurrently, UNFPA Malaysia urgently wishes to reiterate key areas for ensuring Malaysian women and girls needs are centred in the months to come.
Covid-19 and socio-economics of Malaysia’s Sexual and Reproductive Health and Rights (SRHR)
Since the outset of the pandemic, UNFPA has been projecting that the crisis could seriously curtail access to life-saving and essential sexual and reproductive health services, including family planning. Additionally, lockdowns and economic disruptions such as Malaysia’s extended MCOs are expected to greatly increase the incidences of gender-based violence and harmful practices like child marriage.
UNFPA Malaysia wishes to commend the good access to family planning provided by the government, but during the continued lockdowns, it is important to acknowledge that constrained finances and pre-existing social barriers in Malaysia surrounding SRHR can limit women and girls’ access to essentials such as menstrual hygiene supplies, contraception, long acting reversible contraception (LARC), termination, STD testing, pap smears, hormone replacement therapy and even comprehensive antenatal care and postpartum depression treatment.
This is especially true for women living in poverty, women in remote or interior regions and women experiencing domestic violence, who are then unable to influence their own reproductive health during lockdowns.
The Reproductive Rights Advocacy Alliance of Malaysia (RRAAM) acknowledged attending to enquiries of unplanned pregnancies experienced by housewives with at least two or three children. These women and their partners were unable to afford the new pregnancy because of pandemic related economic constraints and job losses.
RRAAM hotline also reported that over the continued lockdowns, women reached out for advice on terminations during a much later stage of pregnancies than usual, as compared to pre-pandemic times. This points to difficulties in obtaining care from doctors and the need to declare SRHR as essential services on a state-based level to facilitate and expedite care.
However, despite the growing economic insecurity and related vulnerabilities of continued lockdowns undermining efforts to secure gender equality, there are actionable solutions for Malaysia to address SRHR inequalities.
Empowering and increasing resources for NGOs to ease their reach to marginalised, underserved women and girls is critical in building capacity for unmet needs; as are guidelines for doctors and nurses regarding SRHR during the pandemic.
Meanwhile, increasing telehealth and telemedicine access to include the B40 and urban poor is crucial. Targeted specific awareness programs, one off treatment plans, LARC and continued comprehensive sexuality education and gender-based violence education are equally essential.
Indeed, multi-sectoral, logical, reasonable, and coherent interventions and SRHR policies during the pandemic lockdowns will improve the lived realities of the poorer women and girls most impacted by this inequality.
The shadow pandemic of domestic violence
Malaysia is currently 16 months along continuing MCO lockdowns. However, just a few months into the pandemic back in mid 2020, there was enough concern on the global rise of gender-based violence cases for the United Nations to describe it as a shadow pandemic.
The risk of domestic violence is further exacerbated by economic distress, job losses and Covid-19 related health concerns which often means women are trapped in homes with their abusers, with decreased access to shelters and psychological support.
Malaysia has also seen a worrying increase in female suicide rates, with 80 per cent of the cumulative 1708 reported suicides since 2019 being young women, which could be linked to gender-based violence.
Globally, the rise in domestic violence and intimate partner violence is a further reflection of existing social and cultural attitudes and norms which privilege men over women and each day that co-ordinated efforts are delayed means more women’s lives and safety on the line.
The shadow pandemic amidst Covid-19 has also meant the burden on women, families and service providers has at least doubled.
However, solutions for ending gender-based violence still remain attainable, so long as the response is multi-sectoral, intersectional and gender integrated and fortified by legislation.
Social protection and welfare for marginalised women and girls
Globally, women are more likely than men to work in precarious, informal jobs while shouldering a greater burden of unpaid care work, and can face interruptions to their work, loss of livelihoods and increased care responsibilities as a result of Covid-19.
This has also been true of Malaysia’s Covid-19 experience thus far. In fact, these exact vulnerabilities faced by urban poor, female led households were highlighted in the recent UNFPA and Unicef Malaysia Families on the Edge Report.
During disease outbreaks, women and children in particular, face a variety of risks, yet they are too often, absent from the design of pandemic responses.
Almost two years into Malaysia’s pandemic lockdowns, core gaps have been exposed regarding social protection and welfare, looking at the recent “White Flag” or “Bendera Putih” movement.
MCO 3.0 has indeed hit our underserved B40 women and communities hard, particularly those in urban and remote areas, such as in Sabah as reflected by the ongoing multitude of aid requests. No income, no cash in hand and limited access to nutritious food has thus become the lived reality for many residents living in the People’s Housing Projects (PPR) around Kuala Lumpur.
Shock-responsive social protection for food security and loss of livelihood for the B40 and even M40 groups will prove critical in protecting these disproportionately female headed households.
Such women also make up the bulk of poor, low-income and self-employed workers who have also been left out of the emergency relief EPF withdrawals and are currently worst hit.
Immediate recognition of unpaid care labour, coupled with vital investments in bridging the digital divide, accessing digital skills, and enhancing online commerce can multiply economic possibilities, as well provide some much-needed optimism. These along with consistent, expanded targeted cash assistance in collaboration with civil society organisations is thus the way forward in meeting highly localised, emergency nutritional and survival needs, over the coming months.
Meanwhile, a centralised, integrated social protection database is a long-term solution to address Malaysia’s social protection and welfare gaps.
Mental health crisis and women and girls
Covid-19 has sparked an increased demand for mental health services globally, not just in Malaysia. The varied stresses of pandemic lockdowns are major contributing factors to this upswing.
UNFPA notes that of the 1,708 cumulative deaths by suicide reported from 2019 until May this year in Malaysia, 83.5 per cent of cases, or 1,427, were female. More than 50 per cent of all suicides were committed by children between 15 and 18 years old.
Addressing the epidemic of suicides among teenagers and young girls in particular, is essential, considering the unique pressures the pandemic and MCO lockdowns place on teenagers, including but not limited to, household abuse and mental distress, limits to counselling practices and services available in schools, social isolation due to school closures, pressures of learning from home and the recent concerns around #makeschoolasaferplace
Currently, Malaysia only has 410 registered psychiatrists, while the World Health Organisation (WHO) recommends 3100 (1 per 10,000 persons) to adequately meet the country’s mental health needs.
As training and recruitment will not address this gap, drawing upon innovative methods will prove key in addressing the suicide crisis.
Leveraging on Malaysia’s robust primary healthcare system is essential, as general practitioners form the first point of contact for 49 per cent of Malaysians seeking mental healthcare, training them to assess and treat would be invaluable for timely intervention.
Empowering the community to ease the burden on the healthcare system is another critical dimension, empowering peers with lived experiences such as peer support specialists with autonomy and licences, can in turn connect localised communities and bolster mental health support networks during these unprecedented times.
Simultaneously, greater efforts to strengthen telehealth and coverage will remain pertinent for virtual consultations essential during Covid-19 lockdowns.
Working with private healthcare providers can also bridge the gap through collation of accurate data and application of precision treatment which identifies risk factors and protective factors to proactively counsel people in distress reaching out to hotlines.
Along this vein, UNFPA Malaysia echoes calls by MIASA Malaysia, the Mental Illness Awareness and Support Association, to reinstate the National Suicide Registry Malaysia (NSRM). A quality data collection system is critical in addressing the current spike in mental health crisis.
Finally, destigmatising mental healthcare also goes hand in hand with the decriminalisation of suicide, another crucial touchstone when it comes to young women and teenagers’ mental health.
Gender budgeting to address equitable pandemic recovery
The psychosocial and socio-economic fallout of continued lockdowns have negatively impacted the lives and wellbeing of Malaysia's women and girls most of all ― with escalations in Gender-based Violence, increasing economic inequity, poverty, increased care work burdens, nutritional deficiencies, decreased access to SRHR, social welfare and much more.
The pandemic’s outsized impact on women must thus not only look at preventing or responding to the surge in gender-based violence against women, but also addressing social protection and job response to adequately support women’s economic security, and compensate care work or the financing of care services.
Gender budgeting tools such as gender impact assessments or gender budget statements can identify gaps in policy responses and direct spending towards gender responsive Covid-19 measures, as seen in EU best practice models. Civil society organisations have also contributed and shown how tools such as expenditure tracking and social audits can be used rapidly and to great effect even with limited data, which indicates its suitability for Malaysia.
Uncertainty surrounding the Covid-19 pandemic’s evolution indicates that governments should apply gender budgeting to design and deliver better recovery packages that move towards gender equal economies. This entails public investment in jobs, care services and social protection for women, investments that are currently not the focus of Covid-19 support and recovery packages but are critical for overall economic recovery.
Indeed, so vital is the role and importance of women's contribution to the Malaysian economy that a 2019 World Bank Report noted that Malaysia’s income per capita could grow by 26.2 per cent ― implying an average annual income gain of RM9,400 (US$2,250) if all economic barriers are removed for women in Malaysia. Given the economic impacts of the pandemic and its lockdowns on Malaysia, this figure becomes an essential, rather than an option, for an equitable and sustainable pandemic recovery.
Gender sensitive budgeting, will form the core of such a response.
It is clear that the Covid-19 pandemic and subsequent containment policies have gravely impacted the development potential as well as the social gains of Malaysia’s women and girls over the past 500 days.
It will be essential to address these core issues that threaten otherwise to cascade into long term impacts for not just women and girls, but also national development.
Timely, evidence-based and policy informed interventions for the benefit of Malaysia’s women and girls through Gender Budgeting will help ensure the nation’s continued progress towards the 2030 SDGs, and that the next 500 days prove brighter.
* The United Nations Population Fund (UNFPA) is an agency under the UN that aims to deliver a world where every pregnancy is wanted, every childbirth is safe and every young person's potential is fulfilled.
** Throughout July 2021 ― UNFPA Malaysia produced a series of 6 special presentations on key vital issues affecting Malaysia’s Women & Girls and Vulnerable populations. These included spotlights on Mental health, Domestic Violence, Social Welfare, Sexual and Reproductive Health & Rights, school safety and the Disabled and Elderly Communities.