Strengthening reproductive and sexual health services to minimize the risk of Zika virus associated complications in newborn

Dear Editor,

Zika virus outbreak, which started in South America in May 2015, over the span of one year, has spread to different nations and territories.^[1] There is a potential risk that the disease can spread to almost all regions across the world, wherever the causative vector is present through the international travelers.^[1] Owing to the apprehension associated with the disease, especially among the vulnerable group of women in the reproductive age-group (mainly pregnant women), because of the disease-related complications (like microcephaly and other neurological disorders), the disease has attracted major public health attention.^[1],[2]

In addition, the disease is very much common among settings with absence of piped water supply (leading to the practice of storing of water) or with poor sanitation facilities, as it provides suitable conditions for mosquito breeding.^[1],[3] Such sort of environmental conditions will be very much prevalent in rural and remote settings, wherein communities are from poor socioeconomic status and have low levels of literacy.^[1],[3] In-fact, the eligible couples in the affected region have not been using any of the contraceptives irrespective of their family size and have a high unmet need for family planning.^[3]

On the contrary, even the health sector has no specific curative option or vaccine available to offer to the high-risk group women, and it is a major limitation of the health system.^[1] The only option left with the health professionals is to counsel women and their spouse to postpone the planned/unplanned pregnancy (by offering appropriate contraceptive measures), so that any potential risk of a congenital defect in the newborn can be avoided.^{[1],[2],[3],[4]} However, for this to happen, the women and girls living in these areas should have prompt access to sexual and reproductive health services, including family planning.^[2],[3] These contraceptive methods offer two-fold advantages and not only avert the risk of congenital defects in newborn, but even plays a defining role in reducing the rates of unplanned pregnancy and associated maternal death rates.^[1],[2] Further, as the disease can be even transmitted sexually, and again, there is a need to strengthen the reproductive and sexual health services.^[1],[3]

The current challenge is to ensure that the plans are translated into actions, and the access to the modern contraceptive methods is universally achieved, especially in affected nations.^[2],[3] In-fact, in Haiti, only one-third of the women in the reproductive age-group has access to the contraceptives and is an issue of grave concern.^[3] Acknowledging the importance of these services in minimizing the risk and the burden on the health system, the need of the hour is to provide information and access to voluntary family planning, to eventually enable women to make informed decisions about their reproductive health, and to prevent them from the future hardship of taking care of a handicapped child.^{[1],[2],[3],[4]}

Further, interventions like to offer serological testing to the asymptomatic pregnant women within 2–12 weeks after their return from a Zika-affected nation or within the first week to the symptomatic pregnant women has been proposed.^[5] In addition, strategies like organizing mobile clinics and discussing reproductive life plans (like pregnancy intention, its timing, etc.), is also expected to improve the existing scenario.^[3],[5]

To conclude, Zika virus disease has raised serious concerns among the health professionals, women and girls of the reproductive age group. However, as the health sector is deficient in terms of the available curative options, there is an indispensable need to strengthen the reproductive and sexual health services to minimize the risk of any major congenital complication.

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Conflict of interest

There are no conflicts of interest.

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.205579