The initial impact of the COVID-19 pandemic was clear and devastating, measured in cases, hospitalizations, and deaths. However, the deeper and longer-lasting effects have been harder to track, especially in vulnerable regions like the Peruvian Amazon. Within these remote communities, the pandemic has left a mark that affects not only the physical health, but also the education and future well-being of adolescents.
Within the framework of Mamás del Río's intervention, the opportunity arose to address this issue in a more specific way, promoting research on the interrelations between reproductive health and education during and after the pandemic. This is how Dr. Lisa Woodson, with her vast experience in sexual and reproductive health, joined the team to lead this research project, which is built on the work that Mamás del Río has developed for almost 10 years in the region.
The pandemic hit hard around the world, but in Peru, the situation was especially serious. In Loreto, one of the most affected regions, the Mamás del Río project had been working long before the health crisis, seeking to reduce maternal and infant mortality in remote indigenous communities, and it was in this context that the pandemic arrived.
Peru recorded the highest COVID-19 fatality rate in the world, so the State implemented strict control measures, such as closing borders and schools, affecting approximately 8 million children and the entire population. In Loreto, where access to health and education services is limited, the impact was devastating.
During the prolonged closure of schools, adolescents faced additional challenges such as school dropouts, exploitation, gender-based violence and increased teenage pregnancies. In light of this situation, there was a need to document, analyse and understand these realities in depth, in order to design better interventions in the future.
Given this need, we see the need for the research led by Lisa Woodson, who has sought to go beyond the immediate data of the pandemic and explore the structural and socioeconomic factors that affect the lives of adolescents in the Amazon. Lisa and her team began interviewing community leaders, adolescents, and health workers to gather a clear and detailed picture of the situation on the ground.
In June 2022, three months after schools reopened, 41 semi-structured interviews were conducted with community leaders, adolescents, and health workers. The bonds of trust established in the communities over the years by the project facilitated access to these key actors for research. The interviews included 12 community leaders and 29 adolescents between 15 and 17 years old (11 pregnant girls, 9 girls who had never been pregnant, and 9 boys). In addition, focus groups were conducted with community health workers and educators to complement and validate the findings.
The research led by Lisa revealed a much more complex picture than the numbers could show. Teenage pregnancy in the region had not only increased during the pandemic, but this increase was both a cause and a consequence of premature unions and school dropouts. The pandemic had exacerbated economic difficulties, access to health care and education, pushing many adolescents towards early motherhood.
The accounts of the adolescents interviewed showed a paradox between social and gender expectations and what they themselves wanted. Some of the pregnant adolescents dreamed of being midwives, nurses or teachers, traditionally feminine roles in their context. In contrast, those who were not pregnant imagined a more diverse future, with aspirations of being architects, engineers or chefs. Interestingly, none of the adolescents, both male and female, saw themselves as parents in the near future, despite social pressures.
In addition to social factors, the pandemic also exacerbated economic inequalities in the Peruvian Amazon. Teenage girls faced a harsh reality: with few economic opportunities and pressure for financial stability, many felt that early marriage and motherhood were their only options.
Lisa’s research not only clarifies the statistics, but also reveals the lived experiences of these adolescents. At the individual, micro and macro levels, layers of complexity are seen that put girls at risk of pregnancy. While some wish to postpone motherhood, economic and social pressures often push them in the opposite direction.
Lisa Woodson and her team have distributed information booklets in Spanish and the Kukama language, sharing the results of the research with the communities where the study was conducted.
Also, together with Mamás del Río and thanks to the Australian Embassy, they are working hand in hand with community leaders and health workers to develop interventions in which young community agents are trained to work hand in hand with community agents from Mamás del Río to prevent teenage pregnancy in Amazonian communities.
Article based on the research "The downstream effects of COVID-19 on adolescent girls in the Peruvian Amazon: qualitative findings on how the pandemic affected education and reproductive health" by Lisa L. Woodson, Adriana García Saldívar, Heidi E. Brown, Priscilla A Magrath, Nicolás Antúnez de Mayolo, Sydney Pettygrove, Leslie V. Farland, Purnima Madhivanan & Magaly M. Blas; "'You have a lot of mirrors': structural and socioecological factors impacting adolescent pregnancy and reproductive health in the Amazon basin, Peru, a qualitative study" by Lisa Labita Woodson, Adriana García Saldívar, Heidi E. Brown, Priscilla A. Magrath, Leslie V. Farland, Magaly M. Blas & Purnima Madhivanan and; "The Power of Poetry: Rethinking How We Use Language in Global Health Research" by Lisa Labita Woodson
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