Abstract
BackgroundReproductive health (RH) care is an essential component of humanitarian response. Women and girls living in humanitarian settings often face high maternal mortality and are vulnerable to unwanted pregnancy, unsafe abortion, and sexual violence. This study explored the availability and quality of, and access barriers to RH services in three humanitarian settings in Burkina Faso, Democratic Republic of the Congo (DRC), and South Sudan.MethodsData collection was conducted between July and October 2013. In total, 63 purposively selected health facilities were assessed: 28 in Burkina Faso, 25 in DRC, and nine in South Sudan, and 42 providers completed a questionnaire to assess RH knowledge and attitudes. Thirty-four focus group discussions were conducted with 29 members of the host communities and 273 displaced married and unmarried women and men to understand access barriers.ResultsAll facilities reported providing some RH services in the prior three months. Five health facilities in Burkina Faso, six in DRC, and none in South Sudan met the criteria as a family planning service delivery point. Two health facilities in Burkina Faso, one in DRC, and two in South Sudan met the criteria as an emergency obstetric and newborn care service delivery point. Across settings, three facilities in DRC adequately provided selected elements of clinical management of rape. Safe abortion was unavailable. Many providers lacked essential knowledge and skills. Focus groups revealed limited knowledge of available RH services and socio-cultural barriers to accessing them, although participants reported a remarkable increase in use of facility-based delivery services.ConclusionAlthough RH services are being provided, the availability of good quality RH services was inconsistent across settings. Commodity management and security must be prioritized to ensure consistent availability of essential supplies. It is critical to improve the attitudes, managerial and technical capacity of providers to ensure that RH services are delivered respectfully and efficiently. In addition to ensuring systematic implementation of good quality RH services, humanitarian health actors should meaningfully engage crisis-affected communities in RH programming to increase understanding and use of this life-saving care.
Highlights
Reproductive health (RH) care is an essential component of humanitarian response
Findings revealed a striking inconsistency between the self-reported provision of RH services and the availability of the minimum supplies and trained staff to adequately provide them: many facilities reported having recently provided a number of RH services, yet—apart from the hospitals in Democratic Republic of the Congo (DRC) and Burkina Faso—the availability of a minimum standard of quality RH services was generally limited
Despite the many obstacles to service delivery, communities affected by crises deserve high quality RH care
Summary
Reproductive health (RH) care is an essential component of humanitarian response. This study explored the availability and quality of, and access barriers to RH services in three humanitarian settings in Burkina Faso, Democratic Republic of the Congo (DRC), and South Sudan. From 2002 to 2004, the Inter-agency Working Group on Reproductive Health in Crises (IAWG) conducted a global evaluation of RH in humanitarian settings [5]. Response to gender-based violence (GBV) was the weakest area assessed, and internally displaced persons (IDPs)—as compared to refugees—were found to lack critical access to RH care. Since 2004, some components of RH have been studied in different humanitarian settings, but research remains limited [6]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.