THE MINIMUM INITIAL SERVICE PACKAGE
FOR REPRODUCTIVE HEALTH IN CRISIS SITUATIONS
The Minimum Initial Service Package (MISP).
WHO and the Inter-Agency Working Group for RH in refugee situations have developed a core
package of minimum reproductive health (RH) interventions that should be put in place in emergency
settings. The objectives of this package are to:
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Prevent and manage the consequences of sexual violence
careful site planning of camps
set up health services for medical treatment of survivors of sexual violence
raise awareness among all staff of the importance of early referral of survivors to health services
coordinate the response between health, community, security and protection services.
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Reduce transmission of HIV
make condoms freely available
enforce universal precautions against HIV (including sufficient supplies, safe waste disposal)
ensure blood transfusion is safe
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Prevent excess neonatal and maternal morbidity and mortality
provide clean delivery kits to all pregnant women and birth attendants
provide health facilities and midwives with midwifery delivery kits.
initiate the establishment of a referral system to manage obstetrics emergencies
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Identify an organization to coordinate and implement the MISP
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Plan for the provision of comprehensive RH services, integrated into primary health care,
as soon as the situation permits
collect background information on RH mortality, STD/HIV prevalence and contraceptive
prevalence.
identify suitable sites for the future delivery of comprehensive reproductive health services
assess the capacity of staff and plan training/retraining
order equipment and supplies for comprehensive reproductive health services.
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In addition to the MISP, WHO has identified two other activities, which experience has shown are
important to include in the core package of reproductive health interventions in emergency settings:
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Meet pre-existing family planning needs
provide basic family planning services in order to meet spontaneous demand.
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Meet needs for menstrual protection
assess the need for menstrual protection and identify methods to meet this need.
For more information and guidance on the design of programs and planning comprehensive RH
programmes after the emergency, consult the following references:
“Reproductive Health in refugee situations, an Inter-agency Field Manual”
“Reproductive Health in Conflict and Displacement, A guide for programme managers”
Available on: http://www.who.int/reproductive-health/ under Resources.
For technical support, contact Dr. Wilma Doedens, Department of Reproductive Health and Research,
World Health Organization, CH-1211 Geneva 27, Switzerland. Email: doedensw@who.int