Taking stock of reproductive health in
humanitarian settings: Preliminary
findings from the 2012-2014 global
evaluation
Sandra Krause
Women’s Refugee Commission
On behalf of the
Inter-agency Working Group on Reproductive
Health in Crises
Inter-agency Working Group (IAWG)
on Reproductive Health in Crises
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1994: Refugee Women and Reproductive Health
Care: Reassessing Priorities.
1994: International Conference on Population
and Development Programme of Action
1995: Formation of the IAWG on Reproductive
Health (RH) in Crises
Inter-agency Working Group (IAWG)
on Reproductive Health in Crises
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2002-2004: First IAWG global evaluation of RH
in humanitarian settings
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RH services were generally well established and
consistent with pre-existing standards in stable
refugee settings.
Gender-based violence and HIV/AIDS services
were comparatively weak.
Services for internally displaced persons were
severely lacking.
Little information regarding the RH of
populations in acute emergencies.
2012-2014 Global evaluation
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Literature review
Institutional capacity assessment
MISP assessment
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In-depth and service availability
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Jordan
South Sudan, DRC, Burkina Faso
SRH funding trends
Health Information System (HIS) review
and analysis
Preliminary findings: Progress
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Increased institutional capacity towards RH in
humanitarian settings
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Improved policies.
Increased dedicated guidelines and resources.
Improved accountability to stakeholders.
Increased investments in dedicated human
and financial resources.
Enhanced integration of disaster risk reduction
in emergency management cycle.
Preliminary findings: Progress
cont’d
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Increased RH programming in humanitarian
settings
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Improved MISP response and
comprehensiveness of clinical services.
Expanded array of program delivery strategies.
Increased number of emergency health and
protection programs noting RH in
humanitarian appeals.
Preliminary findings: Progress
cont’d
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Increased funding for RH to conflict-affected
settings overall

Analysis of official development assistance
(ODA) to 18 conflict-affected countries showed
an increase of 298% in overall ODA for RH from
2002-2011. This reflects a broader increases in
overall ODA.
Preliminary findings: Gaps
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Reproductive health components
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Comprehensive abortion care
Emergency obstetric care, including postabortion care
Long-term and permanent methods of
contraception; emergency contraception
Prevention of mother-to-child transmission of
HIV
Clinical care for survivors of sexual violence
Cervical cancer screening and treatment
Preliminary findings: Gaps cont’d
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Quality of care
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Community perceptions of poor service
quality.
Lack of information about the benefits and
availability of services.
Challenges and delays to implementing
comprehensive RH services.
Discrepancies between NGO-supported and
non-supported health facilities.
Logistics and supply chain gaps.
Preliminary findings: Gaps cont’d
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Funding
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Over half (56.3%) of the 298% increase in total
RH ODA disbursements was due to a
substantial increase in HIV/AIDS funding.
Average annual per capita ODA for RH
activities to non-conflict-affected countries
was 57% higher than to conflict-affected
countries.
Recommendations
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Training and capacity development
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Improve capacity of Ministries of Health and
NGOs.
Strengthen engagement and collaboration of
RH actors through the disaster planning and
response cycle.
Advance “task-sharing” to address human
resource shortages.
Recommendations cont’d
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Implementation
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Improve information, education and
communication among communities.
Strengthen quality transition from MISP to
comprehensive RH services.
Strengthen RH supply chain management and
resupply.
Strengthen attention to RH in urban areas.
Research agenda
Dedicated and predictable funding for the
IAWG on RH in Crises
Next steps
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Publish a series of articles in Conflict and
Health (September 2014).
Implement advocacy and communications
campaign to disseminate findings and
recommendations.
Acknowledgements
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IAWG Global Evaluation Steering
Committee Agencies:
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Centers for Disease Control and Prevention
Columbia University
International Medical Corps
Kings College London
Marie Stopes International
Medecins Sans Frontieres
United Nations High Commissioner for Refugees
United Nations Population Fund
University of New South Wales
Women’s Refugee Commission