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Developing Institutional Capacity for Reproductive Health in Humanitarian Settings: A Descriptive Study.

Tran NT, Dawson A, Meyers J, Krause S, Hickling C, Inter-Agency Working Group (IAWG) on Reproductive Health in Cris - PLoS ONE (2015)

Bottom Line: RHHS work was found not to be restricted to humanitarian agencies (25%), but was also embraced by development organizations (25%) and institutions with dual humanitarian and development mandates (50%).Approximately half of participants reported that their institutions had experienced an increase in dedicated budget and staff for RHHS, a fifth no change, and 1 in 10 a decrease.The results suggest overall growth in institutional capacity in RHHS over the past decade, indicating that the field has matured and expanded from crisis response to include RHHS into DRR and other elements of the emergency management cycle.

View Article: PubMed Central - PubMed

Affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.

ABSTRACT

Introduction: Institutions play a central role in advancing the field of reproductive health in humanitarian settings (RHHS), yet little is known about organizational capacity to deliver RHHS and how this has developed over the past decade. This study aimed to document the current institutional experiences and capacities related to RHHS.

Materials and methods: Descriptive study using an online questionnaire tool.

Results: Respondents represented 82 institutions from 48 countries, of which two-thirds originated from low-and middle-income countries. RHHS work was found not to be restricted to humanitarian agencies (25%), but was also embraced by development organizations (25%) and institutions with dual humanitarian and development mandates (50%). Agencies reported working with refugees (81%), internally-displaced (87%) and stateless persons (20%), in camp-based settings (78%), and in urban (83%) and rural settings (78%). Sixty-eight percent of represented institutions indicated having an RHHS-related policy, 79% an accountability mechanism including humanitarian work, and 90% formal partnerships with other institutions. Seventy-three percent reported routinely appointing RH focal points to ensure coordination of RHHS implementation. There was reported progress in RHHS-related disaster risk reduction (DRR), emergency management and coordination, delivery of the Minimum Initial Services Package (MISP) for RH, comprehensive RH services in post-crisis/recovery situations, gender mainstreaming, and community-based programming. Other reported institutional areas of work included capacity development, program delivery, advocacy/policy work, followed by research and donor activities. Except for abortion-related services, respondents cited improved efforts in advocacy, capacity development and technical support in their institutions for RHHS to address clinical services, including maternal and newborn health, sexual violence prevention and response, HIV prevention, management of sexually-transmitted infections, adolescent RH, and family planning. Approximately half of participants reported that their institutions had experienced an increase in dedicated budget and staff for RHHS, a fifth no change, and 1 in 10 a decrease. The Interagency RH Kits were reportedly the most commonly used supplies to support RHHS implementation.

Conclusion: The results suggest overall growth in institutional capacity in RHHS over the past decade, indicating that the field has matured and expanded from crisis response to include RHHS into DRR and other elements of the emergency management cycle. It is critical to consolidate the progress to date, address gaps, and sustain momentum.

No MeSH data available.


Related in: MedlinePlus

Clinical reproductive health in humanitarian settings services addressed by institutions before and since 2004 (n = 82).
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pone.0137412.g004: Clinical reproductive health in humanitarian settings services addressed by institutions before and since 2004 (n = 82).

Mentions: The results show increased activity over the past decade in almost all clinical areas of work in the institutions from where participants were drawn (Fig 4). These clinical areas were not exclusive to service provision and could involve guideline development, service delivery, technical assistance, training, advocacy, or research. Increases in the institutional coverage of a number of areas were noted by respondents including MISP-related services and some comprehensive RH services: maternal and newborn health, sexual violence prevention and response and broader GBV prevention, HIV prevention, management of sexually-transmitted infections (STIs) or reproductive tract infections (RTIs), adolescent RH, and FP, including emergency contraception. Results indicate that respondents felt that institutions had increased the delivery of HIV care and support including ARV interventions since 2004, but overall, the findings show that this area of activity had less institutional coverage than other components of RH care, despite the fact that the MISP recommends the provision of ARVs for individuals already taking them and for PMTCT. According to respondents, institutions were less active in terms of abortion-related services, which are part of the MISP, cervical cancer screening and treatment, and permanent methods of FP, which are components of comprehensive RH services. With regard to abortion-related services, half of all respondents (49%) reported that their institutions did not conduct activities related to induced abortion, and approximately a third did not address post-abortion care (29%), or referral to safe abortion or post-abortion services (35%). As for FP, institutions reported providing not only short-term methods (88%, e.g. pills, condoms, injectables), but also emergency contraception (77%), long-acting FP methods (79%), and postpartum FP (70%). Permanent FP methods were reportedly addressed by 53% of institutions. With regard to cervical cancer screening, approximately half of respondents said their organizations did not undertake screening (46%) or provide treatment (52%).


Developing Institutional Capacity for Reproductive Health in Humanitarian Settings: A Descriptive Study.

Tran NT, Dawson A, Meyers J, Krause S, Hickling C, Inter-Agency Working Group (IAWG) on Reproductive Health in Cris - PLoS ONE (2015)

Clinical reproductive health in humanitarian settings services addressed by institutions before and since 2004 (n = 82).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4558004&req=5

pone.0137412.g004: Clinical reproductive health in humanitarian settings services addressed by institutions before and since 2004 (n = 82).
Mentions: The results show increased activity over the past decade in almost all clinical areas of work in the institutions from where participants were drawn (Fig 4). These clinical areas were not exclusive to service provision and could involve guideline development, service delivery, technical assistance, training, advocacy, or research. Increases in the institutional coverage of a number of areas were noted by respondents including MISP-related services and some comprehensive RH services: maternal and newborn health, sexual violence prevention and response and broader GBV prevention, HIV prevention, management of sexually-transmitted infections (STIs) or reproductive tract infections (RTIs), adolescent RH, and FP, including emergency contraception. Results indicate that respondents felt that institutions had increased the delivery of HIV care and support including ARV interventions since 2004, but overall, the findings show that this area of activity had less institutional coverage than other components of RH care, despite the fact that the MISP recommends the provision of ARVs for individuals already taking them and for PMTCT. According to respondents, institutions were less active in terms of abortion-related services, which are part of the MISP, cervical cancer screening and treatment, and permanent methods of FP, which are components of comprehensive RH services. With regard to abortion-related services, half of all respondents (49%) reported that their institutions did not conduct activities related to induced abortion, and approximately a third did not address post-abortion care (29%), or referral to safe abortion or post-abortion services (35%). As for FP, institutions reported providing not only short-term methods (88%, e.g. pills, condoms, injectables), but also emergency contraception (77%), long-acting FP methods (79%), and postpartum FP (70%). Permanent FP methods were reportedly addressed by 53% of institutions. With regard to cervical cancer screening, approximately half of respondents said their organizations did not undertake screening (46%) or provide treatment (52%).

Bottom Line: RHHS work was found not to be restricted to humanitarian agencies (25%), but was also embraced by development organizations (25%) and institutions with dual humanitarian and development mandates (50%).Approximately half of participants reported that their institutions had experienced an increase in dedicated budget and staff for RHHS, a fifth no change, and 1 in 10 a decrease.The results suggest overall growth in institutional capacity in RHHS over the past decade, indicating that the field has matured and expanded from crisis response to include RHHS into DRR and other elements of the emergency management cycle.

View Article: PubMed Central - PubMed

Affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.

ABSTRACT

Introduction: Institutions play a central role in advancing the field of reproductive health in humanitarian settings (RHHS), yet little is known about organizational capacity to deliver RHHS and how this has developed over the past decade. This study aimed to document the current institutional experiences and capacities related to RHHS.

Materials and methods: Descriptive study using an online questionnaire tool.

Results: Respondents represented 82 institutions from 48 countries, of which two-thirds originated from low-and middle-income countries. RHHS work was found not to be restricted to humanitarian agencies (25%), but was also embraced by development organizations (25%) and institutions with dual humanitarian and development mandates (50%). Agencies reported working with refugees (81%), internally-displaced (87%) and stateless persons (20%), in camp-based settings (78%), and in urban (83%) and rural settings (78%). Sixty-eight percent of represented institutions indicated having an RHHS-related policy, 79% an accountability mechanism including humanitarian work, and 90% formal partnerships with other institutions. Seventy-three percent reported routinely appointing RH focal points to ensure coordination of RHHS implementation. There was reported progress in RHHS-related disaster risk reduction (DRR), emergency management and coordination, delivery of the Minimum Initial Services Package (MISP) for RH, comprehensive RH services in post-crisis/recovery situations, gender mainstreaming, and community-based programming. Other reported institutional areas of work included capacity development, program delivery, advocacy/policy work, followed by research and donor activities. Except for abortion-related services, respondents cited improved efforts in advocacy, capacity development and technical support in their institutions for RHHS to address clinical services, including maternal and newborn health, sexual violence prevention and response, HIV prevention, management of sexually-transmitted infections, adolescent RH, and family planning. Approximately half of participants reported that their institutions had experienced an increase in dedicated budget and staff for RHHS, a fifth no change, and 1 in 10 a decrease. The Interagency RH Kits were reportedly the most commonly used supplies to support RHHS implementation.

Conclusion: The results suggest overall growth in institutional capacity in RHHS over the past decade, indicating that the field has matured and expanded from crisis response to include RHHS into DRR and other elements of the emergency management cycle. It is critical to consolidate the progress to date, address gaps, and sustain momentum.

No MeSH data available.


Related in: MedlinePlus