Sexual Reproductive Health (SRH) in Emergencies / RAISE Initiative

1. Sexual Reproductive Health (SRH) in Emergencies / RAISE Initiative Goal: Build on current sexual reproductive health programs by integrating emergency preparedness and response and take best practices and lessons learned from SRH programs to inform strategies that address the needs of women and girls in emergencies.

2. What do we mean by Sexual Reproductive Health? Prevention and Care for Survivors of Gender-based Violence Family Planning Prevention and Treatment of STIs/HIV/AIDS Maternal Newborn Care - EmONC

3. Three core areas • Strengthen institutional capacity • Improve staff preparedness • Enhance learning and sharing

4. Why SRH in Emergencies • In general 4% of displaced populations are pregnant women • 15% of all pregnancies result in unforeseen complications • 75% of all maternal deaths are due to five causes (all of which can be treated) • Health including SRH/HIV interventions can reduce negative consequences of disaster on women, girls, families and communities

5. Why SRH in Emergencies? (Cont.) • Reports on rape during conflict detail profound brutality towards women and girls and less frequently men and boys • Family planning can prevent 25-30% of all maternal deaths • The growing number of humanitarian crises, often linked with displacement, food insecurity and poverty, increase vulnerability to HIV and negatively affect the lives of PLHIV

6. Minimum Initial Service Package (MISP) for SRH • Identify focal point for RH within organization • individual • Prevent and manage the consequences of sexual violence • plan camp design or assess setting where affected population is staying • medical response (EC, STI prevention, PEP) • inform the community about prevention and services • protection of at risk groups

7. Components of the MISP Cont. • Reduce HIV transmission • universal precautions • free condoms • safe blood • Continue antiretrovial therapy, home-based care, PMTCT • Prevent excess neonatal and maternal morbidity and mortality • referral for obstetric emergencies • clean and safe deliveries at health facility • clean home deliveries

8. Components of the MISP Cont. • Plan for comprehensive RH services and programs (maternal newborn care including EmONC, family planning, STIs/HIV/AIDS, gender-based violence), integrated into other programs such as primary health care as soon as possible • collect background information • identify suitable sites • order supplies • train staff

9. Minimum Initial Service Package (MISP) for RH in Crisis Situations Objective 5 Objective 2 Plan for COMPREHENSIVE RH services, integrated into Primary Health Care ◙ Baseline info & M&E ◙ ID sites for future delivery of comprehensive RH ◙ Assess staff & ID training protocols ◙ Procurement channels Prevent sexual violence & assist survivors ◙ Protection system in place for displaced populations, especially women & girls ◙ Medical services & psychosocial support available for survivors RH Kit 4 RH Kit 5 RH Kit 7 Objective 3 Transmission of HIV/STI ◙ Universal precautions enforced ◙ Free condoms available ◙ Safe blood transfusion RH Kit 1 Universal precautions through kits 1-12 RH Kit 12 Objective 1 Identify agency/persons to facilitate COORDINATION & IMPLEMENTATION ◙ RH coordinator in place under health coordination team ◙ RH focal person in place in camps ◙ RH kits available & used RH Kit 0 GOAL Mortality, morbidity & disability in crisis-affected populations (refugees/IDPs or populations hosting them) RH Kit 3 RH Kit 9 Objective 4 Prevent EXCESS maternal & neonatal mortality & morbidity ◙ Referral system for EmONC available 24/7 ◙ Midwife delivery kits for clean and safe deliveries @ health facilities ◙ Provide clean delivery kits for visibly pregnant women & birth attendants to ensure clean home deliveries RH Kit 6 RH Kit 2 RH Kit 8 RH Kit 9 RH Kit 10 RH Kit 11 RH Kit 12

10. Minimum Initial Service Package (MISP) for Reproductive Health Distance learning module available at CARE Academy andwww.rhrc.org

11. Resources for SRH in Emergencies Join the interagency working group for RH in emergencies, www.rhrc.org

12. Resources for Mainstreaming Gender For this manual and other resources on gender, go to: http://www.humanitarianreform.org/Default.aspx?tabid=452

13. Resources for Gender-based Violence Programming These and other tools available at http://www.humanitarianreform.org/Default.aspx?tabid=429

14. Resources for HIV/AIDS Programming Under development: Revised IASC Guidelines for Addressing HIV in Humani- tarian Situations • Integrating HIV/AIDS into Humanitarian Action – an Induction Manual

15. Resources for Gender and Sexuality

16. Links for SRH in Emergencies • http://careemergencytoolkit.org/home/ • www.rhrc.org – MISP distance learning module, resources on all RH topics and to join IAWG for RH in emergencies • www.raiseinitiative.org – Fact sheets and resources • http://www.aidsandemergencies.org/cms/ - Resources on HIV/AIDS

17. Listservs and Virtual Network • SRH Google Group – Regular messages on SRH topics including tools, materials, conferences, and workshops • SRH in Emergencies – Bi-weekly messages regarding tools, materials, workshops and conferences • SRH in Emergencies Technical Reference Group • To join or for more information, contact Brooke Barnes at bbarnes@care.org

18. Discussion Questions • What aspects of sexual reproductive health might be relevant to your programming? • What support do you need?