WUNRN
Link to Information & Download
for Inter-Agency
Field Manual on Reproductive Health in Humanitarian Settings: 2010 Revision: http://www.iawg.net/resources/field_manual.html#download
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Pregnancies Don't Wait for Emergencies to End - Field Manual
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By
Cléo Fatoorehchi
UNITED NATIONS, Mar 2, 2011 (IPS) - When disaster
strikes, the initial humanitarian response tends to focus on basic commodities
like food and shelter. But as the crisis or conflict drags on, other critical
needs often go unmet – such as prenatal care for pregnant women, and emergency
contraception for victims of sexual assault.
To close this gap, the U.N. Population Fund (UNFPA) and
Women's Refugee Commission (WRC) - part of the International Rescue Committee
(IRC) – have launched a newly updated Inter-Agency Field Manual on Reproductive
Health in Humanitarian Settings.
The Field Manual targets health officials and providers, such
as doctors, nurses and midwives, as well as policymakers and donors. In
addition to maternal and newborn health and family planning, it also addresses
gender-based violence and sexually transmitted infections.
"When there is a breakdown in civil society... sexual
assaults and violence go way up and people have pregnancies and exposure to
HIV," Sandra Krause, reproductive health programme director for WRC, told
IPS on the sidelines of the U.N. Commission on the Status of Women this week.
"So it's really critical to be able to give women
access to emergency contraception and post-exposure prophylaxis to prevent
HIV," she said.
A rise of violence against women has been documented not
only in armed conflicts but following natural disasters as well, such as this
year's floods in Australia, the 2004 tsunami in Southeast Asia, Hurricane Mitch
in Central America 1998, and the 1991 Mount Pinatubo eruption in the
Philippines.
The disastrous Jan. 12, 2010 earthquake in Haiti, which
affected over three million people, was "a tipping point, with people in
the field recognising there was this priority for reproductive health
services," said Krause.
The Field Manual "outlines what needs to be done in the
early days and weeks", but it also provides guidance for comprehensive
reproductive health services to be settled in the longer term, Krause
explained.
"Reproductive health is critically important for
spacing pregnancies because a lot of women and girls don't want to be pregnant
during an emergency like the tsunami," she said, "so we will always
see a demand for family planning services."
The need for reproductive health services is especially
critical since "15 percent of pregnant women will experience some type of
unexpected complication with the pregnancy and will require care or die,"
she added.
The Inter-Agency Working Group on Reproductive Health in
Crises was founded in 1995, pulling together more than 30 groups, from U.N.
agencies to NGOs to academia. It published its first Field Manual in 1999, creating
the Minimum Initial Service Package (MISP) to ensure reproductive health in
post-conflict or disaster-affected situations didn't fall through the cracks.
But when WRC did a field assessment some years later, it
discovered that most humanitarian workers were unaware of the MISP and did not
use it on the ground.
For the latest edition, input was sought from every sector,
because "if people … invested in it and know what's in it, they're going
to use it," Krause told IPS - what she calls "shared ownership".
WRC also developed a distance-learning module, available in
many languages. The online programme explains, in three or four hours, what the
priority activities should be.
"Each chapter has a final online post-assessment and
people using it can get a certificate. About 4,000 people have completed the
online distance-learning module," said Krause.
Ashley Wolfington, a reproductive health specialist at IRC,
stresses the need for family planning among youth, with girls under 19 years
old experiencing double the risk of complications during pregnancy than older
women.
Krause also pointed out that, "Women and girls play a
tremendous role (in recovery)... and if they're sick or unable to take care of
their families and communities, that's a problem."
"Women who are not suffering from complications from
unsafe abortions or miscarriages of the consequences of rape or HIV
transmissions are much more likely to be able to take care of their families
and contribute to building their communities," she said.
The next step is empowering women themselves to think ahead
in terms of what they can do to protect themselves and communicate with one
another in the event of an outbreak of war and violence.
As part of a global launch, the Field Manual has already been
presented in Santo Domingo in May 2010, in Bangkok in September 2010 and then
in Geneva. The event at the United Nations Monday was the first U.S.-based
launch.