DISPLACEMENTS: IMPLICATIONS FOR SEXUAL AND REPRODUCTIVE HEALTH Dr. Anne A. Khasakhala, Population Studies and Research Institute, University of Nairobi Presented at the Launch of the State of the World Population Report, 2015 University of NairobiISO 9001:2008 Certified

2  It estimated that 26 million women and girls of reproductive age ae among those displaced by conflict or have bee uprooted by disaster.  Their SRH needs must be a priority.  This presentation looks at the major SRH consequences encountered in humanitarian situation both globally and in Kenya Introduction

3 Magnitude of Displacements in Kenya(IDPs, Refugees, Asylum seekers)

4 Status of Displaced

5 Major Sexual and Reproductive Health consequences of displacements  Sexual exploitation and abuse as a tool or means to access basic services or asylum related processes  Lack of access to basic health services due to breakdown of health system in country of origin and especially safe motherhood services hence a high risk of maternal and neonatal mortality  Increased acts of Sexual and Gender Based Violence and sometimes used as a weapon of war or as an opportunistic tendency to vulnerable persons mainly women and girls.

6 Major Sexual and Reproductive Health consequences of displacements  Increased incidents of early marriage as a cultural practice and coping mechanism  Extended ethnic conflict in the country of asylum, usually precipitated by inter-ethnic sexual relationships, sexual violence and marriages  Increased population within the camp further strains already stretched resources in provision of safe motherhood and neonatal health compromising on quality of services being offered

7 Minimum Initial Service Package (MISP)  Interagency Working Group (IAWG) on Reproductive Health in Crises, developed a set of priority practices for health care professionals called the Minimum Initial Service Package (MISP) for Reproductive Health in Crisis Situations designed to: Interagency Working Group (IAWG)Minimum Initial Service Package (MISP) for Reproductive Health in Crisis Situations  prevent and respond to sexual violence;  prevent excess maternal and newborn mortality and morbidity;  reduce HIV transmission; and,  plan for comprehensive RH services in a coordinated manner.

8 Importance of MISP  When implemented from the onset of a crisis, the MISP saves lives and prevents illness, especially among women and girls.  Prevents unnecessary maternal and newborn infections and deaths  Prevent sexual violence and provide assistance to survivors by ensuring protection, medical services and psychosocial support.

9  Prevent the transmission of HIV by providing guidance on standard precautions, such as making free condoms readily available and ensuring blood for transfusion is safe.  Contraceptives must be accessible from the early stages of the crisis, and more comprehensive family planning programs need to be implemented once the situation stabilizes.family planning Importance of MISP

10  Inadequate documentation of the numbers affected and services provided  poor commodity management and security,  limited availability of comprehensive abortion care, and  lack of community mobilization to increase reproductive health service uptake Challenges

11  Commitment by interagency working group (IWG) to monitor and ensure provision of SRH services  Conducive legislative environment  Commitment by National government Opportunities

12  While Remarkable progress has been achieved in addressing SRH of women and girls in humanitarian situations, the growth in need has outstripped the growth in funding and services. Conclusion

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