Refugees and Reproductive Health

This year marks the fifth anniversary of the International Conference on Population and Development (ICPD) Programme of Action, which challenged relief agencies to meet the historically neglected right of refugees to reproductive healthcare (RH). As part of the process of the ‘ICPD+5’ review, agencies involved in providing reproductive healthcare for refugees have focused on assessments of country level experiences in translating ICPD recommendations into real action. The ICPD Programme of Action defines RH as:

A state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.

The reality, however, could not be more different.

Legally, rape is one of the most violent crimes that can be committed against a person (second only to murder), yet society tends to punish the victim more severely than the perpetrator. Women who survive rape in the context of a complex emergency suffer triple trauma: the trauma of war, the trauma of rape, and the trauma of social stigma. Programmes to address rape and other forms of sexual and gender-based violence are a component of comprehensive RH services for refugees. Other components are: safe motherhood including emergency obstetrics, family planning, and the prevention and treatment of sexually transmitted diseases.

Action taken

The Reproductive Health for Refugees (RHR) Consortium was established in 1995 in response to the ICPD Programme of Action. It is committed to promoting comprehensive reproductive health programs for all refugee women, men and adolescents.

The RHR Consortium is active in the UNHCR/UNFPA-sponsored InterAgency Working Group on Refugee Reproductive Health and USAID’s Reproductive Health for Refugees Working Group. Agency members of the consortium provide RH services in more than 30 refugee settings worldwide. The consortium has developed training modules and needs assessment tools, established an advocacy group of refugee women from around the world, and implements a small grants program. Currently in development is a set of monitoring and evaluation tools for RH in refugee settings.

The RHR Consortium’s five-day Training Program for Health Personnel on Reproductive Health Service Delivery in Refugee Settings is now available from CARE. (Contact Dorothy Ngalame on ngalame@care.org). There is currently no charge for production or shipping but, as supplies are limited, priority is given to organisations currently implementing or planning to implement RHR projects in the field. Dorothy should also be contacted for copies of the one-day Introduction to Reproductive Health Issues in Refugee Settings produced by the consortium in 1998.

The RHR Consortium’s small grants program is intended to contribute to the consortium’s goal of institutionalising comprehensive reproductive health services in refugee settings worldwide by supporting local NGOs which address RH issues. Institutionalisation activities might include testing approaches to assessment, design and implementation; providing reproductive health services; advocacy; developing protocols, manuals or training materials; performing in-service training; conducting evaluations; and organising regional or national conferences or meetings. Proposals are accepted for review on an ongoing basis. For specific criteria, email Meriwether Beatty at meriwether_beatty@jsi.com.

The ICPD review

The RHR Consortium, along with programme and donor countries, the UN system and representatives of civil society, other NGOs and the private sector, is currently reviewing progress on the ICPD Programme of Action. A series of activities are underway which will culminate in the UN Special Session in June.

Last November UNFPA sponsored a technical meeting in Rennes, France on Reproductive Health in Crisis Situations. It was noted that, although a great deal of effort has lead to progress on this front, a greater amount of work is still needed: while agencies are active, information diss-emination is not widespread. Greater priority must be given to dissemination strategies in order to share lessons learned.

In February, assessments of (non-crisis) country-level experiences in translating ICPD recommendations into programmes and actions were discussed at a forum in The Hague. At that meeting delegates noted that education and reproductive health programs remain underfunded.

The UN Commission on Population and Development (CPD) also held a preparatory meeting for a Special Session of the General Assembly from 22–30 March where UN member states and representatives of civil society considered a draft report of the Secretary General on the further implementation of the ICPD Programme of Action. The draft report contains key future actions in the areas of population and development.

Contact:
Susan Purdin
Global Technical Advisor for the RHR Consortium
American Refugee Committee
BP 4997
Conakry
Guinea
Fax/Tel: (+224) 42 20 27
Email: sjpurdin@aol.com or susan@irckenya.org

Kate Burns
Senior Programme Officer
Reproductive Health
UNHCR
Email: burns@unhcr.ch

For information on the ICPD Programme of Action: http://www.unfpa.org/public/icpd

Correction [Published in RRN Newsletter 15]

In the article entitled Refugees and Reproductive Health printed in the last RRN Newsletter we would like to make the following correction: The establishment of the RHR Consortium was not ‘a result of ICPD.’ In fact the impetus for establishment of the consortium came from the initiative of Carolyn Makinson at the Mellon Foundation who, in August 1994, called together representatives of CARE, IRC, the Women’s Commission, JSI and MSI and asked them if they would be willing to establish a consortium to tackle the problem of reproductive health for refugees. Subsequently the agencies submitted proposals and were awarded funds from Mellon Foundation in March 1995.