Reproductive Health for Displaced Populations

The provision of reproductive health (RH) services by humanitarian agencies to displaced populations is relatively new. Until recently, the needs of displaced people in emergency settings were often ignored. During the eighties, attempts were made to address the problem, and in the last few years increasing attention has been paid to these needs in emergency contexts. In particular, recognition of the major threat posed by STDs and AIDS and growing media attention to sexual violence among displaced populations has highlighted the importance of the RH agenda in emergency settings. Alongside changes in RH provision in stable settings, the move to implement RH services for displaced populations was accelerated after the International Conference on Population and Development in 1994. The Conference set reproductive health within a rights framework and highlighted the needs of displaced populations.

However, despite the increased recognition of RH concerns in emergencies, in reality the agenda has proved difficult to implement. Some aspects raise ethical and moral concerns to which humanitarian agencies have different attitudes. Bilateral agencies, non-governmental organisations and donors are grappling with difficult decisions as to what services they should provide and how to ensure services are safe and effective. This is also happening in stable settings. In the absence of good data on both needs and impact of RH service provision in emergencies, much of the emphasis on safe provision falls to the judgement of field based practitioners, with important implications for training and appropriate resourcing at that level. In this paper available information about reproductive health among displaced populations is presented. Policies of a number of actors are also described and examples of current RH programmes and the issues facing those attempting to implement them are explored.