International Relief Agencies Provide Reproductive Health Care

Reproductive health program directors should be aware that a number of international organizations provide reproductive health care as part of their relief efforts in crisis situations. Key organizations that conduct research and training, provide monitoring and evaluation, and offer technical assistance to local organizations include agencies of the UN, several international nongovernmental organizations (NGOs), and donor agencies such as the United States Agency for International Development (USAID) and the European Commission Humanitarian Aid Office (ECHO). (See a list of organizations that focus on reproductive health care in crisis situations and their Web sites and Web Table 1)

UNHCR. The United Nations High Commissioner for Refugees leads the coordination of international response to refugee situations. Its primary purpose is to defend refugees’ rights and provide care for refugees. UNHCR supports reproductive health care for refugees worldwide (98).

RHRC Consortium. The Reproductive Health Response in Conflict Consortium, formerly the Reproductive Health for Refugees Consortium, promotes and provides reproductive health care in crisis situations. The consortium consists of seven organizations. Four provide reproductive health care directly to refugees—CARE, Marie Stopes International, the American Refugee Committee, and the International Rescue Committee. JSI Research and Training Institute and the Heilbrunn Department of Population and Family Health, Mailman School of Public Health at Columbia University, conduct research and training and provide technical assistance to local organizations. The Women’s Commission for Refugee Women and Children is an advocacy organization.

Member organizations have provided funding and technical assistance to cooperating local organizations during emergencies. The Consortium also has played a key role in developing materials, tools, and other resources for use in crisis situations (see Table 4 and Web Table 1).

The Inter-Agency Working Group on Reproductive Health in Refugee Situations. The Inter-Agency Working Group (IAWG) focuses on strengthening reproductive health care for refugees and internally displaced persons (93). The IAWG comprises about 30 organizations, including reproductive health NGOs, UN agencies, and academic institutions (62). It was established in 1995 following the first symposium on Reproductive Health in Refugee Situations, organized by the United Nations Population Fund (UNFPA) and UNHCR.

UNICEF, UNFPA, and UNRWA. Among UN agencies, the United Nations Children’s Fund (UNICEF), UNFPA, and the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) all have become increasingly involved in serving refugees (72).

Coordinating with other relief and health care organizations improves the efficiency and speed of efforts on the ground. In Sonagazi, Bangladesh, Red Crescent volunteers use a megaphone and motorcycle to broadcast cyclone warnings among rural villagers. (Photo Credit: Yoshi Shimizu, International Federation of Red Cross and Red Crescent Societies.)

UNICEF had worked in about 60 conflict-affected countries as of 2003, the date of the most recently published estimate (102). UNICEF is the lead agency in the Safe Motherhood Initiative, a global effort to reduce maternal mortality. In this role UNICEF provides clean delivery kits for use in conflict situations (89, 91). For example, in 2003 UNICEF distributed approximately 26,000 clean delivery kits to almost 100 facilities throughout Somalia (90).

UNFPA is the largest supplier of emergency reproductive health supplies and equipment (105). UNFPA currently supports emergency reproductive health projects in more than 50 countries (104, 107).

Following the 2004 tsunami UNFPA helped reproductive health care providers in Indonesia to re-establish services. UNFPA continues to provide the refugee camps with reproductive health kits for midwives and personal hygiene packs for women and girls (108). (For information on ordering reproductive health kits, see Table 4.)

UNRWA works exclusively to provide emergency aid, relief services, education, and health services to Palestinian refugees (88). These services include family planning and maternal and child health care (81, 111).

The International Medical Corps (IMC) has responded to conflicts and disasters in more than 40 countries and currently works in 20 countries. IMC helps local communities by providing reproductive health care including maternal and child health care and HIV/AIDS and STI prevention, and by providing training to increase awareness of sexual and gender-based violence (42). Health professionals from the IMC also recruit and train local doctors, nurses, and other health care providers to ensure that health programs are sustainable once the crisis has passed (41, 43).

Refugees International (RI) is an advocacy organization dedicated to improving the reproductive health of refugees. In 2004 Refugees International had programs in over 60 countries, including Sudan, where it provided relief in the Darfur region. Among its services RI addresses sexual violence, family planning, and emergency obstetric care (69).

US government agencies. Within the US government, the State Department Bureau of Population, Refugees, and Migration and the USAID Office of Foreign Disaster Assistance share primary responsibility for refugee assistance programs (87). The Office of Foreign Disaster Assistance provides substantial assistance in humanitarian crisis situations (85). Recently, USAID has provided funds for reproductive health care in crisis-affected areas of Sudan and tsunami relief in Indonesia, Sri Lanka, and elsewhere (87).

ECHO. The European Commission Humanitarian Aid Office funds refugee projects worldwide, including emergency reproductive health care (23, 109). The ECHO program, Aid for Uprooted People, focuses on creating conditions that foster longterm development. In Asia and Latin America it provides funds to refugee camps, for repatriation, and to assist with reintegration into communities (58).

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