Reproductive Health In Emergency Management

1. Reproductive HealthIn Emergency Management Dr. Nahida Al-Lawati DCH, MRCGP [INT], MSC Community Gynaecology and Reproductive Health

2. What are the elements of the reproductive health? Safe motherhood, including emergency obstetric care; Family planning; Prevention and care of STD and HIV; Sexual violence (against females);

3. What are the priorities in the emergency? • Re-establish normal services as soon as possible • To have clear guidance for local staff of the case management of individuals whose treatment has been disrupted or delayed

4. If significant delay in the resumption of normal services is expected, temporary reproductive health services may need to be established to meet existing and evolving needs.

5. What is the impact of disasters and emergencies on the components of reproductive health programs?

6. High mortality rates among women and children; Increase in STD and HIV/AIDS; Increase in unsafe abortion; Increase in morbidity related to high fertility rates and poor birth spacing

7. Reproductive Health need assessment to identify the type and the extent of reproductive health services needed by the affected population.

8. Demographic Profile: • Total population • Number of women of reproductive age • Number of children 0-15 years • Number of children 0-5 years • Number of female headed households • Estimated number of pregnant women

9. Health Status • Crude birth rate • Maternal Mortality Rate/Ratio • Total Fertility Rate

10. Available services and resources: • Extent and condition of existing health facilities • Staffing and coverage • Inventories of equipment, drugs, and commodities

11. Setting Priorities: • List the problems observed through the assessment exercise. • Consider each problem in terms of: prevalence, seriousness, feasibility of control, community acceptance. • Score each problem and identify the problems that have ranked highest.

12. Setting Goals and Objectives: • Acute emergency phase • Post-emergency phase

13. Acute Emergency Phase: Goals: • Co-ordinate and implement the MISP • Prevent excess neo-natal and maternal morbidity and mortality Objectives: • Promote clean home deliveries by providing clean delivery kits. • Organise a 24 hour referral system for obstetric emergencies • Identify qualified and experienced staff to co-ordinate reproductive health services.

14. Post-Emergency Phase: Goals: • Reduce levels of maternal mortality and morbidity in the population • Reduce the levels of unmet needs for contraception. Objectives: • Improve medical staff skills at the referral clinic level within 6 months. • Ensure local clinic is well equipped with materials and equipments to handle obstetric emergencies by the end of the third month. • Procure sufficient and appropriate contraceptives for post emergency needs within three months.

15. Detailed Plan of Action: • What are the activities • How they will be conducted • When • By whom

17. Considering Constraints and Changes • Cultural taboos about discussing human sexuality • The prevalence of high-risk sexual behavior • Discriminatory social practices • Reproductive health care is not considered a priority as people are focusing only on their immediate survival needs.

18. Identifying resources: • Human resources: adequate and well-trained staff, from the affected population. • Material resources: should rely mainly on local resources.

20. Monitoring and Evaluation • Regular monitoring is necessary for reviewing the progress of each activity in reaching the objectives. • In detecting reproductive health needs. • Two or three indicators should be selected for each activity. • Various tools: forms, registers, reports, etc.

21. Evaluation of the concerned program provides important lessons about designing future activities. • Help donors to determine the impact of their investment. • Results should be shared with all project participants, partners and beneficiaries. • Pre-defines goals, objectives and indicators should serve as the basis for the evaluation.

22. Thank You