Humanitarian response to reproductive and sexual health needs in a disaster: the Nepal Earthquake 2015 case study

Abstract

This case study describes the health response provided by the Ministry of Health of Nepal with support from UN agencies and several other organisations, to the 1.4 million women and adolescent girls affected by the major earthquake that struck Nepal in April 2015. After a post-disaster needs assessment, the response was provided to cater for the identified sexual and reproductive health (RH) needs, following the guidance of the Minimum Initial Service Package for RH developed by the global Inter-Agency Working Group. We describe the initiatives implemented to resume RH services: the distribution of medical camp kits, the deployment of nurses with birth attendance skills, the organisation of outreach RH camps, the provision of emergency RH kits and midwifery kits to health facilities and the psychosocial counselling support provided to maternity health workers. We also describe how shelter and transition homes were established for pregnant and post-partum mothers and their newborns, the distribution of dignity kits, of motivational kits for affected women and girls and female community health volunteers. We report on the establishment of female-friendly spaces near health facilities to offer a multisectoral response to gender-based violence, the setting up of adolescent-friendly service corners in outreach RH camps, the development of a menstrual health and hygiene management programme and the linkages established between adolescent-friendly information corners of schools and adolescent-friendly service centres in health facilities. Finally, we outline the gaps, challenges and lessons learned and suggest recommendations for preparedness and response interventions for future disasters.

A forgotten group during humanitarian crises: a systematic review of sexual and reproductive health interventions for young people including adolescents in humanitarian settings

“…After full-text screening, 14 articles (i.e. 9 peer-reviewed studies [27–35] and 5 grey literature articles [36–40]) met our inclusion criteria and were included in the review (Fig. 1).…”

“…One participant noted that the use of theatre and dance “created trust and opened a space in which these matters could be discussed” [29]. Improved awareness of and attitudes to SRH among adolescents, caregivers and health workers.Availability of and access to services remained a problem.Chaudhary et al (2017)Peer-reviewed [35]Case studyHigh qualityNepalRuralNatural disaster (Acute)Adolescent girls and boys(Age not specified)Establishment of an ASRH working group.Adolescent-friendly service corners set up in reproductive health camps, run by trained adolescent facilitators and volunteers.Establishment of linkages between adolescent-friendly corners and adolescent-friendly services in health facilities.Implementer: Nepal Ministry of Health, UNFPA, World Health Organization (WHO)Donor: Not specifiedAdolescent-friendly corners served over 4231 young people. More than 14,666 adolescents received ASRH services overall.Tanabe et al2012 [38]Grey literatureCase studyHigh qualityThailandPeri-urbanArmed conflict (Protracted)Migrant adolescentsAges 15–24Youth centre- based workshops covering: reproductive anatomy, physical and emotional changes during adolescence, FP, sex and gender, HIV/STI transmission and prevention, consequences of unsafe abortion.Implementer: Adolescent Reproductive Health NetworkDonor: Not specifiedNumbers of new and repeat FP clients decreased form May–June 2011 to May–June 2012.…”

Sexual and reproductive health and rights in humanitarian crises at ICPD25+ and beyond: consolidating gains to ensure access to services for all

“…4 In Nepal, the Ministry of Health coordinated the implementation of the MISP after the 2015 earthquake. 5 In the Philippines, community groups have been trained on SRHR and disaster risk reduction throughout the country. 6…”

“…Despite increases in financial support to SRHR in humanitarian settings since the ICPD, funding remains inadequate to meet the needs of the growing crisis-affected communities. 5 Between 2009 and 2013 there was a significant increase in the number of humanitarian proposals with an SRHR component, but with critical gaps. 5 For example, while the largest share of funds was allocated to maternal and newborn care, it fell short of meeting the programmatic needs.…”

“…5 Between 2009 and 2013 there was a significant increase in the number of humanitarian proposals with an SRHR component, but with critical gaps. 5 For example, while the largest share of funds was allocated to maternal and newborn care, it fell short of meeting the programmatic needs. Family planning comprised the lowest proportion of funding received, while proposals including abortion were practically nonexistent.…”