The 2018 Inter-agency field manual on reproductive health in humanitarian settings: revising the global standards

Abstract

Since the 1990s, the Inter-agency field manual on reproductive health in humanitarian settings (IAFM) has provided authoritative guidance on reproductive health service provision during different phases of complex humanitarian emergencies. In 2018, the Inter-Agency Working Group on Reproductive Health in Crises will release a new edition of this global resource. In this article, we describe the collaborative and inter-sectoral revision process and highlight major changes in the 2018 IAFM. Key revisions to the manual include repositioning unintended pregnancy prevention within and explicitly incorporating safe abortion care into the Minimum Initial Service Package (MISP) chapter, which outlines a set of priority activities to be implemented at the outset of a humanitarian crisis; stronger guidance on the transition from the MISP to comprehensive sexual and reproductive health services; and the addition of a logistics chapter. In addition, the IAFM now places greater and more consistent emphasis on human rights principles and obligations, gender-based violence, and the linkages between maternal and newborn health, and incorporates a diverse range of field examples. We conclude this article with an outline of plans for releasing the 2018 IAFM and facilitating uptake by those working in refugee, crisis, conflict, and emergency settings.

How gains for SRHR in the UN have remained possible in a changing political climate

“…The affirmation of the MISP within an HRC resolution adopted by consensus is particularly significant, given that the MISP had been revised in 2018 to explicitly incorporate safe abortion care. 42 What has contributed to making these gains possible Political stream: self-reinforcing feedback dynamics within the HRC The nature of political negotiations within the UN appears to partially shelter bodies like the HRC from some of the major regressions that anti-SRHR actors may seek. The language in HRC resolutions draws extensively from previously agreed language from the HRC and from other relevant UN bodies like the UN CSW or the UN GA. ** Such previously agreed language is often referred to as the "lowest common denominator".…”

Neonatal Mortality Burden and Trends in UNHCR Refugee Camps, 2006-2017: A Retrospective Analysis

“…Operations in 2014-2015. 9,26 The across and within country variation in NMR, and lack of change over time, suggests that concerted efforts are needed to further understand and address neonatal mortality. UNHCR has already begun this work in some settings, including the establishment of a neonatal mortality audit system in Jordan, and projects focused on improving access to quality health services for women and newborns in Cameroon, Chad, Jordan, Kenya,…”

“…7,8 Although the widely referenced 2018 Interagency Field Manual for Reproductive Health in Humanitarian Crises explicitly highlights the importance of focusing on the maternal-newborn dyad, and the Newborn Health in Humanitarian Settings Field Guide summarizes existing evidence-based guidelines for interventions aimed at reducing neonatal mortality, limited information exists on the implementation or outcomes of these interventions in humanitarian contexts. 9,10 Humanitarian contexts are diverse, with varying population dynamics, burden of disease, economic opportunities, and health system capacity. Across the globe, the number of individuals who have been forcibly displaced as a result of con ict, persecution or human rights violations is at an all-time high.…”

Exploring Congolese refugees’ experiences with abortion care in Uganda: a multi-methods qualitative study

“…1 Although reliable data on abortion in refugee, crisis, and conflict settings is limited, humanitarian stakeholders and agencies recognise the value of abortion as a life-saving procedure 10 and unintended pregnancy is a significant public health issue in humanitarian settings. 9,[39][40] Therefore, efforts to ensure access to safe abortion care for all women, including refugees and displaced populations, must continue. 41 Indeed, the 2018 Interagency Field Manual for Reproductive Health in Humanitarian Settings now provides greater clarity on the need to provide safe abortion care, to the full extent of the law, in different phases of humanitarian emergencies.…”

“…41 Indeed, the 2018 Interagency Field Manual for Reproductive Health in Humanitarian Settings now provides greater clarity on the need to provide safe abortion care, to the full extent of the law, in different phases of humanitarian emergencies. [39][40] This is an important step in increasing access to safe abortion care.…”