Tran Nguyen-Toan, Dawson Angela, Meyers Janet, Krause Sandra, Hickling Carina
School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
WHO Collaborating Centre, Faculty of Health, University of Technology, Sydney, Australia.
PLoS One. 2015 Sep 2;10(9):e0137412. doi: 10.1371/journal.pone.0137412. eCollection 2015.
Institutions play a central role in advancing the field of reproductive health in humanitarian settings (RHHS), yet little is known about organizational capacity to deliver RHHS and how this has developed over the past decade. This study aimed to document the current institutional experiences and capacities related to RHHS.
Descriptive study using an online questionnaire tool.
Respondents represented 82 institutions from 48 countries, of which two-thirds originated from low-and middle-income countries. RHHS work was found not to be restricted to humanitarian agencies (25%), but was also embraced by development organizations (25%) and institutions with dual humanitarian and development mandates (50%). Agencies reported working with refugees (81%), internally-displaced (87%) and stateless persons (20%), in camp-based settings (78%), and in urban (83%) and rural settings (78%). Sixty-eight percent of represented institutions indicated having an RHHS-related policy, 79% an accountability mechanism including humanitarian work, and 90% formal partnerships with other institutions. Seventy-three percent reported routinely appointing RH focal points to ensure coordination of RHHS implementation. There was reported progress in RHHS-related disaster risk reduction (DRR), emergency management and coordination, delivery of the Minimum Initial Services Package (MISP) for RH, comprehensive RH services in post-crisis/recovery situations, gender mainstreaming, and community-based programming. Other reported institutional areas of work included capacity development, program delivery, advocacy/policy work, followed by research and donor activities. Except for abortion-related services, respondents cited improved efforts in advocacy, capacity development and technical support in their institutions for RHHS to address clinical services, including maternal and newborn health, sexual violence prevention and response, HIV prevention, management of sexually-transmitted infections, adolescent RH, and family planning. Approximately half of participants reported that their institutions had experienced an increase in dedicated budget and staff for RHHS, a fifth no change, and 1 in 10 a decrease. The Interagency RH Kits were reportedly the most commonly used supplies to support RHHS implementation.
The results suggest overall growth in institutional capacity in RHHS over the past decade, indicating that the field has matured and expanded from crisis response to include RHHS into DRR and other elements of the emergency management cycle. It is critical to consolidate the progress to date, address gaps, and sustain momentum.
在人道主义环境中推进生殖健康领域(RHHS),各机构发挥着核心作用,但对于提供生殖健康和生殖健康服务的组织能力以及在过去十年中其如何发展,人们了解甚少。本研究旨在记录当前与生殖健康和生殖健康服务相关的机构经验和能力。
使用在线问卷工具进行描述性研究。
受访者代表来自48个国家的82个机构,其中三分之二来自低收入和中等收入国家。发现生殖健康和生殖健康服务工作并不局限于人道主义机构(25%),发展组织(25%)以及具有人道主义和发展双重任务的机构(50%)也参与其中。各机构报告称与难民(81%)、境内流离失所者(87%)和无国籍人士(20%)合作,工作地点包括营地(78%)、城市(83%)和农村地区(78%)。68%的受访机构表示有与生殖健康和生殖健康服务相关的政策,79%有包括人道主义工作在内的问责机制,90%与其他机构有正式伙伴关系。73%报告称经常任命生殖健康协调人以确保生殖健康和生殖健康服务实施的协调。据报告,在与生殖健康和生殖健康服务相关的减少灾害风险(DRR)、应急管理与协调、提供生殖健康最低初始服务包(MISP)、危机后/恢复情况下的全面生殖健康服务、性别平等主流化以及基于社区的项目规划方面取得了进展。其他报告的机构工作领域包括能力发展、项目实施、宣传/政策工作,其次是研究和捐助活动。除了与堕胎相关的服务外,受访者提到其机构在宣传、能力发展和技术支持方面做出了更多努力,以提供包括孕产妇和新生儿健康、性暴力预防与应对、艾滋病毒预防、性传播感染管理、青少年生殖健康和计划生育在内的临床服务。约一半的参与者报告称其机构用于生殖健康和生殖健康服务的专项预算和工作人员有所增加,五分之一表示没有变化,十分之一表示有所减少。机构间生殖健康工具包据报道是支持生殖健康和生殖健康服务实施最常用的用品。
结果表明,过去十年中生殖健康和生殖健康服务的机构能力总体有所增长,这表明该领域已从危机应对走向成熟并得以扩展,将生殖健康和生殖健康服务纳入减少灾害风险及应急管理周期的其他要素。巩固迄今取得的进展、弥补差距并保持发展势头至关重要。