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附带损害:冲突地区被忽视的生殖健康危机。

Collateral damage: the overlooked reproductive health crisis in conflict zones.

作者信息

Okeke Sylvester Reuben, Okeke-Obayemi Deborah Oluwatosin, Njoroge Monicah Ruguru, Yaya Sanni

机构信息

Centre for Social Research in Health, UNSW Sydney, Sydney, Australia.

School of Population Health, UNSW Sydney, Sydney, Australia.

出版信息

Reprod Health. 2024 Dec 27;21(1):198. doi: 10.1186/s12978-024-01941-8.

Abstract

Conflict-affected regions face severe reproductive health challenges that disproportionately impact adolescent girls and young women (AGYW) and children, who are especially vulnerable due to the breakdown of healthcare systems and limited access to essential services. AGYW are at heightened risk due to restricted access to family planning, prenatal care, and emergency obstetric services, while children face malnutrition, disease outbreaks, and developmental delays. These challenges have profound long-term consequences for both their physical and psychological well-being. This commentary explores the underlying causes of reproductive health challenges in conflict zones, including the collapse of healthcare infrastructure, increased sexual violence, forced displacement, and the specific vulnerabilities AGYW and children face. The commentary underscores the urgent need for interventions that address both immediate and systemic gaps in reproductive healthcare, particularly for AGYW and children. A unique policy framework is proposed, integrating emergency reproductive health interventions-such as mobile clinics and emergency health kits-with long-term strategies for rebuilding healthcare systems. The framework emphasizes gender-sensitive, context-specific approaches and sustained investments in healthcare infrastructure to effectively address these challenges and mitigate the long-term effects on vulnerable populations. By aligning with global and regional policy frameworks, including the Inter-Agency Working Group on Reproductive Health in Crises (IAWG) and the Minimum Initial Service Package (MISP), the commentary advocates for embedding reproductive health into all phases of humanitarian action-from emergency response to recovery. This integrated approach provides actionable recommendations to improve the well-being of AGYW, children, and other vulnerable populations, fostering sustainable advancements in reproductive health outcomes.

摘要

受冲突影响的地区面临着严峻的生殖健康挑战,这些挑战对少女和年轻女性以及儿童产生了不成比例的影响,由于医疗系统的崩溃和基本服务获取机会有限,他们尤其脆弱。由于计划生育、产前护理和紧急产科服务的获取受限,少女和年轻女性面临的风险更高,而儿童则面临营养不良、疾病爆发和发育迟缓的问题。这些挑战对他们的身心健康都产生了深远的长期影响。本评论探讨了冲突地区生殖健康挑战的根本原因,包括医疗基础设施的崩溃、性暴力增加、被迫流离失所,以及少女和年轻女性以及儿童所面临的特殊脆弱性。评论强调迫切需要采取干预措施,解决生殖保健方面的直接和系统性差距,特别是针对少女和年轻女性以及儿童的差距。提出了一个独特的政策框架,将紧急生殖健康干预措施(如流动诊所和紧急医疗包)与重建医疗系统的长期战略相结合。该框架强调对性别问题有敏感认识、因地制宜的方法,以及对医疗基础设施的持续投资,以有效应对这些挑战,并减轻对弱势群体的长期影响。通过与全球和区域政策框架保持一致,包括危机中生殖健康问题机构间工作组(IAWG)和最低限度初始服务包(MISP),评论主张将生殖健康纳入人道主义行动的所有阶段——从应急响应到恢复。这种综合方法提供了可操作的建议,以改善少女和年轻女性、儿童以及其他弱势群体的福祉,促进生殖健康成果的可持续进步。

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