This document discusses the importance of reproductive health and family planning services for refugees. It notes that during crises, access to these services is often limited but can help reduce maternal and newborn deaths as well as prevent unwanted pregnancies. While support for reproductive health programs has increased since the 1990s, there are still gaps in implementation, funding, and meeting minimum standards. The document advocates for host countries and donors to ensure laws and funding allow comprehensive reproductive health and family planning services to be provided to refugees.

1. Sudanese refugees in the Tréguine camp in Chad. ACT/LWF/DWS_Chad/Anna Palmén
Access to reproductive health (RH) is both a right and a need, but in
crises these services are not always available or a priority. Providing
reproductive care to those in need would substantially reduce maternal
deaths, new born deaths and unintended pregnancies. During crises,
women and girls are also at greater risk for sexual abuse and exploitation,
including rape. RH programs can offer life-saving protection from sexually
transmitted infections (STIs), unwanted pregnancies and unsafe
abortions, life-threatening pregnancies, and provide neo-natal care for
both mother and child.

2. Women in Bongouanou, Côte d'Ivoire. UN Photo/Hien Macline
Family planning (FP) allows individuals and couples to plan for, and have their
desired number of children; however, over 200 million women worldwide who
want to use contraceptives don’t have access to them. Family planning
benefits extend beyond meeting family size-desires. In precarious situations,
like those refugees find themselves in, smaller families are more financially
sustainable and have more potential for economic well-being. This is
especially important to refugees who have lost everything, and must start over
in means of employment and income generation.

3. Seeking reproductive healthcare in Garhi Habibullah, Pakistan. UN Photo/Evan Schneider
Since the mid 1990s, there has been significant advocacy done to move forward
reproductive health rights and programs for refugees. With the creation of the
Inter-agency Working Group on Reproductive Health in Refugee Situations
(IAWG), further awareness has been raised, and minimum standards guidelines
and protocol were developed. However, there are still great gaps in universal
implementation, minimum standards, and provisions of education and
contraception. A severe lack of funding also negatively impacts the provision of
reproductive health and family planning across emergencies and crises.

4. A woman receives FP care in the Democratic Republic of Congo. Pathfinder International
Family planning leads to better nutrition for children, improves access to
educational and livelihood opportunities (especially for women and girls),
and allows families to better manage their scarce resources. It is
important that FP is included in broader reproductive health initiatives,
which ideally include safe pregnancy/motherhood, nutrition, HIV/AIDS
and STI prevention, and sexual- and gender-based violence. The
integration of services will better meet refugees’ present and future
needs, as well as improve program efficiency and effectiveness of
services.

5. A new family in Rwamawanja Refugee Camp in Uganda. UNFPA
Reproductive health practices traditionally start with the household and
community, but as societal fabrics and infrastructure are broken during
crises, refugees turn to organizations on the ground. Due to lack of
funding or stipulations of host countries, these programs are not always
available. Where implemented, in addition to healthcare, programs should
offer RH education to both men and women. In many instances, family
planning decisions are deferred to men, though some women feel so
strongly about receiving this care, they seek out assistance unbeknownst
to their fathers or husbands. Including men helps alleviate some of their
hesitation towards family planning methods. Good reproductive health
benefits all of the family’s health and finances – something that tends to
resonate with all family members.

6. A Hmong mother and child in a northern province of Vietnam. Nguyen Huy Kham/Courtesy Reuters
Religion and cultural traditions also play roles in family planning. Many
norms dictate that women have little control over sexual or reproductive
decisions, and beyond this, have little input regarding family income.
However, many refugees find themselves in desperate need for
additional income. Women with larger numbers of children are less able
to participate in income generating activities. Family planning can put
women back in control of their reproductive rights, and also allow them
the opportunity to pursue employment outside of the home. Reproductive
healthcare also ensures healthier children, which alleviates the need for
women to stay home to care for the sick.

7. Waiting for healthcare in the Oecusse District on the border area between Timor-Leste and Indonesia. UN Photo/Martine Perret
While support for these programs has increased since the 1990s,
consistency and availability varies greatly by country, organization and
setting. Especially during the emergency phase, reproductive health
and family planning are not only in great need, but are also life saving
programs. Much more needs to be done to improve services and to
adequately meet the needs of all women who currently need, but do
not have access to, modern reproductive health or family planning
methods.

8. A mother and her children in Haiti. WRC
Host countries should respect the rights of all refugees, inclusive of
reproductive health and family planning. Laws, policies and access must be
adequately addressed to allow programs to proceed. Donors should also
continue funding programs to ensure quality services and equipment are
provided, regardless of the duration of the crisis. Organizations must
continue their advocacy, and better educate the communities they work with
to encourage them to use modern methods to prevent illness and death.
Organizations must also participate in better information sharing, and
universal use of minimum standards in order to ensure quality education
and care is provided in all emergencies and crises.