Women and children affected by complex emergencies are subject to some of the greatest health inequities in the world. In addition to lack of primary health care, the absence of specialized reproductive health services is a leading cause of death and diseases among women and girls who are displaced by armed conflict.

The International Rescue Committee established its first reproductive health program in 1992 targeting Liberian refugee women in Ghana and Cote d’Ivoire. Today, the IRC offers a variety of reproductive health services in almost 20 countries around the world. IRC’s reproductive health programs focus on safe motherhood; family planning; control of sexually transmitted infections, including HIV; as well as prevention and response to gender-based violence. Within these priority areas, involving men and addressing the reproductive health needs of adolescents are emphasized.

In areas affected by conflict where pregnancy-related deaths are exceptionally high, IRC provides basic and comprehensive emergency obstetric care to manage complications that arise during pregnancy and childbirth. IRC trains local health workers and educates communities to ensure that women can access good quality care before, during and after giving birth.

In Pakistan where the IRC works with Afghan refugees, clinic records show that nearly all complicated deliveries in the areas where IRC works are cared for in IRC’s facilities. Due to improved access to emergency obstetric care, the maternal mortality ratio (MMR) among the refugee population served by the IRC in Pakistan is at 102 maternal deaths per 100,000 live births—significantly lower than the United Nations’ MMR estimates of 1,900 for Afghanistan and 500 in Pakistan.

IRC’s reproductive health programs provide family planning information and services to promote maternal and child health in communities where they work. IRC emphasizes the importance of birth spacing and provides a wide array of contraceptive methods. In Thailand, IRC introduced a novel way of natural family planning education — Cyclebeads, a color-coded string of beads that helps a woman know where she is in her cycle so she can be aware of her fertile days each month.

The IRC has also strengthened its campaign to control the spread of HIV especially in the prevention of HIV transmission from mother to child. In Tanzania, where the IRC works in four camps populated by Burundian and Congolese refugees, mothers visiting the IRC’s maternal and child health clinics receive pre-test counseling, testing for HIV, post-test counseling and treatment. This has resulted in a decline in the number of HIV-positive children living in the camps.

In addition to a focus on the prevention of HIV transmission, IRC provides care and support for AIDS patients, including the prevention and treatment of opportunistic infections. IRC is expanding its HIV/AIDS clinical services, with its programs in Thailand and Kenya among the first to use anti-retroviral drugs for the treatment of AIDS in humanitarian settings.

For further information:

• Reproductive Health Consortium
• Protecting the Future: A Guide to Incorporating HIV Prevention and Care Interventions in Refugee Settings
• Pain Too Deep for Tears: Assessing the Prevalence of Sexual and Gender Violence Among Burundian Refugees in Tanzania 
• The Minimum Initial Service Package (MISP) Fact Sheet
• Monitoring the implementation of the MISP

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