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Conflict and Health Journal CONTENTS CONFLICT AND HEALTH 2 Advancing reproductive health on the humanitarian agenda: the 2012-2014 global review Sarah K Chynoweth CONFLICT AND HEALTH 17 Evaluations of reproductive health programs in humanitarian settings: a systematic review Sara Casey CONFLICT AND HEALTH 36 Tracking humanitarian funding for reproductive health: a systematic analysis of health and protection proposals from 2002-2013 Mihoko Tanabe, Kristen Schaus, Sonia Rastogi, Sandra K Krause, Preeti Patel BJOG : An International Journal of Obstetrics and Gynaecology 55 Tracking official development assistance for reproductive health in conflict-affected countries: 2002—2011 Mihoko Tanabe, Kristen Schaus, Sonia Rastogi, Sandra K Krause, Preeti Patel i CONFLICT AND HEALTH 72 Progress and gaps in reproductive health services in three humanitarian settings: mixed-methods case studies Sara E Casey, Sarah K Chynoweth, Nadine Cornier, Meghan C Gallagher, Erin E Wheeler CONFLICT AND HEALTH 94 Reproductive health services for Syrian refugees in Zaatri Camp and Irbid City, Hashemite Kingdom of Jordan: an evaluation of the Minimum Initial Services Package Sandra Krause, Holly Williams, Monica A Onyango, Samira Sami, Wilma Doedens, Noreen Giga, Erin Stone, Barbara Tomczyk CONFLICT AND HEALTH 110 Retrospective analysis of reproductive health indicators in the United Nations High Commissioner for Refugees post-emergency camps 2007–2013 Jennifer Whitmill, Curtis Blanton, Sathyanarayanan Doraiswamy, Nadine Cornier, Marian Schilperood, Paul Spiegel and Barbara Tomczyk PLOS ONE 128 Developing Institutional Capacity for Reproductive Health in Humanitarian Settings: A Descriptive Study Nguyen-Toan Tran, Angela Dawson, Janet Meyers, Sandra Krause, Carina Hickling, Inter-Agency Working Group (IAWG) on Reproductive Health in Crisis ii Chynoweth Conflict and Health 2015, 9(Suppl 1):I1 http://www.conflictandhealth.com/content/9/S1/I1 INTRODUCTION Open Access Advancing reproductive health on the humanitarian agenda: the 2012-2014 global review Introduction agencies, national and international The global landscape for reproductive health nongovernmental organizations (NGOs), in humanitarian settings has changed government agencies, donors, and academic dramatically since the International institutions established the Inter-agency Conference on Population and Development Working Group on Reproductive Health in (ICPD) in 1994. Mainstreaming of Crisesa (IAWG), an international network reproductive health into humanitarian health dedicated to improving the reproductive responses has grown, and awareness of the health of communities affected by conflict consequences of neglecting reproductive and natural disaster. IAWG arose from a health services, such as maternal and growing concern with the lack of attention neonatal mortality, HIV transmission, and to reproductive health, despite increasing unsafe abortion, has expanded. Despite these evidence of its need in emergency settings advances, significant gaps remain, and [3]. In its first decade, IAWG made large meeting the reproductive health needs of strides in advancing reproductive health crisis-affected communities is more urgent through advocacy, research, standard setting, than ever: the United Nations High and guidance development, including the Commissioner for Refugees (UNHCR) publication of the seminal Reproductive Health reported that 51.2 million people remained for Refugees: An Inter-agency Field Manual [4]. forcibly displaced due to conflict and The Field Manual was the first technical persecution by the end of 2013—the largest guidance on implementing reproductive number since World War II [1]. An additional health in emergencies and articulated a 22 million were displaced in 2013 by natural minimum standard in reproductive health disasters [2]. Figure 1. service delivery—the Minimum Initial A concentrated effort to address Service Package (MISP) for Reproductive reproductive health in emergencies Health.b IAWG also supported the creation commenced in 1995 when a coalition of UN of the Interagency Reproductive Health Kits, twelve kits of essential medicines and Correspondence: [email protected] supplies, to support rapid implementation of University of New South Wales, High St, Kensington, NSW 2052, Australia the MISP [5]. @ 2015 Chynoweth; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. 1 Chynoweth Conflict and Health 2015, 9(Suppl 1):I1 http://www.conflictandhealth.com/content/9/S1/I1 Figure 1 By the early 2000s, IAWG and its UN Population Fund (UNFPA), IAWG and partners—including the Reproductive Health partners drafted the Granada Consensus on Response in Crises (RHRC) Consortiumc— Sexual and Reproductive Health during had achieved substantial gains. A 1999 study Protracted Crises and Recovery, which documented an increase in evidence, reaffirmed comprehensive reproductive funding, policies, conferences, and new health as a right in protracted settings and NGOs addressing reproductive health in fragile states [11]. The following year IAWG emergencies, reflecting marked progress in released an updated field-test version of the advancing reproductive health on the global Field Manual, which included an extra humanitarian agenda [6]. From 2002 to 2004, chapter dedicated to comprehensive abortion IAWG undertook its first global evaluation care—a particularly neglected area in to assess progress [7]. The findings reproductive health service provision—as confirmed advancements at the policy and well as outlined additional priority activities implementation levels since the mid-90s, but to the MISP [12]. IAWG also served as a significant gaps continued across all technical platform to spearhead two ground-breaking, areas, specifically maternal and newborn complementary programs: the Reproductive health, family planning, gender-based health Access, Information and Services in violence, and HIV and other sexually Emergencies (RAISE) Initiative, which transmitted infections (STIs). focuses on expanding comprehensive IAWG’s second decade, from 2004 to reproductive health services in crises, and the 2014, saw the maturation of the coalition Sexual and Reproductive Health Programme and further advancements to institutionalize in Crisis and Post-Crisis Situations reproductive health into humanitarian health (SPRINT), which works to enhance access responses and improve access to services. to the priority services of the MISP. These Members successfully advocated integrating initiatives are among the first international the MISP as a minimum health standard in efforts to systematically scale up capacity and the 2004 and 2011 revisions of the Sphere implementation of reproductive health Humanitarian Charter and Minimum services in emergencies at the national level. Standards in Disaster Response and the Membership expanded as IAWG actively Inter-Agency Standing Committee Health sought to decentralize and establish regional Cluster Guide[8,9]. Through IAWG’s networks. By the end of 2014, IAWG had advocacy, the MISP was included as a life- 1,680 individual members representing 124 saving activity eligible for Central Emergency countries and 450 different agencies—a Response Fund funding [10]. In 2009, led by significant increase from approximately 50 the World Health Organization (WHO) and members in 2004. With more members, 2 Chynoweth Conflict and Health 2015, 9(Suppl 1):I1 http://www.conflictandhealth.com/content/9/S1/I1 IAWG was able to establish regional chapters additional studies, not yet published, include as well as roughly ten sub-working groups on a long-term trend analysis study that tracked specialized issues related to reproductive official development assistance for health, such as new technologies, urban reproductive health to 18 conflict-affected displacement, and disaster risk reduction. countries for 2002 to 2011 (unpublished Indeed, IAWG’s disaster risk reduction and observations, Patel, Dahab, Tanabe, Murphy, emergency preparedness efforts, including Ettema, Guy, Roberts), a retrospective the SPRINT Initiative and the reproductive analysis of selected reproductive health health group within the UN International indicators from UNHCR’s Health Strategy for Disaster Reduction, have helped Information System across 56 refugee camps promote a comprehensive approach to in ten countries from 2007 to 2013 reproductive health that considers both pre- (unpublished observations, Whitmill, and post-crisis phases. IAWG has galvanized Tomczyk, Blanton, Doraiswamy, Haskew, the field despite lack of sustained, dedicated Cornier, Schilperood, Spiegel), and a survey funding since the coalition’s inception. of humanitarian and development agencies From 2012 to 2014, IAWG conducted a that explored changes in their capacity to second global review to assess progress, address reproductive health in crises since document gaps, and determine future 2004 (unpublished observations, Tran, directions. Seven complementary studies Dawson, Meyers, Krause, Hickling). The were undertaken to provide a snapshot of findings revealed substantial progress since the field. The studies build on those 2004—reproductive
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