scholarly journals Factors affecting the implementation of the Minimum Initial Service Package (MISP) for reproductive health during crisis: the case of Eritrean refugees in northern Ethiopia

2020 ◽  
Author(s):  
Alemayehu Bayray Kahsay ◽  
Alemshet Teshale Haftu ◽  
Afewerki Tesfahunegn Nigusse
Keyword(s):  
Reproductive Health ◽  
Sexual Violence ◽  
Sexual And Reproductive Health ◽  
Home Country ◽  
Refugee Camp ◽  
Health Needs ◽  
Reproductive Age ◽  
Factors Associated ◽  
Service Package ◽  
Women And Girls

Abstract Background: The Minimum Initial Service Package (MISP) is a series of crucial actions required to respond to reproductive health needs at the onset of every humanitarian crisis. Moreover, MISP is a coordinated priority activity to prevent and manage the consequences of sexual violence; prevent excess maternal and newborn morbidity and mortality; reduce HIV transmission; and plan for comprehensive RH services beginning in the early days and weeks of an emergency. During conflicts, natural disasters and public health emergencies, sexual and reproductive health needs are often overlooked. Women and girls may lose access to family planning services, exposing them to unintended pregnancy in dangerous conditions. Women and girls also become more vulnerable to sexual violence, exploitation and HIV infection. In this article we document the practices and factors associated with availability and implementation of services as measured by the MISP for reproductive health in the Eritrean refugee camp, Northwestern zone of Tigray, Ethiopia. Methods: we conducted an institution based cross sectional study from October 07- 30, 2019 among female reproductive age groups (15-49yrs) who arrived and lived in the refugee camp from June 01 to October 07, 2019. A systematic random sampling method was applied to recruit 422 participants. We collected the data through face-to-face interview using a structured questionnaire. Binary Logistic regression was applied to assess factors associated with MISP implementation. Results: About 38% of the refugees utilized Minimum Initial Service Package of reproductive health during their stay in the camp. Factors like age of 15–24 years [AOR = 0.38(95% CI,0.20-0.73)], being rural residents in home country [AOR =0 .53(95% CI,0.34-0.83], short time length of stay in the refugee camp [AOR = 0 .56(95% CI,0.33-0.95)] were negative predictors, while previous exposure to health information[ AOR = 2.24(95% CI1.44-3.48)] was a positive predictor of MISP services utilization among the refugees in the reproductive age. Conclusion: The MISP of reproductive health utilization in the refugee camp is relatively high . Previous information on reproductive health helped the refugees in utilizing the service, while a short stay in the refugee camp, being rural residents in their home country and being young age were barriers to utilization of MISP of RH. Strengthening and introducing sexual and reproductive health services for the youth during early crisis would prevent morbidity in refugees. Key words: MISP, RH, Eritrean Refugee camp, Ethiopia

scholarly journals Addressing the sexual and reproductive health needs of women who use mental health services

2010 ◽  
Vol 16 (4) ◽  
pp. 272-278 ◽  
Author(s):  
Carol Henshaw ◽  
Olivia Protti
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Health Needs ◽  
Reproductive Age ◽  
Health Issues ◽  
Women Of Reproductive Age ◽  
Reproductive And Sexual Health

SummaryPregnancies in women with serious mental illness are high risk and such women are also less likely to engage in the recommended health screening for women of reproductive age. Hence, reproductive health issues are important aspects of physical healthcare that should be assessed in women accessing mental health services. Pregnancy planning and management are crucial in reducing risk of relapse in women with affective disorders, and psychiatrists should acquaint themselves with the screening programmes and reproductive and sexual health services in their area and encourage their patients' uptake of these. Clinicians should be aware of the reproductive impact of medications and the needs of specific groups of women.

scholarly journals A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises

2018 ◽  
Vol 3 (2) ◽  
pp. e000682 ◽  
Author(s):  
Neha S Singh ◽  
Sarindi Aryasinghe ◽  
James Smith ◽  
Rajat Khosla ◽  
Lale Say ◽  
...  
Keyword(s):  
Systematic Review ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Reproductive Age ◽  
Service Utilisation ◽  
Health Providers ◽  
Reproductive Health Services ◽  
Community Based ◽  
Humanitarian Crises ◽  
Women And Girls

IntroductionWomen and girls are affected significantly in both sudden and slow-onset emergencies, and face multiple sexual and reproductive health (SRH) challenges in humanitarian crises contexts. There are an estimated 26 million women and girls of reproductive age living in humanitarian crises settings, all of whom need access to SRH information and services. This systematic review aimed to assess the utilisation of services of SRH interventions from the onset of emergencies in low- and middle-income countries.MethodsWe searched for both quantitative and qualitative studies in peer-reviewed journals across the following four databases: EMBASE, Global Health, MEDLINE and PsychINFO from 1 January 1980 to 10 April 2017. Primary outcomes of interest included self-reported use and/or confirmed use of the Minimum Initial Service Package services and abortion services. Two authors independently extracted and analysed data from published papers on the effect of SRH interventions on a range of SRH care utilisation outcomes from the onset of emergencies, and used a narrative synthesis approach.ResultsOf the 2404 identified citations, 23 studies met the inclusion criteria. 52.1% of the studies (n=12) used quasi-experimental study designs, which provided some statistical measure of difference between intervention and outcome. 39.1% of the studies (n=9) selected were graded as high quality, 39.1% moderate quality (n=9) and 17.4% low quality (n=4). Evidence of effectiveness in increasing service utilisation was available for the following interventions: peer-led and interpersonal education and mass media campaigns, community-based programming and three-tiered network of community-based reproductive and maternal health providers.ConclusionsDespite increased attention to SRH service provision in humanitarian crises settings, the evidence base is still very limited. More implementation research is required to identify interventions to increase utilisation of SRH services in diverse humanitarian crises settings and populations.

scholarly journals Minimum initial service package (MISP) for sexual and reproductive health for women in a displacement setting: a narrative review on the Syrian refugee crisis in Lebanon

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Dana Nabulsi ◽  
Maya Abou Saad ◽  
Hussein Ismail ◽  
Myrna A. A. Doumit ◽  
Fatima El-Jamil ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Narrative Review ◽  
System Level ◽  
Refugee Women ◽  
Service Package ◽  
Syrian Refugee ◽  
Wide Range ◽  
Women And Girls ◽  
Comprehensive Services

Abstract Background Women and girls are disproportionately affected in times of conflict and forced displacement, with disturbance in access to healthcare services leading to poor sexual and reproductive health outcomes. The minimal initial service package (MISP) was created to mitigate the consequences of conflict and prevent poor sexual and reproductive health (SRH) outcomes, especially among women and girls. The aim of this narrative review was to explore the SRH response for Syrian refugee women and girls in Lebanon, with a focus on MISP implementation. Methodology A comprehensive literature search was conducted for peer-reviewed articles in 8 electronic databases and multiple grey literature sites for articles published from March 2011 to May 2019. The target population was Syrian refugee women in Lebanon displaced from Syria as a result of the conflict that erupted in March 2011. The selected articles addressed MISP, SRH needs and services, and barriers to service access. A narrative synthesis was conducted, guided by the six main objectives of the MISP. Results A total of 254 documents were retrieved, from which 12 peer-reviewed articles and 12 reports were included in the review. All identified articles were descriptive in nature and no studies evaluating MISP or other interventions or programs were found. The articles described the wide range of SRH services delivered in Lebanon to Syrian refugee women. However, access to and quality of these services remain a challenge. Multiple sources reported a lack of coordination, leading to fragmented service provision and duplication of effort. Studies reported a high level of sexual and gender-based violence, pregnancy complications and poor antenatal care compliance, and limited use of contraceptive methods. Very few studies reported on the prevalence of HIV and other STIs, reporting low levels of infection. Multiple barriers to healthcare access were identified, which included system-level, financial, informational and cultural factors, healthcare workers. Conclusion This study highlights the main SRH services provided, their use and access by Syrian refugee women in Lebanon. Despite the multitude of services provided, the humanitarian response remains decentralized with limited coordination and multiple barriers that limit the utilization of these services. A clear gap remains, with limited evaluation of SRH services that are pertinent to achieve the MISP objectives and the ability to transition into comprehensive services. Improving the coordination of services through a lead agency can address many of the identified barriers and allow the transition into comprehensive services.

scholarly journals How prepared are young, rural women in India to address their sexual and reproductive health needs? a cross-sectional assessment of youth in Jharkhand

2015 ◽  
Vol 12 (1) ◽  
Author(s):  
Sushanta K. Banerjee ◽  
Kathryn L. Andersen ◽  
Janardan Warvadekar ◽  
Paramita Aich ◽  
Amit Rawat ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Rural Women ◽  
Sexual And Reproductive Health ◽  
Health Needs ◽  
Cross Sectional ◽  
Women In India

Sexual and Reproductive Health Needs of Sex Workers: Two Feminist Projects in Brazil

2007 ◽  
Vol 15 (29) ◽  
pp. 108-118 ◽  
Author(s):  
Alessandra S Chacham ◽  
Simone G Diniz ◽  
Mônica B Maia ◽  
Ana F Galati ◽  
Liz A Mirim
Keyword(s):  
Reproductive Health ◽  
Sex Workers ◽  
Sexual And Reproductive Health ◽  
Health Needs

scholarly journals Trends and Differentials in Receipt of Sexual and Reproductive Health Services in the United States: Services Received and Sources of Care, 2006–2019

2021 ◽  
Author(s):  
Jennifer J. Frost ◽  
Jennifer Mueller ◽  
Zoe H. Pleasure
Keyword(s):  
Health Insurance ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
The United States ◽  
Reproductive Age ◽  
Hiv Care ◽  
Publicly Funded ◽  
Private Providers ◽  
Contraceptive Services ◽  
To Receive

Key Points Seven in 10 U.S. women of reproductive age, some 44 million women, make at least one medical visit to obtain sexual and reproductive health (SRH) services each year. While the overall number of women receiving any SRH service remained relatively stable between 2006–2010 and 2015–2019, the number of women receiving preventive gynecologic care fell and the number receiving STI testing doubled. Disparities in use of SRH services persist, as Hispanic women are significantly less likely than non-Hispanic White women to receive SRH services, and uninsured women are significantly less likely to receive services than privately insured women. Publicly funded clinics remain critical sources of SRH care for many women, with younger women, lower income women, women of color, foreign-born women, women with Medicaid coverage and women who are uninsured especially likely to rely on publicly funded clinics. Among women who go to clinics for SRH care, two-thirds report that the clinic is their usual source for medical care. Among those relying on both private providers and public clinics, the proportion of women who reported receiving a combination of contraceptive and STI/HIV care increased between 2006–2010 and 2015–2019. Implementation of the Affordable Care Act has likely contributed to some of the changes observed in where women receive contraceptive and other SRH services and how they pay for that care: The share of women receiving contraceptive services who go to private providers rose from 69% to 77% between 2006–2010 and 2015–2019, in part because more women gained private or public health insurance coverage and there was a greater likelihood that their health insurance would cover SRH services. There was a complementary drop in the share of women receiving contraceptive services who went to a publicly funded clinic, from 27% in 2006–2010 to 18% in 2015–2019. For non-Hispanic Black women, immigrant women and uninsured women, there was no increase in the use of private providers for contraceptive care from 2006–2010 to 2015–2019. Among women served at publicly funded clinics between 2006–2010 and 2015–2019, there were significant increases in the use of both public and private insurance to pay for their care.

scholarly journals Situation analysis for delivering integrated comprehensive sexual and reproductive health services for displaced population of Kasaï, Democratic Republic of Congo: Protocol for a mixed method study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242046
Author(s):  
Jacques B. O. Emina ◽  
Parfait Gahungu ◽  
Francis Iyese ◽  
Rinelle Etinkum ◽  
Brigitte Kini ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Service Delivery ◽  
Adolescent Girls ◽  
Sexual And Reproductive Health ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Reproductive Age ◽  
Gender Based Violence ◽  
Reproductive Health Services ◽  
Republic Of Congo

Introduction Delivering integrated sexual and reproductive health services (SRHS) in emergencies is important in order to save lives of the most vulnerable as well as to combat poverty, reduce inequities and social injustice. More than 60% of preventable maternal deaths occur in conflict areas and especially among the internally displaced persons (IDP). Between 2016 and 2018, unprecedented violence erupted in the Kasaï’s region, in the Democratic Republic of Congo (DRC), called the Kamuina Nsapu Insurgency. During that period, an estimated three million of adolescent girls and women were forced to flee; and have faced growing threat to their health, safety, security, and well-being including significant sexual and reproductive health challenges. Between August 2016 and May 2017, the “Sous-Cluster sur les violences basées sur le genre (SC-VBG)” in DRC (2017) reported 1,429 Gender Based Violence (GBV) incidents in the 49 service delivery points in the provinces of Kasaï, Kasaï Central and Kasaï Oriental. Rape cases represented 79% of reported incidents whereas sexual assault and forced marriage accounted for respectively 11% and 4% of Gender Based Violence (GBV) among women and adolescent girls. This study aims to assess the availability of SRHS in the displaced camps in Kasaï; to evaluate the SRHS needs of young girls and women in the reproductive age (12–49). Studies of sexual and reproductive health (SRH) in the Democratic Republic of Congo (DRC) have often included adolescent girls under the age of 15 because of high prevalence of child marriage and early onset of childbearing, especially in the humanitarian context. According to the 2013 Demographic and Health Survey (DHS), about 16% of surveyed women got married by age 14 while the prevalence of early child marriage (marriage by 15) was estimated at 30%; to assess the use of SRHS services and identify barriers as well as challenges for SRH service delivery and use. Findings from this study will help provide evidence to inform towards more needs-based and responsive SRH service delivery. This is hoped for ultimately improve the quality and effectiveness of services, when considering service delivery and response in humanitarian settings. Data and methods We will conduct a mixed-methods study design, which will combine quantitative and qualitative approaches. Based on the estimation of the sample size, quantitative data will be drawn from the community-based survey (500 women of reproductive age per site) and health facility assessments will include assessments of 45 health facilities and 135 health providers’ interviews. Qualitative data will comprise materials from 30 Key Informant Interviews (KII) and 24 Focus Group Discussions (FGDs), which are believed to achieve the needed saturation levels. Data analysis will include thematic and content analysis for the KIIs and FGDs using ATLAS.ti software for the qualitative arm. For the quantitative arm, data analysis will combine frequency and bivariate chi-square analysis, coupled with multi-level regression models, using Stata 15 software. Statistic differences will be established at the significance level of 0.05. We submitted this protocol to the national ethical committee of the ministry of health in September 2019 and it was approved in January 2020. It needs further approval from the Scientific Oversee Committee (SOC) and the Provincial Ministry of Health. Prior to data collection, informed consents will be obtained from all respondents.

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