Care with dignity in humanitarian crises: ensuring sexual and reproductive health and rights of displaced populations

Onyango, Monica Adhiambo; Heidari, Shirin

doi:10.1080/09688080.2017.1411093

Cited by 15 publications

(16 citation statements)

References 13 publications

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“…A system which provides poor treatment for poor women strips individuals and families of their basic right to health care. The new study from Bayo et al [8] joins a small group of papers from countries with ongoing humanitarian emergencies [11,30,31], and demonstrates that, regardless of location, women and families demand quality and respect from the health care system. There is an urgent need to improve the culture of care for women and newbornsit will continue to cost lives and dignity if we do not act.…”

Section: Commentmentioning

confidence: 99%

“…Both those needing and providing health care in fragile states and humanitarian emergency settings may be limited in mobility, infrastructure, and security, and may have been subjected to recent violence, loss, and other traumas. Over 60% of maternal deaths and 45% of neonatal deaths worldwide occur in countries with humanitarian crises, and thus quality of care for these women, their families, and providers, cannot be ignored [11][12][13].…”

Section: Commentmentioning

confidence: 99%

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Confronting the culture of care: a call to end disrespect, discrimination, and detainment of women and newborns in health facilities everywhere

Sacks

Peca

2020

BMC Pregnancy Childbirth

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Quality and respect are increasingly recognized as critical aspects of the provision of health care, and poor quality may be an essential driver of low health care utilization, especially for maternal and neonatal care. Beyond differential access to care, unequal levels of quality exacerbate inequity, and those who need services most, including displaced, migrant, and conflict-affected populations, may be receiving poorer quality care, or may be deterred from seeking care at all. Examples from around the world show that mothers and their children are often judged and mistreated for presenting to facilities without clean or "modern" clothing, without soap or clean sheets to use in the hospital, or without gifts like sweets or candies for providers. Underfunded facilities may rely on income from those seeking care, but denying and shaming the poor further discriminates against vulnerable women and newborns, by placing additional financial burden on those already marginalized. The culture of care needs to shift to create welcoming environments for all care-seekers, regardless of socioeconomic status. No one should fear mistreatment, denial of services, or detainment due to lack of gifts or payments. There is an urgent need to ensure that health care centers are safe, friendly, respectful, and hospitable spaces for women, their newborns, and their families.

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Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Confronting the culture of care: a call to end disrespect, discrimination, and detainment of women and newborns in health facilities everywhere

Sacks

Peca

2020

BMC Pregnancy Childbirth

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“…In the context of dispersed refugees and Internally Displaced Populations (IDPs), research efforts with strong methodologies are especially scarce [2,3]. There is a documented disparity between regions, with a gap noted for the Middle East [2,12] except for specific over-researched communities [13] and, despite key initiatives, a gap also remains on Sexual and Reproductive Health (SRH) [12,[14][15][16][17].…”

Section: Research Gapmentioning

confidence: 99%

“…We first conducted a scoping review of the literature in English, including a recent academic series on evidence in humanitarian settings [2-4, 6, 21], research published by humanitarian actors including methodological papers [5,[22][23][24][25], academic analyses of humanitarian and global health partnerships [12,20,26,27], research on SRH and conflicts including the Middle East [14][15][16][17] as well as literature related to research ethics and in conflict settings [8][9][10][11]13]. Then, we compared issues emerging from the literature with our recent experience and we collectively agreed upon a set of 10 key challenges reflecting the main trade-offs we had to negotiate throughout the partnership.…”

Section: Key Documented Challenges Of Conducting Research In Humanitamentioning

confidence: 99%

Conducting operational research in humanitarian settings: is there a shared path for humanitarians, national public health authorities and academics?

Leresche¹,

Truppa²,

Martin³

et al. 2020

Confl Health

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In humanitarian contexts, it is a difficult and multi-faceted task to enlist academics, humanitarian actors and health authorities in a collaborative research effort. The lack of research in such settings has been widely described in the past decade, but few have analysed the challenges in building strong and balanced research partnerships. The major issues include considering operational priorities, ethical imperatives and power differentials. This paper analyses in two steps a collaborative empirical endeavour to assess health service utilization by Syrian refugee and Lebanese women undertaken by the International Committee of the Red Cross (ICRC), the Lebanese Ministry of Public Health (MoPH) and the Harvard François-Xavier Bagnoud (FXB) Center. First, based on challenges documented in the literature, we shed light on how we negotiated appropriate research questions, methodologies, bias analyses, resource availability, population specificities, security, logistics, funding, ethical issues and organizational cultures throughout the partnership. Second, we describe how the negotiations required each partner to go outside their comfort zones. For the academics, the drivers to engage included the intellectual value of the collaboration, the readiness of the operational partners to conduct an empirical investigation and the possibility that such work might lead to a better understanding in public health terms of how the response met population needs. For actors responding to the humanitarian crisis (the ICRC and the MOPH), participating in a technical collaboration permitted methodological issues to be worked through in the context of deliberations within the wider epistemic community. We find that when they collaborate, academics, humanitarian actors and health authorities deploy their respective complementarities to build a more comprehensive approach. Barriers such as the lack of uptake of research results or weak links to the existing literature were overcome by giving space to define research questions and develop a longer-term collaboration involving individual and institutional learning. There is the need ahead of time to create

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“…At an institutional level, the limited access to safe abortions is due to the perceptions that ‘there is no need’, ‘abortion is too complicated to provide in crises’, ‘abortion is illegal’ and ‘donors do not fund abortion services’ [ 9 ]. In addition, a lack of training of health care providers (HCPs), a lack of knowledge about the legal status of abortion in the specific context and humanitarian actors’ and HCPs’ stigmas about and negative attitudes toward abortion constitute additional barriers to safe abortion services in humanitarian settings [ 1 , 10 , 11 ]. However, Gasseer et al [ 3 ] highlight the positive effects that reproductive HCPs in humanitarian settings can have on women’s health outcomes.…”

Section: Introductionmentioning

confidence: 99%

A qualitative study on health care providers’ experiences of providing comprehensive abortion care in Cox’s Bazar, Bangladesh

et al. 2021

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Background Humanitarian settings are characterised by limited access to comprehensive abortion care. At the same time, humanitarian settings can increase the vulnerability of women and girls to unintended pregnancies and unsafe abortions. Humanitarian actors and health care providers can play important roles in ensuring the availability and accessibility of abortion-related care. This study explores health care providers’ perceptions and experiences of providing comprehensive abortion care in a humanitarian setting in Cox’s Bazar, Bangladesh and identifies barriers and facilitators in service provision. Method In-depth interviews (n = 24) were conducted with health care providers (n = 19) providing comprehensive abortion care to Rohingya refugee women and with key informants (n = 5), who were employed by an organisation involved in the humanitarian response. Data were analysed using an inductive content analysis approach. Results The national menstrual regulation policy provided a favourable legal environment and facilitated the provision of comprehensive abortion care, while the Mexico City policy created organisational barriers since it made organisations unable or unwilling to provide the full comprehensive abortion care package. Supplies were available, but a lack of space created a barrier to service provision. Although training from organisations had made the health care providers confident and competent and had facilitated the provision of services, their knowledge of the national abortion law and menstrual regulation policy was limited and created a barrier to comprehensive abortion services. Even though the health care providers were willing to provide comprehensive abortion care and had acquired skills and applied strategies to communicate with and provide care to Rohingya women, their personal beliefs and their perceptions of Rohingya women influenced their provision of care. Conclusion The availability and accessibility of comprehensive abortion care was limited by unfavourable abortion policies, a lack of privacy, a lack of knowledge of abortion laws and policies, health care providers’ personal beliefs and a lack of cultural safety. To ensure the accessibility and availability of quality services, a comprehensive approach to sexual and reproductive health and rights is needed. Organisations must ensure that health care providers have knowledge of abortion policies and the ability to provide quality care that is woman-centred and non-judgmental.

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Care with dignity in humanitarian crises: ensuring sexual and reproductive health and rights of displaced populations

Cited by 15 publications

References 13 publications

Confronting the culture of care: a call to end disrespect, discrimination, and detainment of women and newborns in health facilities everywhere

Confronting the culture of care: a call to end disrespect, discrimination, and detainment of women and newborns in health facilities everywhere

Conducting operational research in humanitarian settings: is there a shared path for humanitarians, national public health authorities and academics?

A qualitative study on health care providers’ experiences of providing comprehensive abortion care in Cox’s Bazar, Bangladesh

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