The Impact of Armed Conflict on Women and Girls - UNFPA

<strong>The</strong>se kits were distributed early in the crisis by NGOs, such as MSI and
the International Rescue Committee, which also provided reproductive health
services in Albania during the conflict, and the Albanian Ministry <strong>of</strong> Health. This
created an outcry among predominantly Catholic critics, potentially delaying the
provision <strong>of</strong> further life-saving services. Certainly, the provision <strong>of</strong> reproductive
health care through primary health-care services was not addressed by the
majority <strong>of</strong> humanitarian organizations. <strong>The</strong>re was much talk among some health
agencies <strong>of</strong> the provision <strong>of</strong> reproductive health in the “second phase” <strong>of</strong>
activities. Meanwhile, refugees remained without their rightful access to
reproductive health-care services.
Humanitarian aid is by no means always provided by organizations taking
part in the development <strong>of</strong> international policy on reproductive health or other
issues. Smaller agencies also provide much needed services but are less likely
to be aware <strong>of</strong> policy changes at the international level and may well be
unacquainted with vital developments in the field <strong>of</strong> reproductive health. This has
implications for the timely and appropriate provision <strong>of</strong> reproductive health
services.
Cultural, linguistic, economic and religious barriers as well as physical
distance play a huge role in the accessibility <strong>of</strong> reproductive health services to
refugee communities, much more so than in the accessibility <strong>of</strong> primary healthcare
services. Service providers must take into account, for example, that
translators may be required, preferably <strong>of</strong> the same sex. Same-sex providers are
imperative in cases <strong>of</strong> STIs and sexual violence. Privacy and confidentiality must
be ensured, even in the emergency phase.
Appropriate training for staff in all elements <strong>of</strong> reproductive health care is
another imperative, especially if referral facilities do not exist and one agency is
providing all components <strong>of</strong> reproductive health care.
Coordination is an important element in the provision <strong>of</strong> health services in
any situation. In refugee settings, the provision <strong>of</strong> reproductive health services
requires close collaboration with other sectors involved in the provision <strong>of</strong> care,
for example, protection and community services. Although it is anticipated that
agencies will provide reproductive health services as part <strong>of</strong> a broader package
<strong>of</strong> primary health care, one agency may not always be able to implement the full
range <strong>of</strong> reproductive health services. Providing comprehensive services,
therefore, requires cooperation and collaboration between agencies.
Access by refugees and IDPs to host community facilities can be
restricted. <strong>The</strong>re are a number <strong>of</strong> reasons for this, including fear <strong>of</strong> encouraging
displaced populations to remain, integration issues as well as retaliation for
actions undertaken by community groups. Women can be especially vulnerable
to such reprisals when, for example, male community members have been killed
or are involved in fighting. Service providers need to be aware <strong>of</strong> these issues
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