Prioritizing Reproductive Health, Empowering Women and Girls

Reproductive health care and women's empowerment go hand in hand. Sometimes, especially in remote settings, access to reproductive health care is also a question of life and death.
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Next week, delegates from around the world will gather in New York City for the 56th session of the United Nations Commission on the Status of Women (CSW). Every year, leaders meet to assess where the world stands on gender equality, and how far we have come -- and need to go -- in advancing women's rights.

This year's theme is the empowerment of rural women and their role in ending poverty and hunger, which very much resonates with the Women's Refugee Commission's work. Millions of women and girls displaced by conflict and natural disasters are currently living in camps or rural villages and settlements in remote areas, often in the most precarious conditions. They, too, deserve the opportunities and the tools to contribute to the well-being of their families and the development of their communities. And when we invest in displaced women and girls, we are also making a long-term investment in peace and stability when conflict ends.

That's why the Women's Refugee Commission will be advocating that the concerns of the displaced be fully integrated in the CSW's delegates' deliberations and in their commitments to action. We will make the point that effective humanitarian assistance programs depend on the full inclusion of displaced women and girls in the design, implementation, monitoring and evaluation of relief and recovery activities. We will argue that the international community must redouble its efforts to improve protection for refugee women and girls in rural areas, ensure they can go to school and acquire skills training and that they are able to safely earn a living. And we will press for a renewed commitment to quality reproductive health care.

Reproductive healthcare and women's empowerment go hand in hand. Sometimes, especially in remote settings, access to reproductive healthcare is also a question of life and death. We know that maternal mortality rates are especially high in conflict-affected countries and that displaced women and girls are at very high risk of sexual violence. These stark facts prompted the development of the Minimum Initial Service Package (MISP) for Reproductive Health Services in Crisis Situations, which is now the established international standard for reproductive health services that should be implemented from the very onset of an emergency. These activities are designed to prevent and respond to sexual violence, prevent maternal and newborn deaths and reduce HIV transmission. The good news is that we have seen real improvements in MISP's implementation since it was launched 13 years ago. But we are still far from seeing comprehensive implementation of the MISP in every emergency. CSW is a good opportunity for all parties to reaffirm their commitment to this goal.

This is also a time to call attention to the essential role that access to comprehensive family planning plays in the health and well-being of displaced women and girls. Unfortunately, as the Women's Refugee Commission found in a recent five-country study conducted with the UN High Commissioner for Refugees, refugee women and girls still don't have consistent access to contraception or basic information about family planning. Even when these services do exist, the quality may be so poor that refugees are deterred from seeking care.

This is unacceptable for so many reasons, not the least of which is the right that displaced women have to such healthcare. And a lack of family planning information and services has a severe impact on their ability to care for their families and participate actively in the social, economic and political life of their communities. All of this is compounded by the reality of forced or early marriage and sexual exploitation and abuse in many conflict-affected areas. The breakdown in support structures during displacement makes many women and adolescents, in particular, more vulnerable.

Tragically, women and girls who cannot access family planning in humanitarian emergencies may be driven to extreme measures to end pregnancies, often putting their lives at risk. I think, for example, of the heartbreaking 2008 statistic from conflict-ridden Sudan where in one three-month period, post-abortion care accounted for the largest percentage of obstetric emergencies. Or I remember the case of a 17-year-old refugee girl in Ethiopia who was told by friends that prolonged use of contraceptives could leave her barren or kill her. She had no information to the contrary, so she stopped using birth control and became pregnant. In desperation, she underwent an illegal abortion that nearly killed her.

Displaced women and girls -- most of whom are dependent on the international community to survive -- deserve so much better from us. We must make it a priority to deliver comprehensive reproductive health care in all humanitarian settings, including full access to family planning. The alternative is needless suffering, avoidable loss of life and missed opportunities for healthy women and girls to build a better life for themselves and their families.

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