Sexual and reproductive health in humanitarian settings
Around the world, women and girls face countless barriers to sexual and reproductive health and rights (SRHR) and related services. When conflicts, natural disasters, public health emergencies and other humanitarian crises are added to the mix, these barriers increase exponentially. In humanitarian settings, healthcare facilities are often inaccessible, damaged, or destroyed; healthcare supply chains are interrupted which limits access to contraception and other SRH-related treatments, including antiretroviral therapy for those living with HIV; and essential SRH services are disrupted, including abortion and post-abortion care, antenatal and postnatal care, and gender-based violence prevention and response interventions. In addition, resources are often shifted away from existing SRH services to respond to the crisis at hand, which may lead to a shortage of health professionals and resources.
The consequences are devastating. Without access to adequate sexual information and services, humanitarian crises can increase the risk of unwanted pregnancies, unsafe abortions, sexually transmitted infections and maternal mortality. For example, 60% of preventable maternal deaths take place in humanitarian settings. Yet, despite evidence that access to SRHR services is essential for protecting and saving the lives of women and girls in these contexts, sexual and reproductive health needs continue to be overlooked in humanitarian interventions.
As the world comes together to mark World Humanitarian Day, we reflect on the vital role and commitment of Canada to ensure access to life-saving SRHR services in humanitarian crises.
Canada’s commitment to championing SRHR in humanitarian action
Canada’s commitment to anchoring SRHR in humanitarian settings stands as a testament to its unwavering dedication to gender equity. Through the Feminist International Assistance Policy (FIAP) and gender-responsive humanitarian interventions, Canada aims to address critical disparities in delivering the services most prominently neglected and most likely to be discontinued under emergencies and resource scarcity.
In 2019, the Government of Canada announced a historic 10-year funding commitment to advancing the health and rights of women and girls worldwide, with an annual $700 million investment dedicated to four of the most underfunded and neglected areas of SRHR (safe abortion care, comprehensive contraceptive care, advocacy for SRHR, and adolescent SRHR including comprehensive sexuality education). This commitment builds on a decade of previous investments, including $2.85 billion under the Muskoka Initiative and $650 million under Her Voice, Her Choice.
Canada’s renewed assistance to women and girls in countries such as Syria, Iraq, Jordan, Lebanon, Yemen and Libya exemplifies the tangible impacts of its commitment to centering sexual and reproductive health care at the forefront of its interventions. Initiatives targeting the prevention and response to gender-based violence, emergency obstetric care delivery, and the distribution of essential equipment and medicines to health facilities are essential to empower women to be agents of change in crises.
Canada’s humanitarian interventions prioritize a cross-cutting approach to gender equity – one that engages women through consultations with implementing partners to integrate their insight across needs assessment, programming implementation, and data monitoring and evaluation to lead post-crisis recovery and reconstruction.
The funding of different civil society organization’s (CSO) work exemplifies this approach, such as Partners in Health Canada’s ‘No Woman or Girl Left Behind’ initiative in Malawi and Sierra Leone and Aga Khan Foundation Canada’s ‘Advancing Sexual and Reproductive Health in Cabo Delgado (SPARC)’ project in Mozambique. Both projects demonstrate the importance of safeguarding SRH at the frontlines of crises. Given their expertise in operating in local contexts, CSOs are equipped to provide comprehensive, evidence-based, culturally sensitive, and community-driven services to fulfill and safeguard the specific needs of women and girls.
While Canada may prioritize gender and recognize the gendered impacts of humanitarian crises in international emergency interventions, this dimension is often missing in practice in the local context. One notable example is Canada’s domestic response to the COVID-19 pandemic, which fell short of adequately integrating a gender lens.
Call to action
While Canada is recognized for its global leadership in improving humanitarian practices to identify and support vulnerable populations, there is room to grow. To build upon past progress, Canada must continue to invest the necessary resources to ensure the systematic consideration of gender equity in all humanitarian interventions.
On this World Humanitarian Day, we stand by the Government of Canada’s Standing Committee on Foreign Affairs’ recommendations regarding “Canada’s Approach to Sexual and Reproductive Health and Rights”. Notably, that the government continues to promote the integration of the Minimum Initial Service Package (MISP) for SRHR as part of its international assistance for strengthening health systems, both in its immediate and ongoing humanitarian assistance. This effort is critical in supporting women and girls through the onset, crisis, recovery and long-term development phases of the humanitarian continuum.
Canada’s commitment to include gender in its humanitarian response is powerful, but strengthening domestic applications could be transformative. By bolstering that commitment here at home, Canada’s leadership on SRHR can set a new standard for crises around the world.