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Women and children
Reproductive Health
Disasters pose particular threats to women during pregnancy, childbirth and postnatal recovery, as well as an increased risk of sexual exploitation, abuse or violence. The Federation promotes reproductive health care as a basic human right for every woman.
Reproductive health in times of disaster is one of the most important technical areas to cover efficiently. Women need to be able to give birth and look after their children safely which means there needs to be provision of both antenatal services and above all safe delivery services. A further consideration is the safe care of women undergoing abortions.
Postnatal care is vital, to ensure that the child immunisation scheme is initiated, that breast feeding is going well and that the new parents have access to family planning services acceptable to their culture.
Reproductive
health also addresses the need for prevention and care of HIV/AIDS.
Strong components are prevention and care of sexual violence
and adolescence sexual health problems.
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Programmes
There are two particularly good examples of mother and child reproductive health programmes from National Societies in Asia. |
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The Pakistan Red Crescent Society has a well-established reproductive health programme which provides services to mothers and children at primary health care level all over the country. The separate mother and child and public health care programmes have been integrated into one reproductive health programme. The main focus is primary health care, which is provided in some of the 61 mother and child health centres and these services need to be expanded. While the Pakistan Red Crecent is able to meet some of the cost of this programme, additional support is needed to integrate an additional 30 MCH facilities over the next three years. The Federation is providing financial assistance to strengthen the public health care and polio eradication activities. The National Society greatly increased its polio eradication activities during the second half of 2001. As a direct result, over 200,000 children were vaccinated against polio.
The Bangladesh Red Crescent Society has a well established network of 60 mother and child health centres located throughout the country. The majority of the centres are located in remote rural areas and offer a package of health services focused on women and children, including antenatal care, safe delivery services and post natalcare, as well as some child health services.
Community health workers at the centres run educational activities stressing reproductive health, safe motherhood, child health, disease prevention and hygiene promotion. Behaviour change activities are delivered via a network of locally established ėMother's Health' forums and village health committees facilitated by the mother and child health centre team.
Community based management committees work to promote local management of the mother and child health centres to encourage self-reliance. This self-reliance model was piloted by the Bangladesh Red Crescent and is being replicated in the 13 mother abd child centres in south-eastern Bangladesh, supported by the German Red Cross, and in a reproductive health project in the central Dhaka division area supported by the Federation.
The quality of care at the mother and child centres is being addressed by skill-based training for health centre midwives. This training focuses on management and counselling of STIs, reproductive health and child survival. Safe delivery training will be given in the future.
A German Red Cross and Bagladesh Red Crescent pilot project is training a select number of midwives at a government certified school. Once trained, these young women will then return to their communities to serve as trained midwives at the Red Crescent mother and child centre. Helaht centre management committees contribute to the cost of supporting the locally recruited midwives. The project, supprted by the Federation, hopes to promote male involvement in all aspects of reproductive health using information obtained from a recent survey.
Reproductive health in refugee situations:
Working with the Pupolation Fund and the Inter Agency Working Group on issues of reproductive health in emergency situations, the Federation has developed a strategy that relies essentially on the use of the Minimum Initial Service Package of care. It entails:
- identifying organisations and individuals to facilitate the coordination and implementation of the package,
- preventing and managing the consequences of sexual violence,
- guaranteeing the availability of free condoms to reduce HIV transmission,
- preventing excess neonatal and maternal morbidity and mortality, by providing clean delivery kits and the establishment of a referral system to manage obstetric emergencies,
- planning for the provision of comprehensive reproductive health services, integrated into primary health care, as the situations permit.
The Federation is now aiming to implement this in all the refugee operations in which it is involved.
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