Over half of all maternal, newborn and child deaths occur in around 50 countries categorized as fragile states. Fragile states have some of the worst health statistics in the world, especially with regard to the health of women and children. Nearly two-thirds of fragile states will fail to halve extreme poverty by the end of this year- the deadline of meeting the Millennium Development Goals (MDGs). The Sustainable Development Goals (SDGs) are set to repeat this pattern without targeting people in conflict and fragile environments. A different approach is needed.
In fragile states, delivery and scaling up of reproductive health services is more difficult than other low-income settings. This is due to poorer governance, severe human resource and financial constraints, the lack of supplies and infrastructure, and particular problems faced by the communities. Under these circumstances family planning is often particularly neglected. Resource constraints are further worsened both by a contested policy environment and a reliance on international aid, which frequently comes with unpredictable and unstable funding.
Despite all these challenges and constraints, progress can be made when strategies are applied which are comprehensive and multidimensional. Strategies that have had most impact have moved beyond medical interventions only, adopting a combined approach to include girls’ education, work on increasing the age of marriage and first pregnancy, family planning and abortion services and efforts to reach out to young people.
On December 10th, 2015, the Royal Tropical Institute (KIT) hosted a symposium titled ‘Sexual and Reproductive Health and Rights in Fragile Environments. Turning challenges into opportunities’. The symposium was organised in collaboration with Cordaid, the International Medical Corps, HealthNetTPO, Share-Net International, and the Ministry of Foreign Affairs of the Netherlands.
The aim of the symposium was to learn from and share evidence-based information of existing SRHR programmes and researches conducted about sexual and reproductive health in fragile environments.
Four topics were explored more in-depth throughout the sessions:
1. Sharing ways how to optimize supply and delivery of SRH in fragile environments
2. Responding to the Sexual and Reproductive Health needs of adolescents in fragile environments
3. Diving deeper into community factors –e.g. gender inequality, social norms/preferences- that influence the uptake of SRHR services in fragile settings
4. Financing for SRHR response in fragile environments; global developments The symposium was facilitated by Sally Theobald, Professor in Social Science and International Health at the Liverpool School of Tropical Medicine in the UK.
Thanks to the 18 speakers from different countries –most of them fragile states- and the session facilitators, the symposium offered a space 3 for inspiring discussions and recommendations for future interventions. About 120 participants joined the meeting from all continents in the world, practitioners in the field of SRHR, fragile settings, humanitarian and development aid, policy makers, researchers, consultants, donors and students.
The recommendations and lessons learned during the symposium will be further addressed through five webinars that will be organized throughout 2016. In addition the organising committee has expressed its interest to organise a second symposium by the end of 2016 on SRHR in fragile environments. The continuation of these learning processes on SRHR in fragile environments is vital to reinforce the sexual and reproductive health and rights, and maternal and child health of many resilient women, men and adolescents living in fragile environments.