By Daniel Cheleste
The United Nations High Commission for Refugees (UNHCR) estimates that over 100 million people worldwide have either fled their home countries or been internally displaced due to conflict, persecution, or natural disasters.
In many refugee settings, women and children constitute approximately 80 per cent of the population. These groups are particularly vulnerable to the consequences of displacement, including sexual violence, unintended pregnancies, and sexually transmitted infections (STIs), including HIV/AIDS.
Increasingly, displacement is driven by political conflicts rather than natural disasters, leading to what experts term “complex political emergencies.” These crises are often prolonged, leaving millions of people in uncertain conditions—either internally displaced within their countries or seeking refuge across international borders. The needs of displaced populations vary depending on their experiences before and during displacement, necessitating tailored health and humanitarian interventions.
My concern
One critical issue that has emerged in recent years is the reproductive health needs of refugees and internally displaced persons. Despite some progress, the provision of reproductive health services remains inconsistent and, in many cases, inadequate. Not all humanitarian organisations prioritise reproductive healthcare during emergencies, and there is insufficient research to guide effective policy decisions. The prolonged nature of many crises further complicates the distinction between emergency relief and long-term development assistance.
Fertility rates are generally high in refugee settings, with many pregnancies occurring among women at high risk of obstetric complications. While the UN and other international bodies register millions of refugees and displaced persons, many remain uncounted, especially those living outside formal camps. Internally displaced persons, in particular, often lack access to security and healthcare services, placing them at heightened risk. Globally, women and girls make up roughly 50 per cent of displaced populations, though this figure varies by region and country. Many face severe threats, including rape, unintended pregnancies, unsafe childbirth, and exposure to STIs.
Until recently, basic healthcare services provided to displaced populations have largely neglected sexual and reproductive health needs. This is despite the fact that reproductive rights for refugees and internally displaced persons are firmly rooted in international law. Addressing these gaps requires a commitment from governments, humanitarian organisations, and host communities to implement comprehensive reproductive health policies.
Recommendations
- Improved maternal and prenatal care: Ensuring that pregnant women in refugee settings receive proper prenatal care and safe delivery services to reduce maternal and infant mortality.
- Training traditional birth attendants: Equipping community health workers and traditional birth attendants with essential skills to assist in childbirth and manage obstetric emergencies.
- Access to contraceptives: Enhancing awareness and access to family planning services to reduce unintended pregnancies and empower women in displaced communities.
- Prevention and treatment of STIs and HIV/AIDS: Providing education, screening, and treatment services to curb the spread of infections among displaced populations.
- Addressing sexual and gender-based violence: Strengthening legal protections and offering psychological and medical support to survivors of sexual violence within refugee and host communities.
Reproductive health is a fundamental right, and addressing these needs among displaced populations is crucial for their overall well-being and dignity. The Ugandan government, in collaboration with international partners, must ensure that these rights are upheld, offering displaced women and girls the care and protection they urgently require.
The writer is a Project management Consultant and Researcher. danielcheleste@gmail.com
