Build resilience and improve adaptation

Family planning is a lifesaving intervention in humanitarian settings. Ensuring continuous access to family planning for populations experiencing a humanitarian crisis is needed, demanded and feasible. Disruption of family planning services can be minimized through a) preparedness actions, b) prompt response interventions and c) coordinated transition back to comprehensive SRH services.

The updated Minimum Initial Service Package (MISP) for Reproductive Health (2018) repositioned family planning “preventing unintended pregnancies” as one of the four main clinical and lifesaving services of the MISP. Preparedness, response and recovery efforts should be tailored to local contexts and shaped by decision-makers at appropriate points within the humanitarian cycle and within the health system. The following priority actions are designed to deliver more effectively to people affected by disasters, conflicts and climate instability, including populations on the move.

Programmatic options

5.1.1 Crisis and nexus funding: Advocate for the prioritization of family planning and strengthen resource mobilization efforts during acute and protracted humanitarian crises through the United Nations Central Emergency Response Fund (CERF) and flash appeals, for example. Mobilize increased and sustained funding across the humanitarian–development–peace nexus for family planning and other SRH interventions with a focus on the preparedness and transition phases.

5.1.2 Disaggregated data: Support disaggregated data collection and identification of core family planning indicators suitable for humanitarian preparedness, response and transition planning.

5.1.3 Forecasting: Provide technical assistance to analyse data for realistic forecasting and quantification exercises for the procurement and prepositioning of family planning supplies, such as mCPR and the availability of family planning services in affected health facilities.

5.1.4 Management tools: Support humanitarian actors to use contraceptive management tools (e.g. MISP, LEAP) to help integrate emergency reproductive health supplies into logistics management information systems (LMIS) as a short-term measure while restoring routine information systems.

5.1.5 Map MISP partners: Map potential humanitarian partners to implement the Minimum Initial Service Package for Sexual and Reproductive Health in Crisis Situations (MISP, including Objective 5 to prevent unintended pregnancies), making note of geographic areas of interventions and capacities. Broaden the partner base and reduce silos by fostering partnerships with climate change/adaptation, resilience, preparedness and disaster risk reduction actors.

5.1.6 Real-time monitoring: Support real-time monitoring of  supply availability and procurement activities to identify gaps in health systems and risks affecting the continued provision of family planning services during and after a crisis or emergency with partners such as the World Food Programme, World Health Organization, UNICEF and other agencies and organizations including the private sector. Monitor and capitalize on best practices and share lessons learned. 

Programmatic options

5.2.1 MISP standards: Secure governments and partners’ adherence to international standards through the integration of the Minimum Initial Service Package for Sexual and Reproductive Health in Crisis Situations (MISP, including Objective 5 to prevent unintended pregnancies) into laws, policies, strategies and plans.

5.2.2 Preparedness: Build preparedness activities including those captured in Minimum Preparedness Actions (MPA) and MISP Readiness Assessments (MRA) into Country Programme Documents and the UNSDCF. 

5.2.3 MISP capacity: Build capacity to implement the Minimum Initial Service Package for Sexual and Reproductive Health in Crisis Situations (MISP), including provision of a mix of short and long-acting methods of contraception, among midwives and other health workers, health managers and programme managers, and partners such as ministries of health, humanitarian organizations and local implementing partners and community networks.

5.2.4 Innovative services: Introduce innovative methods of service delivery, including self-care and online services for family planning that can be sustained during emergencies.

5.2.5 Coordination: Secure UNFPA leadership in humanitarian coordination mechanisms and ensure that family planning services, including modern contraceptives, for crisis-affected populations such as refugees, migrants and the internally displaced are included in Universal Health Coverage and primary health care (UHC/PHC) efforts.

5.2.6 Tools and materials: Develop and disseminate appropriate tools, information and communication materials to support quality improvement and a wider adherence to human rights-based principles in humanitarian contexts.

5.2.7 Local solutions: Encourage the adoption of solutions that are locally developed and owned to improve the coverage of the neediest populations and those furthest behind, including sex workers, persons with disabilities (PWDs) and persons identifying as LGBTIQ+.

5.2.8 Innovative financing: Promote the design and implementation of finance mechanisms, including bridge funding, impact bonds and private sector investments in humanitarian preparedness, transition and building back better efforts with a focus on improving the resilience of health systems and communities. 

Programmatic options

5.3.1 Supply chain forecasting: Provide technical assistance towards restoring routine family planning supply chains and reducing reliance on humanitarian kits and supplies by supporting forecasting of family planning commodity needs and costs as a crisis situation stabilizes. Support forecasting to inform contingency planning for emergency commodity procurement plans as well as routine supply chains, for example including emergency buffer stocks in national procurement plans.

5.3.2 Supply chain capacity: Build national humanitarian actors' capacity in contraceptive supply chain management including prepositioning of commodities and components of the IARH kit management (e.g. forecasting, quantification and supply planning, logistics and pharmacy management, monitoring and data collection, utilization, LMA) for timely distribution to the last mile, with an emphasis on quality assurance of time- and temperature-sensitive medicines.

5.3.3 Post-acute period: Support humanitarian actors to ensure that comprehensive provision of family planning services and the supply of modern methods of contraception are included in planning and funding proposals for post-acute humanitarian settings,supporting the transition to comprehensive services post-MISP. 

Programmatic options

5.4.1 Climate plans: Advocate at global, regional and country levels for inclusion of sexual and reproductive health, including family planning, in country-level climate adaptation, response and contingency plans.

5.4.2 Women and girls at the centre: Advocate for women and adolescent girls to remain at the centre of a humanitarian response, engaging them in design, implementation and in the prioritization of actions and plans.

5.4.3 Resilience plans: Assist national and subnational governments to develop specific resilience plans for health (as per the Sendai Framework) for sexual and reproductive health, including family planning.

5.4.4 Engage communities: Engage communities, including those most at-risk, in designing and implementing preparedness and response interventions to ensure continuity of family planning information and services during the humanitarian response.