Adolescent Sexual and Reproductive Health Programs in Humanitarian Settings: An In-depth Look at Family Planning Services

"In humanitarian settings, child-bearing risks are compounded for adolescents, due to increased exposure to forced sex, and reduced availability of and sensitivity to adolescent sexual and reproductive health services. At the same time, adolescents in humanitarian settings will have similar needs and desire for sexual and reproductive health information and services as their peers in non-crisis settings."

Although adolescent sexual and reproductive health (ASRH) is receiving more attention in humanitarian settings, there was a need for documentation of progress and programmes that effectively integrate SRH services, including family planning, for this age group. To address this gap, the Women’s Refugee Commission and Save the Children - in partnership with the United Nations High Commissioner for Refugees (UNHCR) and the United Nations Population Fund (UNFPA) - undertook a year-long exercise to map existing ASRH programmes that have been implemented since 2009 and to document good practices.

The authors used a practitioner survey and humanitarian funding analyses, key informant interviews, and a collection of good practice case studies. The survey reached 1,200 individuals globally through various listservs. "Based on the more than 200 responses, a mere 37 programs focused on the SRH needs of 10- to 19-year-olds in crisis-affected settings since 2009. Only 21 of these programs offered at least two methods of contraception, and none were in acute onset emergency settings. Despite this lack of programming, promising practices for ASRH in humanitarian settings exist."

Three programmes, among those offering at least two methods of contraception, were identified to be "effective" in their delivery of SRH services by demonstrating enhanced contraceptive uptake: Profamilia in Colombia, the Adolescent Reproductive Health Network in Thailand, and Straight Talk Foundation in northern Uganda. Additionally, several programmes show notable approaches including: utilising a consortium model to address the needs of this population; providing ASRH services within school-based programmes; working with urban displaced populations; and incorporating ASRH into disaster risk reduction activities. Successful programmes: have secured community and adolescent involvement; are responsive to the different needs of adolescent sub-populations; and provide holistic and multi-sectoral services, including protection, life skills, literacy, numeracy, vocational training, and livelihood skills, among other relevant services.

In addition, strong programmes provide refresher trainings, structured supervision, recognition and ongoing mentorship to peer educators to address motivation and retention challenges. Emergency preparedness should involve adolescents in analysing critical needs and preparing information, education, and communication materials, as well as training peer educators for emergencies. Outreach strategies for hard-to-reach adolescents are also critical. The document includes recommendations to donors and governments, the health sector, humanitarian organisations, and development organisations.

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