Sexual and Reproductive health needs assessment of ... - IAWG

Sexual and Reproductivehealth needs assessment ofMobile and vulnerablecommunities in ZimbabweDr.Sathyanarayanan DoraiswamyUNFPA, Zimbabwe

Background• Zimbabwe- a complex emergency• Major waves of displacementa) Fast track land reform (2002)- 160,000b) Operation Murambatsvina (2005)-700,000• IOM Zimbabwe responds to community health needs of MVPs(IDPs) and UNFPA provides support on SRH issues• Few studies have established SRH needs of MVPs

Objectives• To assess the sexual and reproductive health (SRH)needs of mobile and vulnerable populations (MVPs) inZimbabwe• To assess knowledge, attitude and practices amongMVPs with regard to SRH and to assess the barriers tosexual and reproductive health services in thecommunities• To assess the degree to which current health servicesmeet SRH needs of MVPs (availability and accessibilityof SRH services)

Methodology• Quantitative study (Stratifiedcluster sample) design• 62/116 communities in 22 districts• 1900/ 28690 women (15-49)• Tools referenced:IOM Zimbabwe-2007RH assessment in conflict affectedwomen- CDC toolkitInter-Agency Global Evaluation of RHServices for Refugees and IDPsRefugee reproductive health needsassessment (RHR consortium)

Findings-1Thematic area Key indicator/s ProportionSafe MotherhoodFamily planningSexual history,practices& STIsANCHome deliveryStill birthBleeding as a danger signUnwanted pregnancyAttempted terminationMedian age- sexual debutCondom use in last sexPrevalence of genitalulcers/ dischargeTransaction sex(‘widespread’- perception)50%35%10%11%49%46% of above17 (18.7-National)21%20% (35% sought notreatment)78%

Findings-2ThematicareaKey indicator/sProportionHIVSGBVHealthfacilitiesUsing condoms as a method ofHIV prevention-KnowledgeTesting (ever)Prevalence of forced sexHave not sought any serviceAccess to Hygiene suppliesQualitative (observation)80.5% (75.7% National)38.7%(7% National)25%45.7%40% had no access60% >15 kmsBEMONC services notuniformly availableSerious shortage of staff,drugs and supplies

Challenges/ Limitations• Access challenges: a) Politically sensitive population in acharged environment b) Difficult terrain and resourcelimitations- Not all communities studied• Qualitative studies (Men and young people) could not becarried out• Host populations not studied; relative vulnerability notknown• Health facilities- observation only and hence difficult tovalidate

Conclusion/ Recommendation• Knowledge gaps of MVPs in SRH need to be addressedwith a focused IEC/BCC campaign.• Barriers to access: Safe motherhood, FP and GBVservices of the MVP communities need to be urgentlyaddressed by a joint SRH programme for MVPs.• Health facilities in the areas surrounding MVPcommunities need immediate support (staffing andsupplies)

Lessons learnt• SRH needs assessment in populations of humanitarianconcern helps identify key programmatic priorities• Joint assessment provides a good opportunity for furtherstrengthening partnership during planning,implementation, monitoring and evaluation of theprogramme• A complex emergency imposed on a weakening healthcare system pose programmatic challenges to agencies

Thank You