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Understanding Operational Barriers to Family Planning Services in Conflict-affected Countries: Experiences from Sierra Leone

Emily Sonneveldt, Theresa Shaver, and Anita Bhuyan  
pdf   Full Document (pdf 1,162.9 kb)


The United Nations High Commissioner for Refugees (UNHCR) estimates that there were 20.8 million refugees and internally displaced persons (IDPs) at the start of 2006 (UNHCR, 2006). Forced migration due to war and persecution brings with it a host of risks and insecurities resulting from the loss of family and community ties, limited access to food and shelter, disruption of what may be already inadequate health and social services, and increased psychological trauma and physical abuse. Because of the severe social instability that they experience, refugee/IDP women are likely to have irregular access to family planning and little control over their sexual encounters. These factors place women in conflict situations at an increased risk for unintended pregnancies, poorly spaced or high-risk pregnancies, and sexually transmitted infections (STIs)/HIV. Furthermore, adolescents are at a heightened risk of being sexually abused and exploited—increasing their need for a range of complementary services, including appropriate contraception and counseling.

Recognizing the importance of a sound policy environment and the operational guidelines necessary for putting policies into practice, the USAID | Health Policy Initiative, Task Order 1, conducted a study in Sierra Leone in 2007 to: (1) explore refugee/IDP family planning needs before, during, and after conflict; (2) determine the root causes of the barriers to quality, accessible services; (3) build capacity of local groups to analyze operational barriers to services; and (4) devise policy actions and recommendations for overcoming barriers—that are applicable both in-country and in other conflict-affected countries. This study highlights issues affecting provision of family planning in conflict-affected settings.

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Document Type: Technical Reports: Country
No. of Pages: 50 
Country: Sierra Leone 
Keywords: Operational Policy, FP/RH 

Last Updated 12/9/09

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