As humanitarian funding declines, investing in preparedness is essential
In South Sudan, as fighting raged around her, *Kinana knew she was facing enormous obstacles. She sought safety after escaping the horrors of war and was urgently seeking ante-natal care to deliver her baby safely into the world. She eventually found a local clinic, but many other mothers are often less fortunate.
Kinana's predicament illustrates the extreme difficulties faced by women, children and youth, who make up the vast majority of crisis-affected populations.
In times of crises, access to life-saving sexual and reproductive health services, care, and support — such as equipment that ensures safe births and supporting survivors of violence — is compromised. Sexual violence and risks associated with unintended pregnancies and HIV infection surge, as do maternal and neonatal deaths. Women and children are forced to move, urgent and life-saving care may become unavailable, resources are diverted, and a community's protection system starts breaking down.
Losing livelihoods during an emergency, for example, has been shown to increase rates of child marriage and female gential mutilation, as observed during the recent drought in the Horn of Africa. With humanitarian funding in decline, the outlook for women and girls in crisis — whether it be a disease outbreak, political conflict, or climactic event — will be devastating.
One of the most effective safeguards is preparedness. This means acting before
a crisis hits by: building resilient health systems; supporting local governments and organisations; identifying and listening to the most vulnerable, while ensuring they have the means to make informed decisions and cope with a rapidly changing environment; and ensuring sexual and reproductive health (SRH) services are never interrupted.
To better understand East and Southern Africa's ability to ensure the continuity of SRH services in an emergency, an assessment was conducted to identify gaps and opportunities for improvement. The assessment focused on readiness to implement a key emergency response tool — the Minimum Initial Service Package (MISP) — a proven 'first aid kit' for women and girls. Developed by the Inter-Agency Working Group on Reproductive Health in Crises, the MISP includes life-saving interventions used at the start of a crisis to prioritise safe births, address sexually transmitted infections, ensure contraception access, prevent sexual violence and more.
Ultimately, tools like the MISP reinforce to countries that investing in SRH preparedness saves lives now and resources later, according to the joint United Nations Regional Programme, 2gether 4 SRHR.
Research shows that for every $1 invested in preparedness and system resilience, more than $2 is saved in future response costs over four years. Despite the economic benefits and life-saving measures, only a third of countries in East and Southern Africa have disaster preparedness and response policies and plans that include SRH, and fewer than half the countries in the region have the funding to support this work.
In response, 2gether 4 SRHR is working with governments, policymakers and communities to fill this gap by training service providers, strengthening community resilience and advocating for the integration of MISP into disaster preparedness and response plans. With effective advocacy, the number of countries in the region that integrated the MISP into national policies increased from two to 15.
Reaffirming the need for preparedness, a recent assessment on the effects of the El Niño-induced droughts and floods in Southern Africa highlighted the need to integrate HIV and SRH into emergency and climate responses as well as prevention and anticipatory action. The assessment highlighted the importance of strong data systems, flexible funding, and uninterrupted service access, and the need to engage civil society and communities to provide peer-led support, particularly for people living with HIV.
With evidence and region-wide examples, the work ahead calls for greater interaction with communities and investments from governments, donors and other stakeholders to focus on preparedness, ensuring that policy changes result in sustained action.
In an unstable funding environment, preparedness is economically sound for the country and life-saving for those who suffer the most in crises: women, children, and youth. We must act now
before the next crisis hits. Women like Kinana depend on it.
Marietta Wildt is a gender and humanitarian advocate with the UNAids Regional Support Team for Eastern and Southern Africa and Mathias Gakwerere is a humanitarian technical specialist at the United Nations Population Fund regional office for East and Southern Africa.
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