While maternal mortality is a common cause of death among women of reproductive age living in resource-poor settings, the especially demanding harsh living conditions of displaced women make delivering a child even more difficult and life threatening. By offering a "second chance" to those whose regular contraceptive method has failed, EC provides a woman or adolescent girl with the opportunity to avoid an unplanned or forced pregnancy and can reduce her risk of death or illness due to complications from childbirth or unsafe abortion.

War and conflict increase incidents of rape and other forms of gender-based violence; this dire reality is reflected in an increasing number of documented reports and research. Women and adolescents are especially vulnerable to sexual abuse committed by combatants. The use of rape as a weapon of war has been documented during the conflicts in Bosnia and Herzegovina, Burma and Rwanda. Displaced women are also victims of another type of gender-based abuse - sexual exploitation - when men wielding power in the refugee, host-country, and even humanitarian communities demand sex in exchange for safety, food, or other commodities. As a consequence of war, women may be required to exchange sex for resources to support themselves and their families. To make matters worse, women in conflict settings often do not have access to regular family planning methods for protection against unwanted pregnancies. Such circumstances underscore the importance of making EC available for refugee and IDP women.

Responses:

To address the reproductive health needs and rights of refugee women, EC should be made available from the beginning of a response to a humanitarian crisis. The Inter-Agency Working Group for Reproductive Health in Refugee Situations (IAWG), which is comprised over 40 nongovernmental and UN agencies including the World Health Organization (WHO) and UNFPA, developed the Minimum Initial Service Package (MISP) for reproductive health to address the reproductive health needs of displaced women and girls. The MISP is a series of priority interventions to be implemented at the onset of a humanitarian emergency and includes EC as a component of the services to be provided to survivors of gender-based violence. The MISP is included as a standard of humanitarian response in the new SPHERE guidelines, which were published in 2004. View a fact sheet on the MISP here.

In addition, UNFPA includes EC in the prepackaged supply kits it ships to emergency situations. The New Emergency Health Kit (NEHK) is the most recent version of a standardized emergency health kit that contains essential drugs, supplies and equipment for the provision of primary health care services. It contains a midwifery kit, emergency contraceptive pills, and supplies for the adherence to universal precautions. The RH Kit for Emergency Situations complements the NEHK and is made up of 12 sub-kits, which can be ordered separately.

The Women's Commission for Refugee Women and Children - an ICEC member - on behalf of the Reproductive Health Response in Conflict Consortium, has developed a distance learning module, Emergency Contraception for Conflict Affected Settings: A Reproductive Health Response in Conflict Consortium Distance Learning Module, available in English, French, Spanish, Portuguese, Pashto, and Burmese. This publication, available as a PDF, hard copy, or CD-ROM, aims to assist humanitarian workers to deepen their individual understanding of EC and to equip them with the knowledge and skills needed to improve EC implementation in their settings.