Contraceptive Services in Humanitarian Settings and in the Humanitarian-Development Nexus: Summary of Gaps and Recommendations from a State-of-the-Field Landscaping Assessment (March 2021) – World


The Women’s Refugee Commission (WRC) conducted a Landscaping Assessment from 2018-2020 to assess and build the evidence base of barriers, opportunities, and effective strategies for providing contraceptive services to women and girls affected by crisis. The assessment included a literature review, a global contraceptive programming survey, case studies in three humanitarian institutions, and two sets of key informant interviews (KIIs). The second set of KIIs was conducted after the COVID-19 pandemic began and was specifically aimed at understanding the impact of COVID-19 on contraception services. All other assessment components were completed prior to the start of the pandemic.

The results identified several major gaps that hinder access to contraception programs in humanitarian institutions. Based on the results, the main overarching recommendations for governments, donors and implementing agencies across the humanitarian development continuum include:

  • Further raise awareness that contraception is part of the package of basic health services in humanitarian institutions: Conduct ongoing advocacy and mobilization with governments, donors and other partners to bring sexual and reproductive health (SRH), including contraception, into the humanitarian framework Prioritize willingness and response. and recovery, and to improve understanding that contraception is a life-saving health service and the standard of care that must be provided in all crises.

  • Improve the provision of the full range of contraceptive methods, particularly Long-Acting Reversible Contraception (LARCs) and Emergency Contraception (EC): Implement task-sharing policies, remove EC and LARC policy restrictions, and provide EC in a variety of outlets ;; improve vendors’ knowledge of EC and LARCs, including adding and removing LARCs, and provide legal-based contraceptive counseling training that focuses on customer choice and informed decision-making; Raising awareness of the EC and LARC among the population affected by crises.

  • Improving access to contraception services for adolescents and members of other marginalized populations: including youth, people with disabilities and members of other marginalized populations, including local organizations led by these groups, in prevention programs from preparedness to response to recovery; use alternative modalities of service delivery to reach young people and members of other marginalized populations; and stigma through community awareness raising and value clarification activities.

  • Improving contraceptive availability: Engage people with pharmaceutical supply chain management skills during emergency preparedness, response and recovery; Integrating emergency preparedness into investments to strengthen SRH supply chains in stable times, including training on contraceptive management in emergencies; and invest in strengthening SRH supply chains after an acute emergency in order to move to a more stable supply chain.

  • Strengthening of data collection and use for the provision of contraceptive services: training of health care facility staff in the collection, analysis and use of contraceptive data and adequate budget for data collection activities; Standardization and streamlining of contraceptive indicators and data collection tools used in humanitarian institutions; and build the evidence base on effective strategies for the delivery of contraceptive services throughout the emergency programming cycle.

  • Invest in preparedness to deliver contraceptive services: Integrate prevention into emergency preparedness and disaster risk management policies and budgets. Strengthening the capacity of governments and partners across the humanitarian development continuum to engage and respond; and advocate readiness to become a routine part of SRH programming and coordination by governments and development agencies in stable times.

  • Localizing Contraceptive Service Delivery in Crisis Affected Environments: Assisting and empowering local partners, from governments to community-level organizations, to guide contraceptive service delivery from preparedness to response to recovery; Providing flexible, long-term direct funding to local SRH organizations and government agencies; and removing obstacles in the international aid architecture that hinder the participation of local SRH actors.

  • Expansion and institutionalization of mechanisms introduced during COVID-19 to improve the availability and access of contraceptives, including multi-month provision of short-term methods, telemedicine and digital protocols, relocation and transfer of tasks, provision of methods to community -Based, contraception integration into primary health activities and self-care methods, including self-injection of subcutaneous injectables.

A full list of recommendations can be found at the end of each section.

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