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Sexual and Reproductive Health Working Group Bulletin: Rohingya Refugee Response, Cox’s Bazar (January – December 2024)

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Situation Overview

The Sexual Reproductive Health (SRH) Working Group is pleased to present its annual report for 2024, highlighting key achievements, challenges, and strategic priorities. This report reflects the continued commitment to strengthening and fostering partnerships to improve access to essential sexual reproductive health services and drive impactful change for the women and girls in the Cox’s Bazar Rohingya response.

Key Achievements

1. Publication of the SRH WG bulletins: The SRH WG develops and publishes quarterly SRH WG bulletins as summary feedback to the working group partners. In 2024, the quarterly bulletins for Q1, Q2, and Q3 can be found here. This annual bulletin also includes the Q4 bulletin. The regular bulletins, produced by the SRH WG with support from the M&E team, provide SRH WG partners with a situational overview of SRH services and achievements for that period. They also serve as a means of providing feedback to SRH WG members.

2. The development, piloting, and scale-up of the operationalization of the Maternal and Child Health (MCH) Card was a significant initiative aimed at standardizing and harmonizing sexual and reproductive health (SRH) services. Complementing the general health card, this initiative was supported by the Health Sector, the SRH Working Group (SRH WG), and partners. It sought to improve documentation and ensure a continuum of care for mothers and newborns. By the end of the year, the MCH Card was operational in all 33 camps in Cox’s Bazar as well as in Bhasan Char.

3. Recognizing that Cox’s Bazar is prone to natural disasters such as cyclones, floods, and monsoons, the SRH WG, in collaboration with UNFPA and the Health Sector, conducted a Minimum Initial Services Package (MISP) Readiness Assessment (MRA) Workshop. The objective of the workshop was to evaluate the preparedness to implement lifesaving SRH services during emergencies by identifying gaps in crucial areas such as SRH service delivery, supply chain management, human resources, and coordination mechanisms.

The two-day workshop, held on March 12–13, 2024, engaged multiple sectors, including the Government, RRRC’s office, DDFP’s office, UN agencies, humanitarian workers from the health sector, and SRH WG partners. The Action Plan developed during the workshop by various stakeholders is being closely monitored by the SRH WG to ensure that all identified gaps are addressed. Subsequently, the SRH WG has also strengthened the capacity of Mobile Medical Teams (MMTs), which provide emergency lifesaving services during humanitarian crises or natural disasters for the Rohingya community.

4. During the fire incident at Camp 5, which displaced over 5,000 refugees, including many women and girls, the SRH WG, in collaboration with the Health Sector, conducted an SRH needs assessment and distributed emergency reproductive health kits to ensure the continued provision of lifesaving SRH services.

5. On May 5, 2024, in Cox's Bazar, UNFPA, along with the Sexual Reproductive Health Working Group (SRH WG) and its partners, marked the International Day of the Midwife, joining the global celebration.

The vibrant event, themed "Midwives: Vital Climate Solutions," began with a march through Cox's Bazar town. Midwives were accompanied by stakeholders from the health sector, UN agencies, national and international NGOs, and humanitarian actors involved in the Rohingya response. Throughout the day, midwives in Cox’s Bazar showcased various aspects of midwifery and maternal health at dedicated stalls, highlighting family planning, gender-based violence response, skilled delivery, management of pregnancy-related complications, and emergency care.

Keynote speakers, including representatives from government offices (RRRC, DDFP, Civil Surgeon), the health sector, the SRH WG coordinator, the head of the UNFPA sub-office, and UN agency representatives, honored midwives as champions of maternal and child health, recognizing their vital role in addressing challenges exacerbated by climate change, emergencies, and disasters.

6. The SRH WG coordinated and conducted an Inter-Agency Joint Monitoring Assessment between April and May to evaluate SRH service availability, access, and quality across 109 out of 113 health facilities. The assessment report identified critical gaps, including insufficient respectful maternity care, inadequate staffing, and a shortage of reproductive health commodities. Based on these insights, an action plan was developed to address these service gaps.

7. Based on the Family Planning Strategy for the Rohingya Refugees, UNFPA, in collaboration with the Deputy Director of Family Planning (DDFP), piloted a communitybased distribution model in 10 out of 33 camps from May to June to improve family planning service access. Findings indicated that many refugees preferred obtaining contraceptive refills from local drug shops rather than health facilities, leading to an extension of the door-to-door service.

8. During the reporting quarter, the SRH WG, in collaboration with the Health Sector Emergency Preparedness and Response (EPR WG) Working Group, integrated the Minimum Initial Services Package (MISP) for Reproductive Health into the health sector emergency response. This was achieved by training all health sector emergency medical teams on MISP and ensuring the prepositioning of all RH kits and MaMa kits at health facilities. The MISP for Reproductive Health in Humanitarian Crises is a set of life-saving reproductive health interventions designed to be implemented at the onset of an emergency.

In June 2024, the SRH WG, in collaboration with IOM, the GBV Sub-Sector, and the Health Sector, conducted two training sessions for all 33 Emergency Mobile Medical Team (MMT) members. A total of 62 MMT members received this training, including 31 Midwives, 27 Doctors and 4 Incident Commanders.

With this MISP training, the capacity of MMTs to address critical and lifesaving reproductive health needs will be strengthened, ultimately helping to prevent excess morbidity and mortality among women and girls during emergencies.