IEHK 2006 is not designed for reproductive health services: reproductive health kits for emergencies may be ordered after a basic assessment of needs (see Annex 7).
A number of priority reproductive health interventions have been defined as essential for a displaced population during an emergency. The Minimum Initial Service Package for Reproductive Health (MISP) is a coordinated set of activities, including the provision of: emergency obstetric care to prevent excess neonatal and maternal morbidity and mortality; provisions to reduce HIV transmission; and activities to prevent and manage the consequences of sexual violence.
Professional midwifery care is an essential service for which the necessary instruments and medicines are included in the kit. A small quantity of magnesium sulfate for severe pre-eclampsia and for eclampsia is included in the supplementary unit for use as a "holding" measure prior to referral.
The use of emergency contraception is a personal choice that can only be made by the woman herself. Women should be offered counselling on this method so as to reach an informed decision. A health worker who is willing to prescribe ECPs should always be available to prescribe them to rape survivors who wish to use them.1
1 Clinical management of rape survivors. Developing protocols for use with refugees and internally displaced persons. Revised edition. Geneva: World Health Organization; 2004.
In the context of patient post-exposure prophylaxis (Patient PEP), a limited quantity of medicines for: (1) presumptive treatment of sexually transmitted infections, including N. gonorrhoea and C. trachomatis; for (2) prevention of transmission of human immunodeficiency virus (HIV); and (3) prevention of pregnancy (emergency contraception) for survivors/victims of sexual assault (rape), is included in the kit.
Supplies for routine and general treatment of sexually transmitted infections and contraception will have to be ordered separately according to need (see Annex 7).
Comprehensive reproductive health services need to be integrated into the primary health care system as soon as possible and a referral system for obstetric emergencies must be made accessible to the population. It is also recommended that a qualified and experienced person be appointed as reproductive health coordinator.
To assist the implementation of a reproductive health programme, the Inter-Agency Working Group on Reproductive Health in Emergencies (IAWG) has designed a number of reproductive health kits for all levels of the health care system during an emergency (see Annex 7). The kits can be ordered through the United Nations Population Fund (UNFPA)
IEHK 2006 will always be supplied with a Patient PEP module unless there is a specific request not to include these items at the time of ordering.