By Katherine Gambir, research advisor, and Lily Jacobi, advisor, sexual and reproductive health and research, Women’s Refugee Commission
“Supporting national or local organizations to participate and lead in the sexual health and reproductive rights preparedness and response creates a basis for the sustainability of programs because national and local organizations know their communities best.” – Marcelo Kantu, Assistant Director for Monitoring and Evaluation, Associação Moçambicana para Desenvolvimento da Família (AMODEFA)
Cyclone Idai made landfall near the city of Beira in Sofala province, Mozambique, on 14 March 2019, causing catastrophic damage and a humanitarian crisis. By the end of April 2019, some 400,000 people had been displaced due to the cyclone, and in May 2019, 1.85 million people were reported to be in need of humanitarian assistance, including 462,000 women and girls of reproductive age. Humanitarian actors and affected communities reported a troubling spike in gender-based violence (GBV), transactional sex, sexual exploitation, and child marriages in the aftermath of the cyclone.
At the onset of every crisis, it is vital that life-saving sexual and reproductive health (SRH) services, including the full range of contraceptives and post-rape care, are made available as soon as possible. SRH services are essential; while international organizations play a critical role in SRH service delivery, girls and women cannot wait for international actors to arrive before they receive the time-sensitive care they need. That’s why local government and nongovernmental organizations (NGOs), community-led organizations, and civil society organizations, including youth and women’s organizations and organizations of persons with disabilities, are critical when it comes to preparing for and responding to crises, including the provision of SRH services.
It is essential, especially now during the COVID-19 pandemic, that the global humanitarian community – including donor nations – support local governments and organizations that know best what needs to happen, when, and how. The incoming Biden administration has already announced it will take immediate action on several key SRH priorities, including rescinding the Mexico City Policy, also known as the “global gag rule”; rejoining the World Health Organization (WHO); and restoring funding to the UN Population Fund. We must accompany these promises with a strong commitment to invest in local leadership.
In Mozambique, AMODEFA, International Planned Parenthood Federation’s member association, was instrumental in ensuring essential SRH services, including contraception, were available in the aftermath of Cyclone Idai. As the only Mozambican NGO that participated in the emergency coordination mechanism dedicated to SRH, it played a critical role in supporting the Ministry of Health of Mozambique (MISAU) to deliver SRH services and connect communities with humanitarian responders. In December 2019, the Women’s Refugee Commission (WRC) partnered with AMODEFA to document contraceptive and post-abortion care (PAC) services in Cyclone Idai-affected communities in Sofala province.
Access to SRH care, including contraception and PAC, not only saves lives: it is a human right, and positions girls and women to protect their health, pursue their goals, and lead recovery efforts in their communities. By prioritizing SRH from the onset of a response, humanitarian actors can invest in the transformative power of girls and women. As an adolescent girl living in a resettlement center told WRC, “For me, [the contraceptive implant] is a good thing, as I can avoid getting pregnant. I used to have pills, which I forgot to take often. Now, I’m safer.…Right now, I’m studying, and I have a boyfriend. If it wasn’t for the implant, I would be pregnant already. Thanks for existing, implant!”
AMODEFA’s success in the Cyclone Idai response demonstrates the capacity and unique position of local and national organizations to lead effective SRH preparedness and response in collaboration with national and sub-national government agencies, particularly ministries of health. As a trusted Mozambican organization with a long history of providing SRH services and serving the community, it possessed the knowledge of communities and service providers to support the MISAU’s mandate to coordinate SRH service delivery in health facilities and camps for internally displaced persons; deploy community health workers to reach affected populations with information and services; and communicate with communities in their local languages.
The global humanitarian community – including the incoming Biden administration – must invest in preparedness at the local level and engage a diversity of national and local stakeholders to develop humanitarian response capacity. It must provide funding and training, and engage in relationship building to share experiences and best practices—relationships that can be leveraged in the event of a crisis to ensure a coordinated, effective response.
Shifting power from Global North to Global South actors to lead disaster preparedness and response efforts will better meet the needs of the communities we aim to serve.