“Before we delivered at home, now we deliver in hospitals ….”
A candid statement by Nyibol, a 34-year-old South Sudanese refugee who came to Kakuma Refugee Camp back in 2005.
“Years ago, women refused to go to hospitals since they preferred delivering at home. As a result, some developed complications and bled to death while others lost their babies,” she continued.
Reflective in her facial expression, Nyibol confirmed improved uptake of antenatal and post- natal information and services by expectant women. “These days women attend antenatal and post-natal clinics as well as hospital delivery. Women previously feared being operated on if they went to deliver in hospital, which, according to our culture is a sign of weakness,” added Nyibol.
The community leader cited efforts by the International Rescue Committee (IRC) who use community health workers to visit homes and check on the progress of expectant women and new mothers. Introduction of emergency referral services such as ambulances has also helped in reduction of maternal deaths, according to Nyibol.
On community involvement in maternal health, Nyibol underscored the existence of a Community Health Committee that oversees the general health of women and children at the refugee camp. Again, these structures did not exist before.
Nyibol was speaking during a community conversation event held last week at the Kakuma Refugee Camp convened by the United Nations Population Fund (UNFPA Kenya) and partners to build momentum for the 25th anniversary of the ICPD slated for 12th -14th November 2019 in Nairobi.
Refugees from the Kakuma Refugee Camp and the Kalobeyei Integrated Settlement, and host community members from Turkana West Sub County thronged the venue of the meeting.
The interactive community conversation aimed at highlighting the successes and gaps in delivering quality sexual and reproductive health services and protection interventions to refugees and the host community. As part of build-up activities ahead of the ICPD25 Nairobi Summit, the conversation explored progress towards attainment of the ICPD PoA commitments in humanitarian settings.
While there has been progress in all the areas, women and girls living in Kakuma and Kalobeyei still experience violence, including harmful practices such as forced and child marriage. The women and girls also face the unmet need for family planning which stands at 44%, according to UNHCR data.
“Where can one get help as an adolescent girl who needs information and services on reproductive health matters, including pregnancy?” asked an adolescent girl from Monreau Shapelle Secondary School in Kakuma. “Sometimes we require a person in whom we can confide personal reproductive health experiences, but this is difficult because lack of privacy, confidentiality, and stigmatization,” she lamented.
To address this need for safe spaces among adolescent girls and young women, agencies present at the conversation such as the Danish Refugee Council (DRC), IRC and UNHCR urged adolescents to use existing youth friendly centres where an array of youth focused services including life skills are provided. In their staunchly patriarchal societies, women and girls are overtly undermined. Or, as a South Sudanese woman explained, “Our culture prohibits us from making decisions without seeking permission from our spouses. I cannot use any family planning method unless my husband allows me”
It was evident that services are in place, but more educational and awareness programmes should be conducted across the communities.
The development partners committed to engage in concerted efforts to secure sexual and reproductive health rights and protection needs in keeping with the determination to accelerate realization of the ICPD Programme of Action.
Twenty –five years ago in Cairo, Egypt, leaders drawn from 179 countries promised especially women and girls’ reduction in maternal deaths, elimination of violence and ending harmful cultural practices against women, ending unmet need for family planning, and advancing gender equality. This came to be known as the International Conference on Population and Development Programme of Action (ICPD PoA).