Shaping the future: Our strategy for research and innovation in humanitarian response.
Women living in humanitarian crises face significant and unique barriers when trying to prevent unwanted pregnancy and meet their other most basic sexual and reproductive health (SRH) needs. Addressing reproductive coercion (RC) and intimate partner violence (IPV) can help women to regain their reproductive autonomy. With this aim, we implemented this project to adapt and test the Addressing Reproductive Coercion in Health Settings (ARHCES) intervention for the humanitarian setting. ARCHES is a clinic-based harm reduction intervention that empowers women to implement strategies that mitigate the impact of reproductive coercion on their reproductive health.
To create equitable space for the voices and agency of Rohingya women in the implementation of the project, a Community Advisory Group (CAG) was formed comprising of 15 Rohingya women and girls. CAG members provided insights into RC and IPV experiences in the camp setting and advised on adaptation of the ARCHES intervention. A user-centered design (UCD) process was used to adapt the intervention, and CAG members participated in codesign sessions as design team members. The CAG members supported UCD activities with Rohingya women and girls seeking family planning (FP), menstrual regulation (MR), and post abortion care (PAC) services, service providers, and community health workers. The CAG members met four times during the project period to ensure adaptation of the ARCHES intervention in the humanitarian context and smooth implementation of the intervention to reduce RC and IPV.
CAG members were invited to participate with support from community health workers (CHWs). The project team sought CAG members that represented a variety of perspectives in the Rohingya community. CAG members comprised both younger and older women and varying amounts of time living in the camp setting. Some of the CAG members were more recent arrivals in Bangladesh, arriving in 2017 during a large influx of people fleeing religious persecution, ethnic cleansing, and violence from their home country. Others had been in Bangladesh since the 1990s and some were born in the camp setting. Some of the CAG members were active in their community, serving in a volunteer capacity.
Based on the evidence from project findings, the CAG members recommended to scale up the ARCHES intervention in all facilities in the camp setting. They also recommended implementing ARCHES at the community level to reach more women and girls, not only those who come to the clinic for SRH services.
Dipika Paul and Dr. Erin Pearson
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