Experience in Providing Family Planning Services to Migration/Refugee Population in North Sumatra and Bali

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1 Experience in Providing Family Planning Services to Migration/Refugee Population in North Sumatra and Bali DR. Dwi Listyawardhani, M.Sc. Dip.Com Deputy For Family Planning And Reproductive Health Presented on 14 th International Inter Ministerial Conference on Population and Development, Yogyakarta, November 28 th, 2017

2 Outline Reproductive Health Reproductive health in Disaster Areas Family Planning Services in Disaster Areas

3 Reproductive Health Health as a state of complete physical, mental and social well-being, and not merely the absence of disease or disability related to reproductive systems, functions and processes (ICPD, Cairo, 1994). Health as a state of complete physical, mental and social well-being, and not merely the absence of disease or disability related to reproductive systems, functions and processes in men and women. (RI Law No. 36 Year 2009 Article 71 Paragraph 1)

4 Universal Access to Health Reproductive ICPD 1994 efforts to fulfill reproductive rights Law 36, 2009 Ensures the fulfillment of the right to health UU 24, 2007 Disaster Relief MDGs, Goals Health: 1,4,5,6,7 PP 61, 2014 Ensures the fulfillment of the privilege of everyone's health. Ensures maternal health Head of BNPB Decree 173, 2015 National Cluster of Disaster Relief In order to Fulfill the individual reproductive and sexual rights within the life cycle SDGs, Goals, 169 targets, 304 indicators Permenkes 97, 2014 Ensuring maternal health giving healthy quality generation Permenkes 64, 2013 Crisis Health Prevention

5 Universal Access to Reproductive Health Reproductive Health Coverage Aging RH All countries should make reproductive health services which accessible to all individuals at the appropriate age, through the primary health care system as early as possible before 2015 BKKBN Maternal and Child Health Family Planning Post partum FP Adolescent RH Sexual Helath Prevention to DO Prevention to Unwanted pregnancy/ unsafe abortion sexual violence STIs, HIV-AIDS Infertility (ICPD Action Program, Cairo, 1994, para 7.6) Early Detection of Ca Cervics

6 Reproductive Health Services in Disaster / Health Crisis RI Law no. 24 Year 2007 on Disaster Management Protection against vulnerable groups included in Emergency Response (ps 48e), priorities for rescue, evacuation, security, health and psychosocial services (art 55) Minister of Health Regulation no. 64 Year 2013 on Crisis Response Health Article 22: Reproductive Health Services should be available during emergency health crisis response Article 26: Reproductive Health Services should be available immediately post emergency health crisis

7 Why is reproductive health services important in disaster situation? Reproductive health is a part of human rights that must be guaranteed even in emergency situation. Much effort has been made, still less attention to reproductive health. In normal situation there are many problem in the field of reproductive health and these condition will get worse in a disaster emergency. The need for reproductive health will still exist and the fact is that it increases in times of disaster

8 Reproductive Health Problems in Disaster Situations The risk of sexual violence may increase in the health crisis Lack of Family Planning services increases the risks associated with unwanted pregnancies because of contraception drop out Malnutrition and anemia increase the risk of pregnancy complications Labor Labor may occur during population movements Transmission of STI / HIV can increase in areas with high population density Lack of access to comprehensive obstetric care increases the risk of maternal death Women Special needs, ex : protection during menstruation (pads), hygiene kits

9 Family Planning services in disaster areas : Mount Sinabung (North Sumatera) and Gunung Agung (Bali) (1) Family planning services can be done through static or mobile services. Mobile services is Family Planning (KB) service facility, can be used to reach difficult area and have no competent health worker. These facilities can include: Family Planning Service Bus (MUYAN) In disaster areas where the health facility is damaged the service can be done by FP Bus Unit (Muyan). Contraceptive services provided preferably long-term contraceptive methods such as IUD, implant or vasectomy. For tubectomy only performed in static FP services

10 Family Planning services in disaster areas: Mount Sinabung (North Sumatera) and Gunung Agung (Bali) (2) PLKB officers will give counseling, information and education to the community Contraception will be obtained from the health facility at the FP service location, if there is no contraceptives it will be sent from the district warehouse.

11 FP services that provided are injecting KB, Implant, IUD and vasectomy. The service is provided by the midwife from the nearest primary health center, while the vasectomy service is performed by a surgeon from Sanglah Hospital Implementation FP Services in Gunung Agung Disaster (Bali) FP services has been conducted in 2 locations in Ulakan Village, Mangis Subdistrict Karang Asem Regency on October 6, 2017 (6 IUD and 8 Implan). Secondly service in Perbekel Tembok Village Tejakula Subdistrict, Buleleng Regency, October 19, 2017 (IUD 4, Implant 8, Vasectomy 3 and Injection 5) FP services done in 2 MUYAN Bus of Buleleng District and BKKBN of Bali Province and in tent.

12 Implementation FP Services in Gunung Sinabung Disaster (North Sumatera) There are 8 refugees center, in Kota Tengah village only 1 center in kecamatan Simpang Empat. The implant demand is higger than other methods. The number of couples of childbearing age about 8,702 and active participants 6,921people. FP service result : implant retraction 26 people Sub-district has a health facility but not all can serve FP services.

13 Thank You