Gender-based
violence, sexually transmitted infections including HIV, and maternal and
neonatal mortality and morbidity all flourish in times of conflict, says a
review, suggesting clinicians need to be sensitive and aware of the unique
challenges of women’s reproductive health needs in such times, says IANS.
“In an increasingly
globalised world, a working knowledge of reproductive health during conflict
allows clinicians to approach subjects sensitively with women, building a
relationship of trust and understanding, allowing women to gain access to
services they need,” said Benjamin Black from Medecins Sans Frontieres in
Sierra Leone.
Approximately 1.5 billion
people are currently living in countries affected by conflict, fragility or
large-scale violence. Women and children account for approximately 75 percent
of those displaced by conflict and roughly 20 percent of those displaced are
women of reproductive age.
Conflict can negatively
impact all aspects of reproductive health, directly through damage to services,
gender-based violence and forced displacement of populations and indirectly
through reductions in the availability of basic healthcare, the researchers
noted.
Further, the loss of access
to adequate family planning and basic health services also increases reliance
on traditional or harmful methods, including unsafe termination of pregnancy.
Looking at maternal mortality
specifically, high rates are frequently encountered in conflict-affected
populations — eight of the 10 countries with the highest maternal
mortality ratios have experienced current or recent conflict.
Approximately 15 percent of
displaced pregnant women will encounter a potentially life-threatening
complication, such as haemorrhage, sepsis, obstructed labour or eclampsia, the
review noted.
In the context of conflict
and displacement, services are often scarce, resulting in delays in reaching
the care required. Furthermore, the poor security conditions, exodus of
healthcare providers, lack of transport and loss of facilities result in
heightened vulnerability and reduced access to life-saving interventions.
Awareness and recognition by medical staff to these
issues may be beneficial to the women’s care and aid them in accessing the
appropriate services, the authors concluded. The review appeared in the journal
The Obstetrician & Gynaecologist.
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