Reproductive health in Refugee Camps in Greece

Sexual and reproductive health services for persons in need for humanitarian assistance have improved immensely since the 1994 Cairo International Conference on Population and Development, where reproductive health was defined as part of health care people have a right to. Follow it in 1995 Beijing Women´s Conference the addition of sexual health was added. In 1994 a ground-breaking report Refugee Women and Reproductive Health Care: Reassessing Priories was published. In 2018, 24 years have passed since the report, and sexual and reproductive health have become a part of the humanitarian response in today’s refugee setting.
Women are of reproductive age between the ages of 15-49 years according to the World Health Organization (WHO). There are gender specific health and social issues that women face, and processes need to be in place in a humanitarian response to ensure women have access to relevant and timely services. Not addressing sexual and reproductive needs of women, can increase the vulnerability of women and hinder their agency to deal with life in a refugee setting, that already has many challenges. Women need to be empowered to have control over their own sexual and reproductive health and humanitarian actors in refugee settings need to ensure that access and availability of the appropriate services is in place. The main issues that need to be addressed is to ensure organizations are present that are qualified and have knowledge on how to implement sexual and reproductive health services and will work towards preventing and responding to sexual violence, sexually transmitted diseases and HIV, address maternal morbidity and mortality and unintended pregnancies (including family planning and safe abortion services).
The Inter Agency Working Group on Reproductive Health in Crises (IAWG) is a broad based collaborative coalition that works towards expanding and strengthening access to quality sexual and reproductive health services for persons affected by conflict and natural disaster and have been doing so since it was founded in 1995 by over 50 national and international NGOs and UN agencies. The IAWG developed the Minimum Initial Service Package for Reproductive Health (MISP). The UNFPA manages these kits and evaluates them ever few years to ensure it complies with the latest evidence and is more productive. Currently the main objectives of the MISP are:

• Identify an agency to lead the implementation of the MISP
• Prevent and manage the consequences of sexual violence
• Reduce transmission of HIV
• Manage STD´s
• Ensuing availability of contraceptives
• Prevent excess neonatal and material morbidity and mortality
• Plan for the provision of comprehensive RH services integrated into primary health car as soon as the situation permits
In 2018 a new Inter-Agency Field Manual on Reproductive Health in Humanitarian Setting will be published, and additionally access to safe abortions will an objective. The MISP has been included in the Sphere standards since 2004 and in 2010 MISP was included as a life saving intervention by the Central Emergency Response Fund .
There are various standards and laws that ensure and protect women’s right for health care needs. These are both national, regional and international standards and laws. However, implementing and ensuring women are protected by them can be complex, let a lone in a refugee camp setting.
Objective of this thesis is to examine whether women at a reproductive age have access to appropriate sexual and reproductive service they have a right to according to international, regional and humanitarian standards and laws, in a specific refugee camp setting in Greece. Are health service providers aware of these standards and laws?
Also, to identify gaps that exist in services and provide recommendations to improve sexual and reproductive services for women in a specific refugee setting.