Sexual and Reproductive Health of Internally Displaced Women and Children in Melanesia- A Review
Background: Around the world, human beings have been displaced and have suffered the consequences of destruction caused by natural hazards and war conflicts. In Melanesian countries such as Fiji, Vanuatu, Solomon Islands and Papua New Guinea (PNG), displacement is triggered by tribal conflict and natural hazards such as storms, floods, earthquakes, landslides, droughts, tsunamis, and volcanic eruptions: the incidence of which has been increasing. Such hazardous events and tribal conflicts destroy land, homes, farms, food, and the provision of essential services, such as health and education, causing complications to the lives and livelihoods of Internally Displaced Persons (IDPs). Internally displaced persons are victims of natural and human-made disaster displacement and often remain in their own countries. Globally, scholars have developed innovative strategies to build resilience for pre- and post-disaster recovery and have achieved positive outcomes. However, the risks associated with women and children who have been displaced continue to increase. Their Sexual and Reproductive Health (SRH) is often at risk whilst they are evacuated to temporary settlements. Given this, there is a lack of research or understanding into how their SRH could be improved. Since natural hazards and conflicts frequently occur in Melanesian countries, it is crucial to address the SRH of internally displaced women and children pre-and post-disaster to ascertain the appropriate policies and services needed to address their needs.
Aim: This research was conducted to identify the sexual and reproductive health experiences of internally displaced Melanesian women and children in the Pacific region and to identify policy and service provision gaps that could be addressed. The study's outcome is anticipated to assist policymakers and service providers in Melanesian countries in addressing the sexual and reproductive health of internally displaced women and children. Method: The research comprised (1) a narrative review of the Sexual and Reproductive Health (SRH) experiences of internally displaced Melanesian women and children and (2) a policy review of the existing policies addressing the sexual reproductive health of internally displaced women and children in four Melanesian countries, Papua New Guinea, Fiji, Vanuatu, and the Solomon Islands. These policies and strategies were analysed using the United Nations internally displaced guiding principles goals.
Results: The Policy review found that: (1) Fiji, PNG, Vanuatu, and Solomon Islands' national health policies and strategic plans have not addressed the sexual and reproductive health rights of internally displaced women and children. (2) Only Fiji has incorporated UN Guiding Principles for addressing SRH amongst IDPs in its national disaster risk reduction policy and disaster management plan. The narrative review identified three key domains where themes emerged detailing SRH experiences amongst IDPs. These were (1) sexual gender-based violence, (2) the influence of cultural factors on sexual and reproductive health experiences, and (3) a lack of adequate, affordable, quality health services, staff, and resource equipment. Sexual and reproductive health themes included sexual assault, rape, domestic violence, sexual exploitation, human trafficking, unwanted pregnancy, and chronic sexually transmitted diseases. These were raised as significant issues affecting IDP women and children.
Conclusion: Natural hazards and tribal conflict displacement have significantly affected the sexual and reproductive health of internally displaced Melanesian women and children. The facilitators and barriers to sexual and reproductive health experiences associated with natural hazards and conflicts are numerous. Most importantly, the UN guiding principles that protect the SRH of IDPs were lacking in most of the Melanesian countries' policies and strategic plans. Thus, policymakers and service providers need to come together to examine their role in mitigating the impact of natural hazards and tribal conflict displacement and improve the sexual and reproductive health needs of internally displaced Melanesian women and children.