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Sexual & Reproductive Health

Sexual and Reproductive Health 


Overview

 

UNFPA works to ensure sexual and reproductive health and rights remain at the very center of development. The 1994 International Conference on Population and Development draws a clear connection between reproductive health, human rights and sustainable development. It is a lifetime concern for both women and men, from infancy to old age. Evidence shows that reproductive health in any of these life stages has a profound effect on one's health later in life. UNFPA supports programmes tailored to what people face at different times in their lives, including comprehensive sexuality education, family planning, preconception care, antenatal and safe delivery care, postnatal care, services to prevent sexually transmitted infections (including HIV), and services facilitating preventive screening, early diagnosis and treatment of reproductive health illnesses including breast and cervical cancer.

 

Maternal Health

 

Despite significant progress in reducing maternal mortality rates in Palestine since the 1990s, there has been a troubling regression in recent years. Maternal mortality ratio has gradually worsened, with a notable 67% increase from 2020 to 2021, partly attributed to the impact of COVID-19. Around 78% of maternal deaths in 2020 were preventable with timely and adequate obstetric care during crucial periods. While the majority of women give birth in health facilities with skilled assistance, approximately 94,000 marginalized Palestinian women lack access to sexual and reproductive health services. Concerns persist regarding the quality of care, especially in emergency obstetrics, and adherence to standards and protocols, influenced by weak regulation and referral management. The need to address gaps in maternal mortality reporting and estimation has been underscored. Disturbingly, every fourth pregnant woman faces high-risk situations, with anemia affecting 25% and preterm births occurring in approximately 23% of cases. Overburdened maternity facilities lead to early discharge and reduced antenatal/postnatal care visits. The ongoing humanitarian crises further compound the challenges faced by maternal healthcare. The inadequate accessibility and low quality of care, including shortages of skilled providers, specialized expertise, essential medicines, and medical equipment, as well as poor clinical management and adherence to protocols, contribute to the maternal health crisis in Palestine.

 

To combat preventable maternal deaths, UNFPA focuses on the following approaches:

  • Ensuring timely access to high-quality emergency obstetric and newborn care.
  • Providing skilled health workers, especially midwives, throughout the continuum of care during pregnancy and childbirth.
  • Making modern contraception available and accessible to all women.

 

National Maternal Mortality Report 2020

UNFPA is committed to supporting maternal health and preventing maternal mortality through various measures:

  • Facilitating policy dialogue forums with duty-bearers to advocate for the rights of women and achieve transformative results.
  • Strengthening the monitoring system to ensure the provision of quality, accessible, and acceptable sexual and reproductive health services, aligned with associated rights.
  • Adopting a cross-sectoral approach that integrates sexual and reproductive health and rights (SRHR) into national strategic planning across social, health, education, and labor sectors.
  • Developing protocols and mechanisms to enhance the monitoring of maternal mortality.
  • Increasing accessibility to integrated, high-quality sexual and reproductive health services and supplies.
  • Incorporating SRHR in emergency plans during political, humanitarian, and environmental crises.
  • Strengthening midwifery training curricula, institutions, associations, and regulations to improve maternal care.

 

Through these efforts, UNFPA strives to ensure the well-being and safety of women during pregnancy and childbirth, and to uphold their rights to sexual and reproductive health in Palestine.

 

Towards Reducing Maternal Mortality in Palestine: Stories from the Ground

Midwifery is a great and honorable profession” – a midwife’s story

 

Family Planning

 

UNFPA is dedicated to strengthening family planning services in Palestine and ensuring access to safe and voluntary contraceptive methods. We firmly believe that family planning is a fundamental human right and a key driver of gender equality and women's empowerment. It is also a crucial element in reducing poverty and fostering sustainable development.

 

In Palestine, despite a prevalence of modern family planning contraception at 57.35% in 2019, there remains an unmet need for family planning that has unfortunately increased from 10.9% in 2014 to 12.9% in 2019. This gap is influenced by various factors such as limited access to information and services, lack of support from partners or communities, and negative attitudes among service providers towards different family planning methods. Gender discrimination, social norms, and 'son preference' also contribute to shaping family planning choices in Palestine.

 

To address these challenges, UNFPA actively advocates for expanding the contraceptive method-mix and introducing new methods in family planning. We work towards incorporating family planning as an essential component of sexual and reproductive health in health plans and strategies. This involves enhancing the commitment of service providers and policymakers to deliver comprehensive family planning services through securing financial resources, improving monitoring and marketing of services, and advocating for better counseling and attitudes of service providers.

 

Furthermore, UNFPA fills gaps in service provision by addressing weak counseling, promoting the utilization of midwives for services like inserting and removing IUDs, and ensuring consistent availability of necessary commodities. We also emphasize the importance of documenting and reporting family planning data accurately, establishing well-functioning logistics systems to deliver commodities efficiently, and integrating family planning services into women empowerment programs alongside reproductive health, gender, education, youth, awareness, and health promotion initiatives.

 

To foster a supportive environment, UNFPA supports peer-to-peer education for women and actively engages men, extended family members, and the community, including media and leaders, in promoting family planning and challenging societal norms. By working collaboratively and comprehensively, UNFPA aims to enhance family planning services and empower individuals to make informed choices about their reproductive health, ultimately contributing to the well-being and empowerment of Palestinian women and families.

A Much Neglected Service - Assessment of Family Planning Services in Palestine: Challenges and Opportunities

Family Planning Method Mix in Palestine - Challenges and Opportunities

Family planning - contraception methods

 

Breast Cancer

 

Breast cancer is a prevalent and concerning issue for women in Palestine, being the most common cancer and the third leading cause of cancer-related deaths. The survival rate is estimated to be as low as 40%, compared to higher rates in other countries. This rising trend of breast cancer cases over the past decade has significant consequences for women's well-being and quality of life. It is crucial to prioritize breast cancer as a critical health concern in Palestine and focus on improving access to and utilization of breast care services.

 

Pathway to Survival - the Story of Breast Cancer in Palestine

 

UNFPA is actively responding to this issue and working towards improving outcomes and quality of life for women impacted by breast cancer in Palestine. Through:

  • Enhancing early detection through screening programs, and provision of mammography machines and ultrasounds; 
  • Providing comprehensive training for healthcare providers;
  • Supporting the establishment of treatment centers;
  • Supporting community efforts for prevention and early detection;
  • Strengthening psychological support to affected women and their families;
  • Addressing stigma and misconceptions surrounding breast cancer.

How Farah’s Life was Transformed - A Story of a Breast Cancer Survivor from Gaza

How Can a Nurse Navigator Model for Breast Cancer Improve Women’s Lives?

 

Left behind and marginalized communities

 

UNFPA puts special emphasis on increasing access of disadvantaged groups to high quality and comprehensive sexual and reproductive health services

 

  • Midwifery-led counseling home visits in remote areas in the Gaza Strip. Since 2022, the home visits have benefited around 12,000 pregnant, lactating, postmenopausal, married and unmarried women, and adolescent girls living in refugee camps, remote rural and urban areas. The package of sexual and reproductive health counseling services includes antenatal, prenatal and preconception care, safe delivery, family planning, adolescent health, postmenopausal, genital infections, and psychosocial support services. All of these services are often unavailable in health facilities as a comprehensive package.

UNFPA supported the operationalization of eight mobile clinics. In 2022, the mobile clinics targeted 50 vulnerable communities in Jenin, Hebron, Jordan valley, Tulkarem and Qalqilya. Providing a comprehensive model of health care services, the mobile clinics improved access of 28,163 people to primary and integrated sexual and reproductive health, including gender-based violence detection and referral.

 

How a UNFPA-Supported Mobile Clinic Serves the Most Marginalized Communities in Palestine

 

SRHR Emergency Preparedness

 

UNFPA plays a crucial role in the emergency preparedness in Palestine, actively participating as a member of the SRH Emergency Preparedness Committee and supporting the development of the SRH Emergency Preparedness Plans.

 

To promote the integration of the humanitarian-development nexus approach, UNFPA has successfully established 18 Sexual and Reproductive Health Emergency District Teams at the Ministry of Health. These teams are instrumental in ensuring community preparedness for sexual and reproductive health emergencies.

 

Recognizing the importance of knowledge and skills, UNFPA supports training of health professionals from the Ministry of Health, NGOs, and the health cluster on the Minimum Initial Service Package (MISP), which equips healthcare providers with the necessary tools and expertise to effectively and efficiently address SRH needs in emergency situations.

 

Furthermore, UNFPA supports governmental safe motherhood and emergency delivery centers to effectively handle emergency obstetric care, sexual and reproductive health services, and gender-based violence response during crises and emergencies. By strengthening these centers, UNFPA contributes to ensuring that essential SRH and GBV services are available to those in need during challenging circumstances.

 

SRHR Coordination

 

UNFPA plays a vital role in coordinating sexual and reproductive health and rights (SRHR) efforts in Palestine through its leadership of key working groups and coalitions. The organization leads the Sexual and Reproductive Health Working Group, the Mobile Clinic Working Group, and the Adolescent Health Coalition, providing effective coordination, information sharing, and strategic planning for SRHR stakeholders.

 

As part of its commitment to reducing maternal mortality rates, UNFPA supports the National Maternal Mortality Committee. This committee launched the 2020 National Maternal Mortality Report, which serves as a crucial resource for accelerating progress in maternal health. UNFPA has also established Near Miss and Maternal Mortality Focal Points in all governmental hospitals, enhancing their knowledge and skills in effectively tracking maternal mortality cases. This effort not only improves data collection but also increases the commitment of healthcare providers to monitor and address maternal health issues.

 

UNFPA actively promotes knowledge exchange among national stakeholders in SRHR. The organization facilitates the dissemination of experiences and models in sexual and reproductive health and rights through conferences and events such as the National Obstetric Conference and the International Nurse and Midwifery Conference. These platforms provide opportunities for sharing expertise, exchanging experiences, and staying updated on new scientific knowledge, ultimately contributing to the improvement of SRH services' quality in Palestine.