Advancing SRHR in a challenged region
By Lydia Zigomo , Regional Director, United Nations Population Fund (UNFPA) East and Southern Africa
In the scorching heat of northern Mozambique, Fatima’s story is emblematic of the many women across the region whose lives have been upended by conflict.
Forced to flee her village when violence erupted, she walked for days, cradling her two-year-old daughter with little more than the clothes on her back. The conflict had taken everything from her — her home, her livelihood, and her sense of security. But what worried her most was that she was pregnant and had no safe place to give birth.
When Fatima reached a displacement camp, the uncertainty of her future weighed heavily on her. Through UNFPA’s mobile clinics, she accessed life-saving prenatal care. A skilled birth attendant assisted in the safe delivery of her baby boy, and Fatima received postpartum support, including contraception options to plan for her future.
In the face of conflict and displacement, access to sexual and reproductive health services means survival. These services are not just about health — they are a lifeline.
East and Southern Africa, as diverse as it is resilient, faces one of the most complex humanitarian challenges of our time. Conflict, economic instability, and climate-induced crises are driving millions from their homes, disproportionately affecting women, adolescents, and youth. In 2024, nearly 65 million people across the region need urgent humanitarian assistance. Extreme weather, like El Niño, has worsened natural disasters, spread cholera outbreaks, and deepened food insecurity. Forced displacement has become the norm, increasing risks of gender-based violence (GBV), child marriage, and trafficking, particularly for women and girls.
This week, the Government of Kenya hosted a Humanitarian Partners Round Table, which addresses the realities faced by populations in crisis. The theme, “People on the Move: Advancing Sexual and Reproductive Health and Rights (SRHR) in Humanitarian Settings”, captured the urgency of addressing these complex issues and ensuring the most vulnerable are not left behind.
As forced displacement surges across the Horn of Africa, with the region projected to host 23.6 million forcibly displaced people by the end of the year, the burden on overstretched health systems is immense. Women and girls, in particular, bear the brunt of these crises. Fleeing conflict, drought, or economic collapse, they face not only physical danger but the erosion of their sexual and reproductive health rights. In such fragile environments, access to contraception, safe childbirth, and GBV protection is often out of reach.
A lifeline in crises
Evidence shows that in times of crisis, the risks of maternal death, unwanted pregnancies, and sexually transmitted infections rise sharply. Yet, even in these extreme conditions, access to essential sexual and reproductive health services is often deprioritized.
Since the 1994 International Conference on Population and Development (ICPD) in Cairo, tremendous progress has been made but progress has slowed, and in some cases, stalled. The most marginalized — those in conflict and climate-affected areas — remain far behind.
At the 30th anniversary of the ICPD in April 2024, global leaders reaffirmed their commitment to close these gaps. They committed to ensuring universal access to SRH, eliminating GBV, and upholding the rights of women and girls. This roundtable in Nairobi continues that work, taking the bold vision forward in even the most challenging settings.
Moreover, the State of the World Population Report 2024 highlights that nearly half of all pregnancies worldwide are unintended, with social and economic consequences. It calls for urgent global action to address gender inequality and ensure every woman has the ability to plan her future.
In humanitarian contexts, these issues are critical as displaced women face significant barriers to accessing contraception and safe childbirth. As a result, the risk of maternal deaths is twice higher in humanitarian settings.
Time for a movement
Every day without action deepens the risks for women and girls in crisis-affected areas. Their health, safety, and futures depend on us–and we all have seats on the table to do something.
Let this discussion be the start of a new era of humanitarian action and where we can truly build a future where SRHR is a reality for all, even in the most difficult times.
The march continues.
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This thought piece is a reflection from the People on the Move: Advancing SRHR in Humanitarian Settings Regional Humanitarian Partners Roundtable, held in Nairobi, Kenya, on 3 October 2024. The event brought together key stakeholders to address the urgent need for sexual and reproductive health and rights (SRHR) in humanitarian settings across East and Southern Africa, particularly for displaced women, adolescents, and youth.
