Intended for healthcare professionals

Analysis Self Care Interventions for Sexual and Reproductive Health

Self care interventions could advance sexual and reproductive health in humanitarian settings

BMJ 2019; 365 doi: (Published 01 April 2019) Cite this as: BMJ 2019;365:l1083

Self care interventions for SRHR

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  1. Carmen H Logie, associate professor12,
  2. Kaveh Khoshnood, associate professor3,
  3. Moses Okumu, doctoral student1,
  4. Sabina Faiz Rashid, dean4,
  5. Fidan Senova, sexual and reproductive health educator5,
  6. Hamza Meghari, graduate student6,
  7. Claire Uwase Kipenda, community health worker7
  1. 1Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
  2. 2Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
  3. 3Yale School of Public Health, New Haven, CT, USA
  4. 4James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
  5. 5Çukurova University Faculty of Medicine, Balcalı Hospital, Adana, Turkey
  6. 6Institute for Global Health, University College London, London, UK
  7. 7Interaid Uganda, Kampala, Uganda
  1. Correspondence to: C Logie carmen.logie{at}

Forcibly displaced people often lack access to adequate sexual and reproductive health services. Carmen Logie and colleagues examine the role of self care interventions in filling the gap

In 2017, the estimated number of people forcibly displaced by conflict and human rights violations increased by 2.9 million1 to a record high of 68.5 million people.1 Humanitarian crises disrupt communities to such an extent that they require national or international resources and help.12 Forcibly displaced people include those who have left their home but have not crossed an international border (internally displaced people); those who have left their country because of persecution, war, and violence (refugees); and people who have applied for sanctuary in another country (asylum seekers).1

Self care interventions are strategies by which people can take control of their own health. Self care interventions for sexual and reproductive health include health promotion (eg, HIV self testing), preventing and controlling illness and disease (eg, pre-exposure prophylaxis for HIV prevention), and self treatment and medication (eg, self managed abortion through self administered mifepristone and misoprostol unsupervised by a healthcare provider).345 Self care interventions may be particularly appropriate for humanitarian crises when countries may lack sufficient trained health workers, have poorly maintained and unsustainable health infrastructures, and lack evidence based sexual and reproductive health practices and policies.6

Most (85%) forcibly displaced people are accommodated by low and middle income countries.1 Sudden and protracted emergencies often lead to the collapse of healthcare systems in affected countries, and overstraining of healthcare systems in the host countries.7 This may result in inadequate or interrupted access to sexual and reproductive health services and rights.28910 Uganda, a low income country, provides an example of one such humanitarian crisis. Over a million refugees …

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