In recent years, conflict, violence and disasters have brought a dramatic rise in the number of displaced people, both within and across national borders. There are an estimated 26 million women and girls of reproductive age living in emergency situations, all of whom need sexual and reproductive health (SRH) information and services. The average length of time an individual now spends displaced is 20 years, and three quarters of countries with the highest maternal mortality ratios are fragile states as defined by the Organisation for Economic Co-operation and Development. Sexual violence is also prevalent. A recent Global Review demonstrated that significant gaps remain in access to safe abortion and reproductive health care in humanitarian settings.
Providers are an essential component of safe abortion care globally. In humanitarian settings providers have unique needs to provide safe, competent care. To support providers in offering safe, evidence-based reproductive health care, the WHO has recently developed a process for adapting reproductive health guidelines to the humanitarian setting, and developing provider tools. This process was developed following a review of the literature, and in consultation with experts in guideline methodology, emergency response, SRH and rights, epidemiology, implementation research, and program managers. The methodology has been applied to the Medical Eligibility Criteria for Contraceptive Use, and a tool of the adapted guidelines developed and field tested. Similar efforts may further provision of safe abortion care in the humanitarian settings.