Sexual and Reproductive Service Interventions for Menstrual Regulation, Safe Abortion, and Post-abortion Care and Their Effectiveness During Disaster Response: A Global Systematic Review

Abstract

Sexual and reproductive health (SRH) services are crucial for women especially during disasters, to reduce maternal mortality and morbidity from miscarriages, unsafe abortions, and post-abortion complications. This study explored the SRH interventions provided during disaster response. A systematic review was conducted to identify what menstrual regulation (MR), safe abortion (SA), and post-abortion care (PAC) approaches/interventions exist to promote resilience in the health system in disaster settings; what intervention components were most effective; and challenges and opportunities to meeting SRH rights. Five electronic databases were searched, resulting in 4194 records. Following the screening process, seven publications were included. The intervention-related information in each publication was assessed based on availability, accessibility, acceptability, and quality. Two SRH approaches/interventions were found. The effectiveness of intervention components could not be conducted due to the limited number of relevant studies. Challenges were found at facility and community levels, and opportunities included overcoming them, making MR, SA, and PAC integral to the mitigation phase, and policy change to overcome barriers related to unaffordability and inaccessibility. Recommendations are provided to encourage research and policy towards improving neglected SRH in disaster settings to realize Sustainable Development Goal 3 and the Global Strategy and Sendai Framework’s priority to promote disaster-resilient health systems.