MISP Coordination in Nepal

Location:

Introduction:

An inter-agency evaluation was undertaken to document the implementation of the MISPMinimum Initial Service Package within 5 months after the April 2015 earthquake in Nepal in one urban (Kathmandu) and one rural (Sindhupalchowk) district. The study explored awareness of the MISPMinimum Initial Service Package, implementation of the standards, and factors that influenced implementation using both quantitative and qualitative methods. Methods included secondary data review, focus group discussions, key informant interviews, and health facility assessments.

Findings:

MISPMinimum Initial Service Package priority activities were largely available in both districts. The quality of certain services was low when they were available, specifically clinical care for survivors of sexual violence, syndromic management of sexually transmitted infections (STIs) and standard precautions in some settings. Community knowledge about culturally sensitive SRHSexual and reproductive health issues, the benefits of seeking care, and the location of services for sexual violence and STISexually transmitted infections including HIVHuman immunodeficiency virus were a major gap when compared to contraception or maternal health services. In addition, many key informants were not aware of available services such as emergency contraception and post-exposure prophylaxis for sexual violence survivors.

Lessons Learned:

Availability of the MISPMinimum Initial Service Package in the two study districts appears to be associated with three key factors:

1. Commitments and investments in SRHSexual and reproductive health by the Government of Nepal and partners pre-crisis;
2. Existence of emergency and disaster risk management for health initiatives that include the MISPMinimum Initial Service Package in preparedness activities and pre-positioning of RH KitsInter-Agency Reproductive Health Kits; and
3. Leadership and collaboration among partners in the immediate response to secure donor support and to implement coordinated and innovative strategies to reach affected communities. Community engagement in the initial response is critical including informing communities about the benefits for sexual violence survivors seeking timely health care and the location of services.