FOREWORD

Reproductive health is a right; and like all other human rights it applies to refugees and persons living in refugee-like conditions. To exercise this right, populations caught up in conflict and living in emergency situations must have an enabling environment and access to complete reproductive health information and services so they can make free and informed choices. They also must feel comfortable and secure in discussing their most private concerns with those who seek to help them.

Quality reproductive health services must be based on refugees', particularly women refugees', needs. They must also respect refugees' various religious and ethical values and cultural backgrounds while conforming to universally recognised international human rights standards. Therefore, full information on options, and access to reproductive health services should be provided, leaving the decision to the individual.

Reproductive health care covers a wide range of services. These are defined as follows in the Programme of Action of the International Conference on Population and Development (ICED) held in Cairo, Egypt, in September 1994: family-planning counseling, information, education, communication and services; education and services for prenatal care, safe delivery and post-natal care, and infant and women's health care; prevention and appropriate treatment of infertility; prevention of abortion and the management of the consequences of abortion; treatment of reproductive tract infections, sexually transmitted diseases, including HIV/AIDS; breast cancer and cancers of the reproductive system, and other reproductive health conditions; and active discouragement of harmful traditional practices, such as female genital mutilation.

Providing comprehensive and high-quality reproductive health services requires a multi-sectoral integrated approach. Protection, health, nutrition, education and community service personnel all have a part to play in planning and delivering reproductive health services.

The best way to guarantee that reproductive health services meet the needs of the refugee community is to involve the community in every phase of the development of those services: from designing programmes to launching and maintaining them to evaluating their impact. Only then will refugees benefit from services specifically tailored to their needs and demands; and only then will they have a stake in the future of those services.

This Inter-agency Field Manual on Reproductive Health in Refugee Situations is the result of a collaborative effort of many UN agencies, governmental and non-governmental organisations and refugees themselves. Information in this Manual is based on the normative, technical guidance of the World Health Organization. A draft of the Field Manual was first issued in 1996 and tested extensively in the field. This new version can, and should, be shaped and adapted to suit the particular circumstances and requirements of each refugee situation as it arises and evolves.

We are pleased with the progress already made in meeting the reproductive health needs of refugees and persons living in refugee-like situations; but we also know this is no time to lose momentum. We hope the Field Manual will serve to improve the health and well-being of refugees and foster more responsive and appropriate actions in the field.

Gro Harlem Bruntland
Director General
WHO

Nafis Sadik
Executive Director
UNFPA

Sadako Ogata
High Commissioner for refugees
UNHCR