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Delivering SRH Services During a Humanitarian Crisis: The Central African Republic Experience

The Central African Republic (CAR) experienced a civil war that largely involved the government, rebel groups and armed militia.

The Central African Republic (CAR) experienced a civil war that largely involved the government, rebel groups and armed militia. The peak of this violence -in December 2013, left thousands of people dead, with thousands of women, children and men being internally displaced, and many others fleeing to neighbouring countries.

The instability caused by the conflict took a huge toll on the political, economic and social growth of the country, with critical sectors such as administration, security, education and public health being greatly affected. Thousands of internally displaced populations were unable to seek treatment for their injuries, diseases and other medical conditions. In addition, they were unable to access much-needed sexual and reproductive health (SRH) services.

ACABEF’s Response

IPPF’s Member Association in the Central African Republic; l’Association Centrafricaine pour le Bien-Etre Familial (ACABEF) is credited as one of the leading reproductive health service providers in the country. In its response to the humanitarian crisis resulting from the conflict, ACABEF intervened in many of the internally displaced and refugee camps by offering a wide range of sexual and reproductive health services to the displaced populations located in different sites.

Some of the services that ACABEF provided included:

  • Family planning services
  • Free condoms
  • Ante-natal services to pregnant women
  • Treatment and management of Sexually Transmitted Infections (STIs)
  • HIV information, testing, counselling and management services

Why ACABEF’s Succeeded in its Provision of SRH Services in Conflict Areas

ACABEF adequately prepared for the provision of these services, including ensuring that all actors were involved in the planning, delivery and management of the services offered.

  • Before going into an internally displaced camp to provide sexual and reproductive health services, ACABEF first sent out a team that made exploratory investigations. This team engaged with traditional leaders and local authorities -in the presence of rebel group leaders (COMZONE) about their intentions to provide services to the populations in need.
  • ACABEF, through its peer educators and volunteers, identified young people living in these camps, who then sensitized the displaced populations of the organization’s intended activities in the camps
  • ACABEF sensitized different stakeholders; including representatives of the community as well as the armed groups on the modalities involved in ensuring that there would be smooth provision of reproductive health services in the camps and peripheral villages. Discussions about the safety of health workers and clients/beneficiaries during provision of services were prioritized
  • On mutually agreed dates, the ACABEF team provided the much-needed sexual and reproductive health services without worry, owing to the prior negotiations which guaranteed their security
  • ACABEF’s health providers referred clients with complicated cases to other health facilities capable of handling the respective needs.

Owing to these stringent arrangements, ACABEF successfully provided sexual and reproductive health services to 36 Bangui sites and 15 outlying villages. Thousands of men, women and young people greatly benefited from ACABEF’s intervention.

Challenges Experienced

  • In some areas, there were armed groups that were hostile to interventions by Non-Governmental Organizations (NGOs) and international organisations. This affected ACABEF’s service delivery in such areas.
  • Owing to the free services offered through the mobile clinics, ACABEF was unable to serve the large number of clients who turned up for services. They were subsequently referred to nearby health facilities.

Lessons Learned

  • The involvement of community actors and other stakeholders is key to the successful provision of reproductive health services to internally displaced populations
  • Despite the high level of hostility between affected groups, ACABEF has always been called upon to intervene with regard to provision of reproductive health services because of the organization’s credibility.

The collaboration of ACABEF with partners to provide quality SRHR services to the internally displaced was identified as one of the Member Association’s Good Practices during the 3rd Cycle of Accreditation. A Good Practice is an activity or practice that has been proven to work and yields positive results. The sharing of Good Practices by IPPF Member Associations offers learning experiences for their counterparts.

See other Good Practices from our Member Associations:

Leading Efforts to End Child Marriage: The Case of Senior Chief Theresa Kachindamoto of Malawi

Mobile Clinics in Cape Verde: Taking Services Closer to the People

Awarding the Best Performing Clinics: Lesotho Planned Parenthood Association (LPPA)

What’s in a Game? ABUBEF’s use of Playing Cards for Youth SRHR Education

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Featured photo: IPPF/Files/ToanTran Photos 3 & 4: IPPF/Files/TommyTrenchard



Central African Republic



Related Member Association

Association Centrafricaine pour le Bien-Etre Familial