In a world increasingly affected by natural disasters, prolonged conflict, economic and political crises, and disease outbreaks, there is an urgent need for new models and innovative ways for advancing sexual and reproductive health and rights (SRHR).
The Approaches in Complex and Challenging Environments for Sustainable SRHR (ACCESS) Consortium will produce a set of scalable, evidence-based, participatory approaches that support and engage marginalised and under-served populations in complex and challenging environments to claim and access comprehensive sexual and reproductive health (SRH) information and services.
Ensuring that all people are able to enjoy their sexual and reproductive health and rights by 2030 requires progress on reaching the most under-served and marginalised populations, including those living in humanitarian settings and other contexts where social disadvantage intersects with oppressive political, climatic, or conflict situations.
The COVID-19 pandemic is a real example which is having a devastating impact around the world, adding to the existing difficulties experienced by women and girls and marginalised populations, and weakening already fragile health systems. Without action, conditions will worsen – rising insecurity may cause conflict and place a further strain on SRH services.
Funded with UK aid from the UK government and led by IPPF, the consortium is comprised of Frontline AIDS, Internews, the London School of Hygiene & Tropical Medicine, The Open University, and the Women’s Refugee Commission. By leveraging each partner’s comparative strengths, ACCESS will develop a set of evidence-based tools and models that can be adapted and transferred to a range of settings for an improved, community-led SRHR response.
By working with diverse communities in diverse settings in Lebanon, Mozambique, Nepal and Uganda in collaboration with IPPF Member Associations, ACCESS will co-design and test innovative solutions that enable the most marginalised and under-served people to access comprehensive, evidence-based sexual and reproductive health (SRH) information and services. Compounded by COVID-19, each country has unique circumstances:
- Lebanon, which hosts a huge number of refugees, including 1.5 million refugees from Syria and multi-generational Palestinian refugees who have been in camps and settlements for decades, straining the relatively small health system.
- Mozambique, which is in the recovery phase after the devastation of Cyclones Idai and Kenneth in 2019, and is vulnerable to the effects of recurrent natural disasters in the context of extreme poverty and low levels of development.
- Nepal, which experienced a devastating earthquake in 2016 and has been working to build resilience to prepare for the impact of climate-driven hazards.
- Uganda, which faces multiple challenges, including natural hazards, large influxes of refugees from unstable bordering countries, and a restrictive SRHR policy environment.
Through a participatory process that works with communities to identify their SRHR needs, barriers and priorities, as well as to create, test, and refine innovative solutions, ACCESS will contribute to advancing universal SRHR through four outputs:
- Resilience: Communities prone to destabilising events, including natural disasters and the effects of protracted conflicts, are better prepared for SRH response and recovery.
- Quality Services: Innovative, evidence-based service delivery modalities improve the availability, accessibility, and responsiveness of quality SRH services for communities in complex and challenging environments.
- Agency and Equity: Marginalised populations have increased awareness of their sexual and reproductive rights and increased agency to demand and access SRHR information and services, with the support of an enabling environment.
- Influence: Evidence generated from the project influences and impacts policy and practice across the humanitarian-development continuum.
Tools & resources
- Take your training (TYTO) online course
- Principles into practice: Co-creation of learning in complex and challenging environments. (Discussion guide and toolkit)
- Facilitator’s Kit: Community Preparedness for Reproductive Health and Gender
- IPPF Comprehensive HIV Services Package
Papers & publications
Co-creation, participation, and decolonisation:
- Community participation is crucial in a pandemic: Community participation is crucial in a pandemic - The Lancet
- Reimagining authorship guidelines to promote equity in co-produced academic collaborations
- Colonial Conundrums: What happens when a global north-based Sexual Reproductive Health and Rights (SRHR) consortium attempts to adopt a decolonising approach?
- Unpacking power dynamics in research and evaluation on social accountability for sexual and reproductive health and rights
Reaching the most under-served and marginalised populations:
- Sexual and reproductive health service considerations for people of diverse sexual orientation, gender identity and expression, and sex characteristics (SOGIESC): a systematic review protocol
- COVID-19 testing acceptability and uptake amongst the Rohingya and host community in Camp 21, Teknaf, Bangladesh
Comprehensive Sexuality Education (CSE):
- Effective comprehensive sexuality education: What is known and what is needed?
- Online comprehensive sexuality education: What is known and what is needed?
- Comprehensive Sexuality Education (CSE) for out-of-school refugee youth: What is known and what is needed?
- Full Review: Effective Comprehensive Sexuality Education (CSE)
- A graphic elicitation technique to represent patient rights
- Methods to measure effects of social accountability interventions in reproductive, maternal, newborn, child, and adolescent health programs: systematic review and critique
- Preparing humanitarians to address ethical problems
- Covid-19 in humanitarian settings: addressing ethics to reduce moral distress
In April 2021, IPPF received formal notification of the FCDO’s decision to terminate the grant to the ACCESS Consortium. The project closed on 31 December 2021.