Putting sexual and reproductive health and rights first during emergencies
13 August 2025Nirajan Khadka, Technical Advisor for Sexual and Reproductive Health and Rights at Plan International Nepal, highlights why sexual and reproductive health must be a priority during emergencies. He explains how the organisation works to support girls and young women, especially those most at risk, ensuring they get the care they need when it matters most.
Why sexual and reproductive health matters in crises
When emergencies happen, whether natural disasters, conflicts, disease outbreaks, or displacement, they cause great harm to health services and increase risks for many people. Girls and young women, especially those from marginalised groups, are more vulnerable to issues like unwanted pregnancies, unsafe abortions, violence, and infections. During such times, health systems often break down, making it harder to get help. Protecting sexual and reproductive health and rights (SRHR) in emergencies is essential to keep people safe, healthy, and treated with dignity.
Making sure everyone can get help
Not everyone can easily access sexual and reproductive health services during emergencies. Young girls, LGBTQIA+ people, those with disabilities, refugees, and other groups face extra barriers. We at Plan International Nepal work hard to make sure these groups are not left out. We provide menstrual hygiene kits, mobile clinics, counselling, and safe spaces tailored to the needs of diverse communities. We also train staff and partners so they can deliver care that respects people’s rights and identities.
Plan International Nepal also uses data to understand who faces the most challenges. For example, after the 2023 earthquake in Jajarkot, a Rapid Gender Assessment was done to help identify and respond to the specific needs of adolescent girls, pregnant women, people with disabilities, LGBTQIA+ individuals, and older people.
How we prepare and respond
We do more than just respond to emergencies. We plan to include sexual and reproductive health in all stages of crisis preparation and recovery. Some of the ways we do this include:
- Inclusive planning: Incorporating gender equality and social inclusion in emergency plans through the Ready to Respond Plan and a gender equality and social inclusion Action Plan for 2024–2028.
- Training: Nepal was the first country in the Plan federation to deliver face-to-face training on sexual and reproductive health in emergencies to staff, especially emergency response teams. These trainings are also shared with local partners.
- Relief kits: Pre-positioning dignity kits, child kits, and other non-food items to be ready for quick distribution, within 72 hours, during disasters like the 2023 Jajarkot earthquake and 2024 floods in Madhesh and Bagmati.
- Safe spaces: Setting up safe and inclusive places for distributing aid, with strong safeguarding measures, survivor support, and feedback systems.
- Adolescent-Friendly services: Under the Adolescent SRHR project in Bardiya, building health centres that are friendly to adolescents, gender-sensitive, and accessible to people with disabilities. These centres provide counselling, menstrual health education, family planning, and STI prevention, even during emergencies.
Overcoming challenges in emergencies
Talking openly about sexual and reproductive health can be difficult in many communities due to social and cultural stigma. This often stops people from seeking the help they need. We work with communities, local leaders, and young people to change attitudes and reduce stigma.
Access is also a challenge because emergencies can damage roads and health facilities, especially in remote areas. To tackle this, the organisation uses mobile clinics, partners with local health centres, and keeps SRHR kits ready to go.
There is also a shortage of trained health workers who feel confident providing care that is sensitive to adolescents and gender issues. We address this by training staff regularly on the Minimum Initial Service Package (MISP) and safeguarding.
Minimum Initial Service Package
The Minimum Initial Service Package, or MISP, is a set of basic sexual and reproductive health services that should be provided right at the start of an emergency. Its goal is to save lives and protect health, especially for women and girls. MISP focuses on:
- Preventing and managing sexual violence
- Providing clean and safe childbirth services
- Offering family planning to avoid unwanted pregnancies
- Preventing and treating sexually transmitted infections, including HIV
- Making sure there is coordination between health teams to deliver these services quickly and well
MISP is a global standard recognised in emergency response to ensure that sexual and reproductive health care is available from day one, even when systems are under great pressure.
Finally, policy gaps and poor coordination sometimes mean SRHR is not prioritised in national emergency plans. Plan International Nepal advocates for better inclusion of SRHR in disaster response systems and works with governments to improve coordination.
By combining training, planning, advocacy, and community work, we ensure that girls and young women from all backgrounds, including the most vulnerable, can access the sexual and reproductive health services they need, even in emergencies.
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