1. Minimum Initial Service Package (MISP) for Reproductive Health
Objective 1
Ensure health cluster/sector identifies agency
to LEAD implementation of MISP
• RH Officer in place
• Meetings to discuss RH implementation held
• RH Officer reports back to health cluster/sector
• RH kits and supplies available & used
RH Kit
0
Objective 5 Objective 2
Plan for COMPREHENSIVE RH services, Prevent SEXUAL VIOLENCE & assist survivors
integrated into primary health care • Protection system in place especially for women
• Background data collected & girls
• Sites identified for future delivery of comprehensive
• Medical services & psychosocial support available
GOAL
RH for survivors
• Staff capacity assessed and trainings planned • Community aware of services
• RH equipment and supplies ordered Decrease mortality,
morbidity & disability in RH Kit RH Kit
RH Kit RH Kit RH Kit 3 9
crisis-affected populations
4 5 7
(refugees/IDPs or popula-
tions hosting them) Objective 3
Objective 4
Reduce transmission of HIV
Prevent excess MATERNAL & NEWBORN
morbidity & mortality • Safe and rational blood transfusion in place
• Standard precautions practiced
• Emergency obstetric and newborn care services • Free condoms available
available
• 24/7 referral system established RH Kit Standard precautions RH Kit
• Clean delivery kits provided to birth attendants 1 through kits 1-12 12
and visibly pregnant women RH Kit
• Community aware of services 12
RH Kit RH Kit RH Kit RH Kit RH Kit RH Kit
2 6 8 9 10 11

2. CRISIS POST-CRISIS The RH Kit is designed for use for a 3-month period for a varying population number and
Crude mortality rate Mortality returns to level of is divided into three "blocks" as follows:
>1 death/10,000/day surrounding populations Block 1: Six kits to be used at the community and primary health care level for 10,000 persons / 3 months
SUBJECT AREA MINIMUM (MISP) RH SERVICES COMPREHENSIVE RH SERVICES KIT NUMBERS KIT NAME COLOR CODE
• Provide contraceptives, such as • Source and procure contraceptive Kit 0 Administration Orange
condoms, pills, injectables and supplies Kit 1 Condom (Part A is male condoms + Part B is female condoms) Red
IUDs, to meet demand • Provide staff training
FAMILY PLANNING Kit 2 Clean Delivery (Individual) (Part A + B) Dark blue
• Establish comprehensive family
planning programs Kit 3 Post-Rape (Part A + B) Pink
• Provide community education Kit 4 Oral and Injectable Contraception White
• Coordinate mechanisms to prevent • Expand medical, psychological, Kit 5 STI Turquoise
sexual violence with the health and social and legal care for survivors
Block 1 contains six kits. The items in these kits are intended for use by service providers delivering RH care at the
other sectors/clusters • Prevent and address other forms of community and primary care level. The kits contain mainly medicines and disposable items. Kits 1, 2 and 3 are
• Provide clinical care for survivors GBV, including domestic violence, subdivided into parts A and B, which can be ordered separately.
GENDER-BASED
of rape forced/early marriage, female
VIOLENCE Block 2: Five kits to be used at the community and primary health care level for 30,000 persons / 3 months
• Inform community about services genital cutting,
• Provide community education KIT NUMBERS KIT NAME COLOR CODE
• Engage men and boys in GBV
Kit 6 Delivery (Health Facility) Brown
programming
Kit 7 IUD Black
• Ensure availability of emergency • Provide antenatal care
obstetric and newborn care • Provide postnatal care Kit 8 Management of Complications of Abortion Yellow
services • Train skilled attendants (midwives, Kit 9 Suture of Tears (Cervical and vaginal) and Vaginal Examination Purple
• Establish 24/7 referral system for nurses, doctors) in performing
MATERNAL AND Kit 10 Vacuum Extraction for Delivery (Manual) Grey
obstetric and newborn emergencies emergency obstetric and newborn
NEWBORN CARE Block 2 is composed of five kits containing disposable and reusable material. The items in these kits are intended for
• Provide clean delivery packages to care
visibly pregnant women and birth • Increase access to basic and use by trained health care staff with additional midwifery and selected obstetric and neonatal skills at the health centre or
hospital level.
attendants comprehensive emergency
• Inform community about services obstetric and newborn care Block 3: Two kits to be used at referral hospital level for 150,000 persons / 3 months
• Ensure safe and rational blood • Establish comprehensive STI KIT NUMBERS KIT NAME COLOR CODE
transfusion practice prevention and treatment services, Kit 11 Referral level for Reproductive health (Part A + B) Fluorescent Green
• Ensure adherence to standard including STI surveillance systems
precautions • Collaborate in establishing Kit 12 Blood Transfusion Dark Green
• Guarantee the availability of free comprehensive HIV services as Block 3 is composed of two kits containing disposable and reusable supplies to provide comprehensive emergency
STIs, INCLUDING HIV, obstetric and newborn care at the referral (surgical obstetrics) level. It is estimated that a hospital at this level covers a
condoms appropriate
PREVENTION & population of approximately 150,000 persons. Kit 11 has two parts, A and B, which are usually used together but which
• Provide syndromic treatment as • Provide care, support and treat-
TREATMENT can be ordered separately.
part of routine clinical services for ment for people living with HIV/
patients presenting for care AIDS NOTE: Agencies should not depend solely on the Inter-agency RH Kits and should plan to
• Provide ARV treatment for patients • Raise awareness of prevention,
integrate the procurement of MISP/RH supplies in their routine health procurement systems.
already taking ARVs, including for care, treatment services of STIs
PMTCT, as soon as possible
RESOURCES:
How to order RH Kits for Crisis How to order RH Kits: ► Reproductive Health in Humanitarian Settings: An Inter-agency Field Manual:
Situations booklet: http://www.iawg.net/resources/field_manual.html
UNFPA Procurement Services Section ► MISP Distance Learning Module: http://misp.rhrc.org
UNFPA – Contact local country offices Emergency Procurement Team ► SPRINT Facilitator’s Manual for SRH Coordination:
or Midtermolen 3 www.ippfeseaor.org/en/Resources/Publications/SPRINTFacilitatorsManual.htm
► UNFPA/Save the Children Adolescent Sexual and Reproductive Health Toolkit in Humani-
220 East 42nd Street 2100 Copenhagen
tarian Settings: A companion to the Inter-Agency Field Manual on Reproductive Health in
New York, NY 10017 USA Denmark Humanitarian Settings: www.unfpa.org/public/publications/pid/4169
Tel: + 1 212 297 5245 Tel: +45 3546 7368 / 7000 ► RHRC Monitoring and Evaluation Toolkit: www.rhrc.org/resources/general_fieldtools/toolkit/
Fax: +1 212 297 4915 Fax: + 45 3546 7018 ► CDC RH Assessment Toolkit for Conflict-Affected Women:
Email: hru@unfpa.org procurement@unfpa.dk http://www.cdc.gov/reproductivehealth/Refugee/RefugeesProjects.htm
► Inter-agency Working Group on Reproductive Health in Crises: www.iawg.net
www.rhrc.org/resources/rhrkit.pdf
► Reproductive Health Response in Crises (RHRC) Consortium: www.rhrc.org
April 2010 © IAWG. Based on Inter-Agency Field Manual on Reproductive Health in Humanitarian Settings.