CASE STUDY 2

Mobile SRH Delivery
During Crises

Philippines

Context

In 2021, Typhoon Odette swept through 11 out of 17 regions in the Philippines, destroying everything in its wake. It was the third-strongest storm ever recorded in the Northern Hemisphere. Of the estimated 98,000 pregnant women in typhoon-affected areas, about 24,000 were at risk of obstetric complications. Approximately 13,000 cases of gender-based violence survivors needed care. 95% of Philippine evacuation centers did not have women-friendly safe spaces, raising the risk of gender-based violence and poor health outcomes for mothers and children. There was a severe need for SRH clinical services, particularly in rural areas that were most affected by the typhoon and hardest to access due to infrastructure damage.

Organization

The United Nations Population Fund (UNFPA) Philippines works to advance sexual and reproductive health and rights (SRHR) and address gender equality issues in the country. Their initiatives focus on improving maternal health, preventing gender-based violence, and ensuring access to contraceptive services and reproductive health services.

Approach

In partnership with the government of the Philippines, UNFPA Philippines has deployed innovative ways to ensure uninterrupted SRH care during and after crises through two methods:

Mobile clinic vehicles called Women’s Health on Wheels (WHoW) provide rapid response to women in dire need due to climate disasters and other emergencies. They are designed to get to hard-to-reach remote areas immediately after crisis events. UNFPA, with support from the Department of Foreign Affairs and Trade Australia and in partnership with the Philippines government, deployed two WHoW mobile clinics after Typhoon Odette to move between five different rural provinces. During non-disaster times, these WHoW are used for contraceptive services and maternal health outreach activities in far-flung regions. One WHoW was deployed to the Maguindanao province during the extreme flooding brought about by Typhoon Pablo in late 2022. The mobile units are the first of their kind in the country to address medical issues surrounding reproductive health and gender-based violence in the aftermath of a crisis, particularly in remote areas. The clinics are equipped with air-conditioned rooms, medical beds, audio-visual systems for information sessions, laboratory equipment, solar panels for power, and satellite Internet connectivity. Local governments provide drivers, administrative staff, and medical teams.

E-bikes ridden by health workers and midwives were used to resupply contraceptives to households and provide counseling to deliver services in 20 municipalities in Laguna and Riza during the COVID-19 pandemic. Post-pandemic, these bikes are now being used by midwives to provide immunization services to children in hard-to-reach barangays (villages). These e-bikes remained part of the local government fleet for serving communities in times of displacement due to climate events. The e-bike fleet was created through the support of Canada, the Philippine Society for Responsible Parenthood, Inc., and the Asia Pacific Management and Research Group.

Results to Date

After Typhoon Odette struck Southern Leyte in December 2021, WHoW was deployed to provide mobile clinical services such as prenatal care, safe deliveries, early management and referral of complicated pregnancies, referral of GBV cases, cervical cancer screening, contraceptive services, and other health information sessions. About 400 internally displaced people were served, including:
- 74 pregnant women provided with at least one prenatal care visit (17 were adolescents)
- 3 safe deliveries and 6 complicated pregnancies initially managed and referred
- 41 women and girls provided FP services
- 39 women screened for cervical cancer
- 231 women and girls provided with SRH and GBV information
- 1 GBV case referred
The health workers on e-bikes reached a total of 5317 individuals in two provinces between June 2021 and June 2022 and delivered contraceptive products and services to 4762 people.

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