Title: Redressing Gendered Health Inequalities of Displaced Women and Girls in contexts of Protracted Crisis in Central and South America (ReGHID)
Funder: Economic and Social Research Council

Abstract: The overarching objective of ReGHID is to improve the delivery of SRH and SRHR of reproductive age women (aged 25-49) and adolescent girls (15-24) in situations of protracted displacement, to engender both evidence-based advocacy and concrete policy proposals for improving coverage of SRH services and developing responsive and inclusive durable solutions for wellbeing and development of all. ReGHID will: - Develop new quantitative and qualitative empirical evidence on the impact of displacement on the SRH needs of women and adolescent girls in Central America and Venezuela (WPs 1-3) - Co-produce research with non-governmental and civil society organisations working with displaced women and adolescent girls to uncover the lived experiences of their right to health in relation to SRH, and the strategies of displaced women and adolescent girls deploy to meet those needs, including from public and non-state providers in places of transit and settlement (WP2) - Co-produce a holistic understanding of the pressure that the SRH needs of displaced women and adolescents place on local health systems in places of settlement, including an analysis of the resources and capacity required to meet SRH needs and rights (WP3, WP4) - Analyse whether and how health systems respond to, compromise or deny SRH needs and rights for migrant women and girls in places of settlement (WP4) - Co-develop with health service researchers, local and regional stakeholders a 'Comprehensive Healthcare Model', proposing concrete changes at local (public) health system level to deliver gender-responsive and rights-based services (WP4) - Co-develop and implement with key local stakeholders (including associations of women and adolescent girls, NGOs, and the OIM), strategies for guiding planning for the effective delivery of displaced women and adolescent girls' SRHR through 'the AGAPE guide': 1) Assessment of female displaced migrant SRH needs and SRHR, 2) Guidance in identifying and accessing services in destinations, 3) Assistance in processes of movement and sites of transit and settlement, 4) Protection from wrongs and harms that impact on SRH, 5) Enabling self-reliance and movement to durable solution (WP5, WP6) Research fieldwork and impact activities will be conducted in key places of settlement of women and girls from Honduras, Guatemala and El Salvador in Tapachula, Mexico; Venezuelan migrants in Manaus and Roraima, Brazil, and Norte de Santander, Colombia; and places of return after protracted displacement in Tegucigalpa and San Pedro Sula in Honduras and San Salvador in El Salvador. The project will be delivered by an interdisciplinary and international consortium that unites leading academics from health economics, political science, demography and social statistics, international development, human rights, gender studies, anthropology, migration and public health. Participants are drawn from leading research institutions in Central and South America region (Honduras, El Salvador, Brazil, Colombia and Mexico), the Universities of Southampton and York. It benefits from the participation of key regional intergovernmental and non-governmental organisations including the Council of Ministries of Health for Central America (COMISCA), the regional office of the International Organisation for Migrations (IOM), Medicos Sin Frontera (MSF, Mexico), United Nations Population Fund (UNFPA), and FLACSO/Costa Rica. Outreach and impact will be achieved through a set of activities in partnerships with NGOs and IOM embedded in their routine work and working directly with displaced women and adolescent girls throughout the work packages.

Lay abstract: Women and young girls who are driven by necessity to leave their countries in Central and South America (often on basis of gendered threats such as sexual violence) face a range of gender-specific threats to their health and well-being both in the process of migrating and in the places of settlement that they reach. Sexual and reproductive health is a key component of social development and well-being that is particularly at risk in contexts of displacement (risks of rape and sexual assault, of sexual disease, of lack of contraception or sanitary materials are all features of processes of forced displacement in this region and elsewhere) and the ability of displaced women and girls to access and exercise their sexual and reproductive health rights faces a number of obstacles. These can range in the immediate local context from lack of awareness of rights or of the practical knowledge and skills to negotiate health systems on the part of displaced women and girls to the lack of capacity of local health services to address the needs of displaced females, where these immediate problems point to wider issues of national and regional health governance, of the need for effective planning for flexible responsiveness to crises of displacement that may become protracted and the fair sharing of responsibility for securing rights protection. This matters not only because securing these rights is integral to recognising the dignity of women and girls, but also because it is critical to enabling displaced women and girls to act as agents of development, as productive social and economic agents whose activities support the achievement of Sustainable Development Goals. ReGHID will: - identify the sexual and reproductive health needs of women and adolescent girls displaced from Central America to Mexico and from Venezuela to Brazil and Colombia; - analyse the challenges that displaced women and girls face in relation to SRH; - assess the impact of displacement on local health systems in the area of SRH, noting the obligations of receiving and transit states to ensure that the human right to health for all is respected and protected; produce original primary data about gendered patterns of inequalities affecting access to and delivery of care in women and girls' SRH during displacement. It does so in order to propose human rights-based and deliverable responses addressing (a) the immediate and longer-term SRH needs of women and adolescent girls in displacement, including guidance, skills and information to equip them to articulate their SRHR; and (b) a responsive Comprehensive Healthcare Model as a policy solution to protect the SRHR of migrant women and girls in contexts of protracted displacement. To be able to do this work, the project has been co-designed, and will be cooperatively carried out, through a partnership between academics and major UN and NGO agencies from the fields of migration, displacement, aid and development. The project will be delivered by an interdisciplinary and international consortium that unites leading academics from health economics, political science, demography and social statistics, international development, human rights, gender studies, anthropology, migration and public health. Participants are drawn from leading research institutions in Central and South America region (Honduras, El Salvador, Brazil, Colombia and Mexico), the Universities of Southampton and York. It benefits from the participation of key regional intergovernmental and non-governmental organisations including the Council of Ministries of Health for Central America (COMISCA), the regional office of the International Organisation for Migrations (IOM), Medicos Sin Frontera (MSF, Mexico), United Nations Population Fund (UNFPA), and FLACSO/Costa Rica. The consortium represents a unique balance of relevant research and policy experience

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: GENERIC HEALTH RELEVANCE