Preparing for and Responding to Sexual and Reproductive Health in Disaster Settings: Evidence From Fiji and Tonga
Authors: Beek Kristen , Drysdale Robyn , Kusen Matthew , Dawson Angela 
Published: April 2021

Abstract
BackgroundPacific Island countries are vulnerable to natural disasters, including cyclones and earthquakes. Disaster preparedness is key to a well-coordinated response to preventing sexual violence and assisting survivors, reducing the transmission of HIV and other STIs, and preventing excess maternal and neonatal mortality and morbidity. The International Planned Parenthood Federation (IPPF), in collaboration with its Member Associations and national and international partners, has focused on building country capacity as part of the SPRINT program to implement global standards for sexual and reproductive health and rights (SRHR) during disasters. In 2016 Tropical Cyclone Winston peaked near Fiji, and in 2018, Tropical Cyclone Gita severely impacted Tonga. This study aimed to identify the capacity development activities undertaken as part of SPRINT in Fiji and Tonga and how these enabled the SRH response to both cyclones.MethodsThis descriptive qualitative study was informed by a framework designed to assess public health emergency response capacity across various levels (systems, organizational, and individual) and two phases of the disaster management cycle (preparedness and response). key informants were recruited purposively to include diverse individuals from relevant organisations and interviewed by telephone, Zoom, Skype and email. Template analysis was used to examine the data.FindingsEight key informants were interviewed from eight organisations involved in response to cyclones Winston and Gita. Differences in the country contexts were highlighted. The existing program of training in Tonga, investment from the IPPF Humanitarian Hub, the status of the Tonga Family Health Association as the key player in the delivery of SRH, together with its long experience of delivering contract work in short time-frames and strong relationship with the Ministry of Health facilitated a relatively smooth and rapid response. In contrast, training was rapidly delivered in Fiji during the immediate response to the cyclone with the support of surge staff from IPPF. In Fiji, the response was initially hampered by a lack of clarity concerning stakeholder roles and coordination, but linkages were quickly built to enable a response. Participants highlighted the importance of personal relationships, individuals and organizations' motivation to respond, and strong rapport with the community to deliver SRH. DiscussionThis study highlights the need for comprehensive activities at multiple levels within a country and across the Pacific region to build capacity for an SRH response. While the SPRINT initiative has been implemented across several regions to improve organisational and national capacity preparedness training for communities can be strengthened. This research outlines the importance of formalising partnerships and regular meetings and training to ensure the currency of coordination efforts in readiness for activation. However, work is needed to further institutionalise SRH in emergencies in national policy and accountability mechanisms.