Collateral damage: the overlooked reproductive health crisis in conflict zones

Conflict-affected regions face severe reproductive health challenges that disproportionately impact adolescent girls and young women (AGYW) and children, who are especially vulnerable due to the breakdown of healthcare systems and limited access to essential services. AGYW are at heightened risk due to restricted access to family planning, prenatal care, and emergency obstetric services, while children face malnutrition, disease outbreaks, and developmental delays. These challenges have profound long-term consequences for both their physical and psychological well-being. This commentary explores the underlying causes of reproductive health challenges in conflict zones, including the collapse of healthcare infrastructure, increased sexual violence, forced displacement, and the specific vulnerabilities AGYW and children face. The commentary underscores the urgent need for interventions that address both immediate and systemic gaps in reproductive healthcare, particularly for AGYW and children. A unique policy framework is proposed, integrating emergency reproductive health interventions-such as mobile clinics and emergency health kits-with long-term strategies for rebuilding healthcare systems. The framework emphasizes gender-sensitive, context-specific approaches and sustained investments in healthcare infrastructure to effectively address these challenges and mitigate the long-term effects on vulnerable populations. By aligning with global and regional policy frameworks, including the Inter-Agency Working Group on Reproductive Health in Crises (IAWG) and the Minimum Initial Service Package (MISP), the commentary advocates for embedding reproductive health into all phases of humanitarian action-from emergency response to recovery. This integrated approach provides actionable recommendations to improve the well-being of AGYW, children, and other vulnerable populations, fostering sustainable advancements in reproductive health outcomes.