Impact of climate-induced drought on sexual and reproductive health services : a comparative policy analysis from East Nusa Tenggara and Turkana county

Abstract

This report examines the impact of climate-induced drought on the sustainability of sexual and reproductive health (SRH) services, with a particular focus on maternal healthcare and contraceptive access in two drought-prone and resource-limited regions: East Nusa Tenggara (NTT) in Indonesia and Turkana County in Kenya. The study employs a comparative case study approach, analysing secondary data from 2008 to 2023 to assess how prolonged drought conditions affect key SRH indicators, including antenatal care (ANC), skilled birth attendance (SBA), and modern contraceptive use. Findings reveal that both regions exhibit significant service delivery challenges during droughts, including decreased ANC and SBA coverage, reduced contraceptive uptake, and increased food insecurity, all of which disproportionately affect women and adolescent girls. In Turkana, drought has led to severe declines in skilled birth attendance, while NTT continues to lag in maternal health indicators due to geographic isolation and systemic underinvestment. The policy analysis of Kenya’s Health Sector Disaster Risk Management Plan (2014–2018) and Indonesia’s MoH Regulation No. 75 of 2019 concerning Health Crisis Management reveals critical gaps in disaster preparedness and the integration of SRH services, as both frameworks lack specific guidance on maternal health continuity, emergency contraception, and SRH monitoring. While Kenya focuses on emergency response strategies, such as mobile clinics and dignity kits, Indonesia emphasizes long-term solutions, including midwife training and community outreach initiatives. The report concludes that a hybrid approach combining rapid response with sustained health system strengthening is essential for building climate-resilient SRH services. Key recommendations include integrating the Minimum Initial Service Package (MISP) into national health sector frameworks, improving contraceptive supply chains, tracking sexual and reproductive health (SRH) data during crises, and strengthening coordination between disaster management and health ministries. By implementing these measures, governments and health actors can better safeguard reproductive health rights and ensure continuity of care in the face of growing climate threats.