The Minimum Initial Service Package (MISP) for reproductive health (RH) is a coordinated set of priority activities designed to prevent excess morbidity and mortality, particularly among women and girls at the onset of humanitarian emergencies. The MISP objectives aim to prevent and manage the consequences of sexual violence; reduce HIV transmission; prevent excess maternal and newborn morbidity and mortality; and plan for comprehensive RH services. Additional priority activities of the MISP include making contraceptives available to meet demand, syndromic treatment for sexually transmitted infections (STIs) and ensuring antiretrovirals (ARVs) for continuing users. It is key to remember that while the MISP represents priority actions for the early days and weeks of emergencies, the aim is to ensure all crisis-affected populations have access to comprehensive RH services as soon as possible.

For more information about the IAWG’s work on the MISP, please see the MISP Sub-Working Group page.

Key Messages:

The Minimum Initial Service Package (MISP) for reproductive health is a set of priority activities that form a Sphere minimum standard to be implemented at the onset of every humanitarian crisis. These life-saving activities form the starting point for reproductive health programming and should be built upon as soon as possible with comprehensive reproductive health services and sustained throughout protracted crises and recovery.

The MISP can be implemented without a new needs assessment because its use has been justified by documented evidence.

Neglecting the MISP during a humanitarian crisis may lead to grave consequences including preventable maternal and newborn deaths, sexual violence and subsequent trauma, sexually transmitted infections (STIs), unwanted pregnancies, unsafe abortions, and the possible spread of HIV.

Facts & Stats

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Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth. Ninety-nine percent of all maternal deaths occur in developing countries.

Reference: Maternal Mortality, WHO, 2015


Newborn or neonatal deaths account for 45% of all deaths among children under 5. The majority of all neonatal deaths (75%) occur during the first week of life and between 25% to 45% occur within the first 24 hours.

Reference: Newborns: Reducing Mortality, WHO, 2016


The seven countries with an under five mortality rate above 100 are all located in sub-Saharan Africa.

Reference: Levels & Trends in Child Mortality. UNICEF, WHO, World Bank, UN, 2015


A study by United Nations High Commissioner for Refugees (UNHCR) revealed that 54% of women that survived rape in refugee camps in seven countries did not receive emergency contraception (EC) within 120 hours of an incident in 2007.

Reference: Keesbury J. et al., Emergency Contraception in Emergencies: Assessing Progress, Identifying Challenges. Reproductive Health in Emergencies Conference 2008.

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Of the eight groups in Zaatri Camp in Jordan, women in only three of the groups knew of adolescent centers in the camp. Of the women that knew about centers, they were unclear as to whether the centers offered RH services.

Reference: Reproductive Health Services for Syrian Refugees in Zaatri Refugee Camp and Irbid City, Jordan. W. Doedens, N. Giga, S. Krause, M. A. Onyango, S. Sami, E. Stone, B. Tomczyk, H. Williams, 2013