Continuity of care in crisis: Community based mobile health teams for sexual and reproductive health services in post-earthquake period in Türkiye.

Mobile health services reached 83% of women who applied for sexual and reproductive health services in the earthquake-affected Hatay province.

• Total of 15,841 women's applications were recorded in the cross-sectional phase
• 83% of these applications were reached by mobile services
• All women who received services were given health education
• HASUDER (Association of Public Health Specialists) mobile services were highlighted as critical in reaching women, adolescents, and migrants

The frequency of genitourinary infection among women served was 25.0% in the post-earthquake period.

• Genitourinary infection rate of 25.0% was documented among the 15,841 women in the study population
• Poor hygiene conditions in post-earthquake living situations were identified as contributing factors
• Deteriorated living conditions were noted as deepening health vulnerabilities
• Lack of privacy was identified as a major barrier to care

Family planning methods were provided to 35.3% of women, while hygiene supplies including cotton underwear and sanitary pads were distributed.

• Family planning methods were given to 35.3% of women served
• Cotton underwear was provided to 72.0% of women
• Sanitary pads were provided to 22% of women
• Limited family planning access was identified as a major pre-existing barrier that was exacerbated after the earthquake

Pre-existing gaps in sexual and reproductive health services were exacerbated after the earthquake, with multiple barriers restricting access.

• Major barriers identified included lack of privacy, poor hygiene, limited family planning access, and low SRH awareness
• Gender and migration-related challenges such as language barriers, economic hardship, and cultural isolation restricted service access
• Deteriorated living conditions and widespread healthcare disruptions across all service levels further deepened vulnerabilities
• Bureaucratic barriers and limited public sector collaboration were noted as obstacles to service delivery

NGOs played a crucial role in addressing unmet sexual and reproductive health needs in the post-earthquake period.

• Qualitative data were collected through five focus group interviews (one healthcare workers group of 5 staff and four women groups of 16 women) and 13 in-depth interviews (4 academics, 6 NGO representatives, 3 service providers), totaling 34 participants
• Thematic content analysis identified NGO service provision as a key emerging theme
• NGOs became essential in bridging services and building resilience following the earthquake
• Bureaucratic barriers and limited public sector collaboration were noted as challenges for NGO operations
• Intersectoral collaboration was identified as a critical theme in the qualitative findings

The study used a mixed-methods design combining cross-sectional quantitative analysis of service records with phenomenological qualitative inquiry.

• Research was conducted in Hatay province, Türkiye following the 2023 earthquake that killed more than 50,000 people
• Cross-sectional phase evaluated recorded service data from 15,841 women's applications
• Qualitative phase used purposeful and snowball sampling with five focus group interviews and 13 in-depth interviews
• Thematic content analysis was conducted on qualitative data
• Study population included women, adolescents, and migrants

Strengthened coordination, infrastructure, and inclusive SRH integration were identified as urgently needed, with community-based mobile service delivery highlighted as vital.

• The earthquake deepened health system gaps while NGOs became essential in bridging services
• Community-based mobile service delivery was characterized as 'vital' by the authors
• Strengthened coordination, infrastructure, and inclusive SRH integration were described as 'urgently needed'
• HASUDER mobile services were specifically highlighted as a critical model for reaching vulnerable populations