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

## TL;DR

After a major earthquake in Türkiye, mobile health teams helped provide sexual and reproductive health services to women in crisis, highlighting the need for better coordination and community-based care.

## Contribution

This study demonstrates the effectiveness of community-based mobile health services in delivering SRH care during disasters and identifies key barriers and solutions.

## Key findings

- Mobile services reached 83% of women seeking SRH care in the earthquake-affected region.
- NGOs like HASUDER played a crucial role in addressing unmet SRH needs and providing essential supplies.
- Pre-existing SRH service gaps worsened post-earthquake due to privacy issues, poor hygiene, and limited access to family planning.

## Abstract

More than 50 thousand people lost their lives in the earthquake that occurred in Türkiye in 2023. This study aimed to evaluate the Sexual and Reproductive Health (SRH) services provided in earthquake region in Hatay province in Türkiye with qualitative and quantitative methods.

The research type is mixed; cross-sectional and phenomenological. The recorded data were evaluated for cross-sectional phase and purposeful and snowball sampling was conducted for qualitative phase. Data were collected through five focus group interviews (one healthcare workers group-−5 staff- and four women group-−16 women-) and 13 in-depth interviews (4 academics, 6 NGO, 3 service providers) as totally 34 participants. Thematic content analysis was conducted.

Eighty three percentage of 15,841 women's applications were reached by mobile services. All of women were given health education. The frequency of genitourinary infection is 25.0%. Family Planning (FP) method was given to 35.3% of the women, cotton underwear was given to 72.0%, and sanitary pads were given to 22%. Emerging themes included social determinants, the gap in SRH services, community based mobile services and service provision by NGOs like HASUDER (Association of Public Health Specialists) and intersectoral collaboration. Reported that pre-existing gaps in SRH services were exacerbated after the earthquake, with major barriers including lack of privacy, poor hygiene, limited family planning access, low SRH awareness. Related to social determinants, gender and migration-related challenges such as language barriers, economic hardship, cultural isolation restricted service access. NGOs played a crucial role in addressing unmet needs. However, bureaucratic barriers and limited public sector collaboration were noted. Deteriorated living conditions, and widespread healthcare disruptions across all service levels further deepened vulnerabilities. The HASUDER mobile services were highlighted as critical in reaching women, adolescents, and migrants.

The earthquake deepened health system gaps, while NGOs became essential in bridging services and building resilience. Strengthened coordination, infrastructure, and inclusive SRH integration are urgently needed. Community-based mobile service delivery is vital.