“I don’t know if we’ll ever live in harmony”: a mixed-methods exploration of the unmet needs of Syrian adolescent girls in protracted displacement in Lebanon

Abstract

Background The current crisis in Syria has led to unprecedented displacement, with neighbouring Lebanon now hosting more than 1.5 million conflict-affected migrants from Syria. In many situations of displacement, adolescent girls are a vulnerable sub-group. This study explores and describes the self-reported unmet needs of Syrian adolescent girls who migrated to Lebanon between 2011 and 2016. Methods This mixed-methods study focusing on the unmet needs of adolescent girls was part of a larger research project on child marriage among Syrian migrants in Lebanon. Participants were recruited using purposive sampling in three field locations in Lebanon by locally trained research assistants. One hundred eighty-eight Syrian adolescent girls chose to tell qualitative stories about their own experiences. Using handheld tablets and an application called “Sensemaker” stories were audio-recorded and later transcribed. Participants were asked to then self-interpret their stories by answering specific quantitative survey-type questions. Demographic information was also collected. NVivo was used to undertake deductive coding of the qualitative data using Maslow’s Hierarchy of Needs as an analytic frame. Results Among the 188 self-reported stories from adolescent girls, more than half mentioned some form of unmet need. These needs ranged across the five levels of Maslow’s Hierarchy from physiological, safety, belonging, esteem and self-actualization. Nearly two thirds of girls mentioned more than one unmet need and the girls’ expressed needs varied by marital status and time since migration. Unmet esteem needs were expressed in 22% of married, and 72% of unmarried girls. Belongingness needs were expressed by 13% of girls who migrated in the last 1–3 years and 31% of those who migrated in the previous 4–5 years. Conclusion Many needs of displaced Syrian adolescent girls remain unmet in this situation of now protracted displacement. Girls most commonly expressed needs for love and belonging followed closely by needs for safety and basic resources. The level and type of unmet need differed by marital status and time since displacement. Unmet needs have been associated elsewhere with physical illness, life dissatisfaction, post-traumatic stress, depression, anxiety and even death. These results can inform integrated interventions and services specifically targeting adolescent girls and their families in the protracted migration situation now facing Lebanon.

The sexual and reproductive healthcare challenges when dealing with female migrants and refugees in low and middle-income countries (a qualitative evidence synthesis)

“…Barriers were analyzed to identify the strongest themes at each level. From the selected studies, 12 mentioned strong individual level barriers [ 28 – 30 , 34 , 42 – 49 ], 11 stated barriers at the social and community level [ 28 – 31 , 34 , 42 , 45 , 46 , 48 , 50 , 51 ], 10 mentioned issues related to the institutional and health care level [ 28 , 30 , 31 , 34 , 43 , 46 , 48 – 51 ], and 9 mentioned structural level barriers [ 28 , 30 , 31 , 45 – 48 , 50 , 51 ]. In eight studies, we identified all of the four-level barriers to SRH utilization among migrants and refugees.…”

“…Lack of female healthcare workers, denial of service based on marital status, discrimination, inhumane treatment, lack of confidence to provide the service, language barrier, and poor skills and policy knowledge were common barriers. Healthcare in turn often complains about burnout and work overload [28,30,43,44,48,50,51].…”

Identifying psychosocial problems, needs, and coping mechanisms of adolescent Syrian refugees in Jordan

“…The development of the interview guide was guided by the published literature review (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(30)(31)(32)(33)(34)(35)(36)(37) on the topic and by consultation with a group of experts that included a psychologist, a sociologist, a family physician, and two schoolteachers. Each consultant was approached by the investigators, provided with the developed tool and requested to provide feedback on the clarity, comprehensiveness, and appropriateness of the questions.…”

“…Not only can the crisis in Syria exacerbate pre-existing mental disorders within the refugees, but it could also trigger the surfacing of multiple psychosocial problems (14,15). Previous studies have investigated the psychosocial problems and needs among Syrian refugee adolescents (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). However, few studies looked at Syrian adolescents in Jordan (30)(31)(32)(33)(34)(35)(36)(37).…”