Reproductive health of Syrian refugee women in Lebanon: a descriptive analysis of the Sijilli electronic health records database

Abstract

Background The Syrian conflict has been responsible for the highest exodus of refugees, with Lebanon hosting the greatest number of refugees per capita, which placed a significant strain on an already overburdened healthcare system. Women are the most vulnerable group in times of conflict and displacement, with sexual and reproductive health and rights often neglected. This study focuses on the obstetric characteristics and pregnancy outcomes of Syrian Refugee (SR) women in Lebanon, in Comparison to their pre-displacement data. Methods This study is a secondary analysis of de-identified data from the Sijilli database. The data reported and analyzed were the refugees’ socio-demographics, obstetric history, pregnancy outcomes, experienced maternal and neonatal complications, breastfeeding history and duration, and contraception use and types. Data were reported in both frequencies and means/medians. Chi-square test, t-test, and ANOVA tests were used to compare pregnancies in Syria to those that happened in Lebanon. Results A total of 1065 female records were included in this study, with 634 ever-pregnant women and the total number of pregnancies being 3272. SR women were shown to get pregnant in Lebanon at a younger age compared to cases in Syria. The number of gravidities is equal in women who got pregnant in Syria and those who moved later to Lebanon. The mean spacing between pregnancies has decreased comparing SR women who got pregnant in Syria only versus those who got pregnant in Lebanon only. Among the mixed group, the mean spacing between pregnancies as well as the prevalence of spontaneous abortions significantly increased after displacing to Lebanon. C-section rate was higher among SR women after moving to Lebanon. Also, maternal complications and not breastfeeding have increased after moving to Lebanon. A prior pregnancy was significantly associated with higher contraception use rate. The most common methods of contraception were oral contraceptive pills and intra-uterine devices. Conclusion The C-section deliveries, spontaneous abortions and maternal complications have all increased among SR women after being displaced to Lebanon. While the age at first pregnancy, mean spacing between their pregnancies and breastfeeding rates have decreased after moving to Lebanon. SR women are less likely to use contraceptives after their displacement. It is necessary to address access to reproductive healthcare and antenatal care delivery among displaced refugee women living in informal tented settlements.

Maternal Health Outcomes in the context of fragility: A Retrospective Study from Lebanon

“…While there are several studies re ecting the state of maternal health in Lebanon (29,(33)(34)(35)(36), very few focus on recent health data of disadvantaged women, particularly in primary healthcare settings (37,38).…”

Maternal health outcomes in the context of fragility: a retrospective study from Lebanon

“…While there are several studies reflecting the state of maternal health in Lebanon [32,[36][37][38][39], very few focus on recent health data of disadvantaged women, particularly in primary healthcare settings [40,41].This gap in the availability of recent data may be attributed to several factors including the migrating nature of disadvantaged populations [42], the lack of systematic data collection and follow-up, and the COVID-19 pandemic which significantly shifted the priority agenda for many researchers. In addition to that, many studies focus on testing specific interventions that aim to improve maternal heath [43,44], skipping as such the important examination of baseline data and maternal health status of the targeted population.…”

“…This strain was already evident due to limited capacities, shortage in skilled health professionals, as well as limited supply of medications and equipment [ 14 – 16 ]. Additionally, it has been revealed that women's health, among other critical healthcare concerns, represents a central concern for refugees in Lebanon, further underscoring the complexities faced by the healthcare system [ 17 ].…”