Syrian refugee women’s access to family planning services and modern contraception during overlapping crises in Bekaa, Lebanon

Abstract

Background Political, financial, and pandemic crises in Lebanon have affected both provision of reproductive health services including family planning and modern contraception methods as well as women’s interest and ability to seek those services. This study aims to explore the impact of the compounding crises on the provision and use of family planning services including modern contraception methods for Syrian refugees in Lebanon focusing on the perspectives of Syrian refugee women. Methods We carried out 12 Focus Group Discussions (FGDs) with 119 Syrian refugee women recruited from two cities in West Bekaa, Lebanon from inside and outside the informal tented settlements. We used Skype video calls to moderate the FGDs due to the limited mobility at the time of the study because of Covid-19. We used thematic analyses to analyse the data. Results The crises seemed to exacerbate supply side barriers, which influenced provision of family planning services and women’s demand for them. These included Covid-19 regulations and maltreatment by staff at public health facilities, disruption of outreach reproductive health services that provide family planning and modern contraception, and reduced supply of modern contraception methods. On the demand side, women reported financial limitations in accessing and paying for services, concern over being infected with Covid-19, and concerns about insecurity. Conclusions We suggest possible interventions to address these challenges and better reach these populations. These include using mobile health technology (mHealth) that may provide contraceptive counselling and/or can inform refugee women about where they may receive family planning and modern contraception. These services may also support Syrian refugees to access care they are entitled to receive and may also address disruptions in service provision due to overlapping crises, including availability and rising costs of contraceptives. These can be coupled with mobile outreach reproductive health services that provide family planning. We also suggest considering the provision of Long Acting Reversible Contraception (LARC) for Syrian refugee women, which would reduce a barrier of needing to revisit health facilities to obtain an additional supply of contraception pills.

Factors associated with family planning use among refugee and host populations in Adjumani district, West Nile, Uganda: a comparative study

“…It is evident that women have no access to FP services because they are not only unfamiliar with the environment but also on mobility. This finding is supported by studies done in Turkiye and Lebanon [ 37 , 38 ] which revealed that refugee women during mobility have little or no access to FP services. Some of the reasons are language barrier, limited information about FP, no method of choice among others.…”

Gender identity as a barrier to accessing adequate and inclusive healthcare for Syrian refugees in Lebanon's Northern regions

“…The study found that since 2019, disruption of reproductive health services that provide family planning and modern contraception, as well as the reduced supply of modern contraception methods were major outcomes of Lebanon's economic demise and its COVID-19 restrictions (Mourtada and Melnikas, 2023). According to the same study, women also reported "financial limitations in accessing and paying for services, " and "concerns about insecurity" as major contributors to the decrease in their access to quality gendersensitive care (Mourtada and Melnikas, 2023).…”

“…A 2023 study published in BMC Women's Health that explored the impact of Lebanon's compounding crises on the provision and use of family planning services including modern contraception methods for Syrian refugee women in the Beqaa found these types of gender-focused services were largely impacted by the local and national contexts (Mourtada and Melnikas, 2023). The study found that since 2019, disruption of reproductive health services that provide family planning and modern contraception, as well as the reduced supply of modern contraception methods were major outcomes of Lebanon's economic demise and its COVID-19 restrictions (Mourtada and Melnikas, 2023). According to the same study, women also reported "financial limitations in accessing and paying for services, " and "concerns about insecurity" as major contributors to the decrease in their access to quality gendersensitive care (Mourtada and Melnikas, 2023).…”