Understanding processes of risk and protection that shape the sexual and reproductive health of young women affected by conflict: the price of protection

Abstract

BackgroundIt is assumed that knowing what puts young women at risk of poor sexual health outcomes and, in turn, what protects them against these outcomes, will enable greater targeted protection as well as help in designing more effective programmes. Accordingly, efforts have been directed towards mapping risk and protective factors onto general ecological frameworks, but these currently do not take into account the context of modern armed conflict. A literature overview approach was used to identify SRH related risk and protective factors specifically for young women affected by modern armed conflict.Processes of risk and protectionA range of keywords were used to identify academic articles which explored the sexual and reproductive health needs of young women affected by modern armed conflict. Selected articles were read to identify risk and protective factors in relation to sexual and reproductive health. While no articles explicitly identified ‘risk’ or ‘protective’ factors, we were able to extrapolate these through a thorough engagement with the text. However, we found that it was difficult to identify factors as either ‘risky’ or ‘protective’, with many having the capacity to be both risky and protective (i.e. refugee camps or family). Therefore, using an ecological model, six environments that impact upon young women’s lives in contexts of modern armed conflict are used to illustrate the dynamic and complex operation of risk and protection – highlighting processes of protection and the ‘trade-offs’ between risks.ConclusionWe conclude that there are no simple formulaic risk/protection patterns to be applied in every conflict and post-conflict context. Instead, there needs to be greater recognition of the ‘processes’ of protection, including the role of ‘trade-offs’ (what we term as ‘protection at a price’), in order to further effective policy and practical responses to improve sexual and reproductive health outcomes during or following armed conflict. Focus on specific ‘factors’ (such as ‘female headed household’) takes attention away from the processes through which factors manifest themselves and which often determine whether the factor will later be considered ‘risk inducing’ or protective.

Crisis upon crisis: a qualitative study exploring the joint effect of the political, economic, and pandemic challenges in Lebanon on Syrian refugee women’s fertility preferences and behaviour

“…This increased stature within the household may enable women to make their own decisions regarding use of contraception, which could be the case for Syrian refugee women who started working as a result of men losing their jobs. This transformative nature of agency was also highlighted in an article describing the impact of internal displacement on women’s agency in two resettlement locations in Sri Lanka [ 32 ]. The article also emphasised the transformative nature of agency during resettlement and how women used it to reestablish their livelihoods in the resettlement areas [ 32 ].…”

“…This transformative nature of agency was also highlighted in an article describing the impact of internal displacement on women’s agency in two resettlement locations in Sri Lanka [ 32 ]. The article also emphasised the transformative nature of agency during resettlement and how women used it to reestablish their livelihoods in the resettlement areas [ 32 ]. These findings suggest that development programs that focus on female livelihoods and engagement in work outside the home may influence family size, other sexual and reproductive health (SRH) outcomes, and gender equity indicators as well.…”

Salud sexual y reproductiva en mujeres víctimas del conflicto armado

“…Lo anterior genera preguntas respecto a si hay o no coerción en el inicio de estas relaciones. En las mujeres víctimas del conflicto armado son frecuentes la violencia sexual, separación familiar y desaparición forzada (13,14).…”

Sexual and Reproductive Health Information and Experiences Among Syrian Refugee Adolescent Girls in Lebanon

“…Adolescent girls living in situations of conflict and forced displacement in LMICs are particularly disadvantaged given their lack of access to school-based SRH programs and the disruption of family and friend networks through which girls access information around puberty and menstruation. At the same time, girls affected by conflict and displacement often face increased risk of early sexual initiation, marriage, and childbearing (Hutchinson et al, 2017; Neal et al, 2016), and therefore stand to lose the most from not receiving adequate information about sex, reproductive health, and contraception.…”