Sexual and reproductive health of Sudanese refugee girls in Chad: mixed methods study with perspectives from 12-19 year old girls, parents, and health workers.

Autor: Casey SE; RAISE Initiative, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Ave, B2, New York, NY, USA. sec42@columbia.edu., Ngarmbatedjimal A; Laboratoire de Sociologie, d'Anthropologie et des Etudes Africaines (LASA), Department of Sociology, College of Humanities and Social Sciences, University of N'Djamena, BP 1117, N'Djaména, Chad., Varelis T; RAISE Initiative, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Ave, B2, New York, NY, USA., Diarra A; RAISE Initiative, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Ave, B2, New York, NY, USA., Kodjimadje T; Laboratoire de Sociologie, d'Anthropologie et des Etudes Africaines (LASA), Department of Sociology, College of Humanities and Social Sciences, University of N'Djamena, BP 1117, N'Djaména, Chad., Abdelaziz M; Laboratoire de Sociologie, d'Anthropologie et des Etudes Africaines (LASA), Department of Sociology, College of Humanities and Social Sciences, University of N'Djamena, BP 1117, N'Djaména, Chad., Djerambete V; Laboratoire de Sociologie, d'Anthropologie et des Etudes Africaines (LASA), Department of Sociology, College of Humanities and Social Sciences, University of N'Djamena, BP 1117, N'Djaména, Chad., Miangotar Y; Laboratoire de Sociologie, d'Anthropologie et des Etudes Africaines (LASA), Department of Sociology, College of Humanities and Social Sciences, University of N'Djamena, BP 1117, N'Djaména, Chad., Tamira S; Laboratoire de Sociologie, d'Anthropologie et des Etudes Africaines (LASA), Department of Sociology, College of Humanities and Social Sciences, University of N'Djamena, BP 1117, N'Djaména, Chad., Ndingayande A; International Rescue Committee Chad, BP 5208, N'Djaména, Chad., Vourbane K; International Rescue Committee Chad, BP 5208, N'Djaména, Chad., Madjigoto R; Laboratoire de Sociologie, d'Anthropologie et des Etudes Africaines (LASA), Department of Sociology, College of Humanities and Social Sciences, University of N'Djamena, BP 1117, N'Djaména, Chad., Luketa S; International Rescue Committee Chad, BP 5208, N'Djaména, Chad., de Paul Allambademel V; Laboratoire de Sociologie, d'Anthropologie et des Etudes Africaines (LASA), Department of Sociology, College of Humanities and Social Sciences, University of N'Djamena, BP 1117, N'Djaména, Chad.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2024 Nov 19; Vol. 24 (1), pp. 3217. Date of Electronic Publication: 2024 Nov 19.
DOI: 10.1186/s12889-024-20581-y
Abstrakt: Background: In humanitarian settings, refugee girls' vulnerability to negative sexual and reproductive health (SRH) outcomes and the barriers they face to access to SRH services increase. Despite global guidelines on adolescent sexual and reproductive health and rights (SRHR) in humanitarian settings, evidence on the diverse knowledge, attitudes, and behaviors of refugee adolescents are limited.
Methods: This mixed methods study used a cross-sectional survey and participatory research activities to explore the knowledge, attitudes, and behaviors of 12-19 year old refugee girls from Darfur living in two refugee camps in Wadi-Fira, Chad. Focus group discussions with parents of adolescents and in-depth interviews with health workers were conducted to better understand community attitudes toward adolescent SRHR and barriers to accessing services.
Results: Overall, SRH knowledge, including of contraceptive methods, was mixed, but older girls had better knowledge than younger girls. Despite stigma around adolescent sexual activity expressed in this community, 20.9% of girls had already had sex. The majority of girls believed that health workers would maintain confidentiality if they sought contraception. Among girls who had ever had sex, 18.0% were currently using a modern contraceptive. None were using a long-acting method, but most obtained their method at the camp health center. Parents and health workers described how social stigma toward premarital sex and unintended pregnancy impeded adolescent access to SRHR information and services, although the midwives described helping girls to seek contraception.
Conclusions: Despite community stigma towards premarital sex and contraception for adolescents, some girls in the camps successfully managed to receive a contraceptive method, demonstrating both their interest in and need for contraception. Although midwives were largely supportive of adolescent access, expanding contraceptive service delivery channels and making services more adolescent-responsive would further increase adolescent access. Gender transformative programming engaging girls and boys, should be expanded to improve adolescent knowledge and self-efficacy with respect to SRHR. These efforts must also engage parents and community members to create an enabling environment for adolescent SRHR and reduce stigma.
Competing Interests: Declarations Ethics approval and consent to participate Ethical approvals for all study components and consent procedures were obtained from Columbia University's Institutional Review Board (IRB-AAAT0905) and the Direction de la Recherche et de l’Innovation, Direction Generale Technique de l’Enseignement Superieur, de la Recherche et de l’Innovation in Chad. All participants aged 15 and over provided verbal informed consent. Because this study met the criteria for minimal risk, parental consent for 15–17 year olds was waived. For 12–14 year old participants, verbal informed consent was obtained from their parent or guardian followed by verbal assent from the adolescent. This study was conducted according to the ethical principles of the Declaration of Helsinki. Consent for publication Not applicable. Competing interests The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: