A Systematic Review of Sexual and Reproductive Health Knowledge, Experiences and Access to Services among Refugee, Migrant and Displaced Girls and Young Women in Africa.

Olena Ivanova,Masna Rai,Elizabeth Kemigisha

doi:10.3390/ijerph15081583

Abstract

Adolescent girls and young women are an overlooked group within conflict- or disaster-affected populations, and their sexual and reproductive health (SRH) needs are often neglected. Existing evidence shows that forced migration and human mobility make girls and women more vulnerable to poor SRH outcomes such as high risk sexual behaviors, lack of contraception use, STIs and HIV/AIDS. We performed a systematic literature review to explore knowledge, experiences and access to SRH services in this population group across the African continent. Two databases (PubMed and Web of Science) were searched and from 896 identified publications, 15 peer-reviewed articles published in English met the inclusion criteria for this review. These consisted of eight applied qualitative, five quantitative and two mixed-method study designs. The quality of the studies was evaluated by the mixed-methods appraisal tool (MMAT) using scores in percentages (0–100%). Available evidence indicates that knowledge of young women and girls regarding contraceptive methods, STIs and HIV/AIDS are limited. This population group often experiences gender-based and sexual violence and abuse. The access and availability of SRH services are often limited due to distances, costs and stigma. This review demonstrates that there is still a dearth of peer-reviewed literature on SRH related aspects among refugee, migrant and displaced girls and young women in Africa. The data disaggregation by sex and age should be emphasized for future research in this field.

Highlights

Every year, thousands of people around the world flee their homes to escape conflict, disasters and violence within their own country or by crossing international borders
From 960 records, 15 studies met the inclusion criteria. They were conducted in nine African countries which included Uganda, Ethiopia, DR Congo, Somalia, Kenya, Nigeria, Djibouti, Rwanda and Sierra Leone [6,16,17,18,19,20,21,22,23,24,25,26,27,28,29]
The aim of this review was to combine the existing evidence on sexual and reproductive health (SRH) knowledge, experiences and access to services of young women and girls aged 10–24 in crisis and humanitarian situations. Such studies were largely absent and this review pointed out the lack of available peer-reviewed literature on SRH of girls and young women in the African region, where multiple conflicts are ongoing for decades, putting their health, including SRH at risk

Summary

Introduction

Thousands of people around the world flee their homes to escape conflict, disasters and violence within their own country or by crossing international borders. During these humanitarian emergencies, refugees and internally displaced persons (IDPs) suffer a great pressure which affects their health. Adolescent girls and young women (10–24 years old) are an overlooked group within conflict- or disaster-affected populations, and their sexual and reproductive health (SRH) needs remain largely unmet [1]. The synergy of crisis as well as the neglect of SRH needs, increases vulnerability of adolescent girls to unwanted pregnancies, HIV and sexually transmitted infections (STIs), maternal death and sexual violence [2,3,4]. Public Health 2018, 15, 1583; doi:10.3390/ijerph15081583 www.mdpi.com/journal/ijerph

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