Abstract
Prior to the conflict, Syria had relatively high fertility rates. In 2010, it had the sixth highest total fertility rate in the Arab World, but it witnessed a fertility decline before the conflict in 2011. Displacement during conflict influences fertility behaviour, and meeting the contraceptive needs of displaced populations is complex. This study explored the perspectives of women and service providers about fertility behaviour of and service provision to Syrian refugee women in Bekaa, Lebanon. We used qualitative methodology to conduct 12 focus group discussions with Syrian refugee women grouped in different age categories and 13 in-depth interviews with care providers from the same region. Our findings indicate that the displacement of Syrians to Lebanon had implications on the fertility behaviour of the participants. Women brought their beliefs about preferred family size and norms about decision-making into an environment where they were exposed to both aid and hardship. The unaffordability of contraceptives in the Lebanese privatised health system compared to their free provision in Syria limited access to family planning services. Efforts are needed to maintain health resources and monitor health needs of the refugee population in order to improve access and use of services.
Highlights
The current conflict in Syria is described by the United Nations High Commissioner for Refugees (UNHCR) as “the worst humanitarian crisis in the 21st century”, resulting in 4.3 million refugees displaced to neighbouring countries and 7.6 million displaced internally by December 2015.1 Over one million refugees have been displaced to Lebanon, where they live within local communities in makeshift housing, informal tented settlements (ITS) or rented spaces
Earlier studies looking at fertility behaviour among refugees in several settings examined desired and actual number of children, birth intervals, family planning practices and abortion, and explained an increase in fertility as due to the need to replace lost children, while a decrease in fertility was seen as due to the difficult living conditions of refugees.[6,26]
We focused on Syrian refugee women’s fertility behaviours in Al-Marj, Bekaa, revealing the complex interplay of contextual factors some encouraging the maintenance of high fertility and some conducive to lowering fertility
Summary
The current conflict in Syria is described by the United Nations High Commissioner for Refugees (UNHCR) as “the worst humanitarian crisis in the 21st century”, resulting in 4.3 million refugees displaced to neighbouring countries and 7.6 million displaced internally by December 2015.1 Over one million refugees have been displaced to Lebanon, where they live within local communities in makeshift housing, informal tented settlements (ITS) or rented spaces. Low fertility was attributed to inadequate nutrition among Khmer refugees in Cambodia;[3] high fertility associated with S75. Fertility behaviour in the context of forced migration is complex, contextual and influenced by a number of factors that act and interact at varying degrees, difficult to predict in the long term.[6]
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