Abstract
Background: A humanitarian crisis disrupts the existing health care system limiting access to sexual reproductive health (SRH) services. The Asia and the Pacific region is home to 9.2 million refugees as of September 2020, most originating from Afghanistan and Myanmar. Afghan and Rohingya refugees have long been deprived of formal SRH education and face decades of discrimination in SRH services that can affect health outcomes. Purpose: This review examines the SRH status of Afghan and Rohingya refugee women of reproductive age in Asia and their needs and experiences in accessing these services and commodities. Methods: This protocol will follow the PRISMA checklist and standards for quality assessment of systematic reviews. The search strategy will be sought out all relevant peer-reviewed literature from five online bibliographic databases—SCOPUS, EMBASE (Ovid), MEDLINE (Ovid), CINAHL, and PROQUEST— using search terms related to the research questions. The review will include qualitative, quantitative, and mixed-method studies to understand the status of SRH of Rohingya and Afghan refugees across Asia. Content analysis will undertake following the Minimum Initial Service Package (MISP) objectives. The review will use the mixed methods appraisal tool (MMAT) to assess the quality of individual studies. However, no studies will be excluded based on this assessment. Result: The findings of this review will provide insight into the needs, status, and experiences of SRH of the Afghan and Rohingya refugee women of reproductive age in Asia and could contribute to health service planning to deliver evidence-based interventions and policies to improve SRH outcomes in humanitarian settings across Asia. Systematic review registration: The review was registered in the PROSPERO database with ID CRD42021253975.
Highlights
A humanitarian crisis disrupts the existing health care system limiting access to sexual reproductive health (SRH) services
The review will be guided by the following question: What are the sexual and reproductive health status of Afghan and Rohingya refugee women of reproductive age in Asia and their needs and experiences accessing these services and commodities? METHODS Study design
To ensure the findings were contemporary, we will only include the studies that were published from 2000 to the present. This date is closely aligned with publication of the first field manual that provides a description of the Minimum Initial Service Package (MISP) in 1999 that aims to provide life-saving SRH services in humanitarian settings (Casey, 2015; Singh, 2018; WHO, 2010)
Summary
Sexual and reproductive health (SRH) is fundamental to individual health and wellbeing and basic human rights and prerequisites of population and development (Desrosiers et al, 2020; Singh, 2018). War, conflict, genocide, violence, political instability, and natural disasters exacerbated by climate change have resulted in approximately one billion people requiring humanitarian assistance in 68 countries This includes 54 million women, girls, and young people (UNFPA, 2020). Around 9.4 million Afghan refugees require humanitarian assistance, and 2.3 million women and girls of reproductive age need sexual and reproductive health services (UNHCR, 1951). Around 316,000 Rohingya women of reproductive age (15-49) live in Bangladesh mostly in Cox's Bazar, including 63,700 pregnant women (UNFPA, 2018b) These women face challenges accessing sexual and reproductive health services, including skilled birth attendants and experience early marriage, forced marriage, early childbearing, and GBV (Huang & Schnabel, 2018). Further research is needed to understand the SRH services available to Afghan and Rohingya women and girls across the Asian region and the experiences of these refugees accessing these services
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