The female face of migration: unveiling the livelihood strategies and struggles of displaced syrian women

BackgroundTurkey hosts the world’s largest community of Syrians displaced by the conflict. The Minimum Initial Service Package (MISP) is a coordinated set of priority reproductive health services. There is not any scoping review assessing the RH situation of Syrian refugees in Turkey within the framework of the MISP objectives. The objectives of this review is to identify the situation of sexual and reproductive health (SRH) among Syrian refugee women in Turkey, and document the health services provided for them in terms of the components of MISP. We hoped to show evidence of gaps and help guide future research to focus on priority areas to improve the range, quality, and access to SRH services and to recommend public health interventions.MethodThe literature search was conducted in Turkish and English. Multiple electronic databases (Turkish Medline, Google Scholar, PubMed, Web of Science, Medline, Cochrane Database of Systematic Reviews, EBSCOHost, CINAHL, and Embase) were searched from January 2011 to May 2018. References published in the peer-reviewed literature, the grey-literature, and on websites were eligible for inclusion if they had conducted research on one or more of the following SRH topics specifically for Syrian women in Turkey: maternal and neonatal health/antenatal care, HIV and sexually transmitted infections, use of contraceptives, sexual violence, and services delivery and accessibility. References were excluded if any of the following criteria were relevant: not specific to Syrian women refugees in Turkey. Firstly, the titles and abstracts of the articles that were found were examined to determine if they met the eligibility criteria. Secondly, if the abstracts and titles met one or more of the eligibility criteria, the full text of the articles have been examined. Finally, standard forms were prepared and used to summarize the articles narratively. The results of the screening were recorded in Excel spreadsheets for comparison, and any disagreements among the researchers were resolved by consensus. The studies were grouped according to the MISP objectives.ResultsA total of 24 publications were eligible for inclusion in the review. Consanguineous marriage rate was 56%. The rate of marriage under age 18 were very high. Mean age at first marriage was found to be between 18 and 20. The rate of antenatal care was inadequate. The rate of using a modern contraceptive method was 24% among married and all age groups of Syrian women. The rates of unmet family planning needs were about 35%. Among patients admitted to gynecology outpatient clinics, about half of the applicants were reported to have abnormal vaginal discharge. The reported rates of sexual violence were about 8%. Only 20% of Syrian women had regular gynecological visits.ConclusionOverall, we conclude that early marriage, low modern contraceptive use, unmet need for contraception, sexual and gender-based violence are the major SRH issues reported. There is a need for further studies to identify the barriers limiting service uptake as well as to document successful practices. Long term strategies to improve the SRH status of Syrian refugee women should be developed with participation of all stakeholders. This review is significant in terms of that it is the first scoping review assessing the RH situation of Syrian refugees in Turkey within the framework of the MISP objectives. Based on the data of this review, relevant policy makers should consider to improve the SRH status of Syrian women refugees in Turkey.

Objective The aim of this descriptive study was to determine the traditional health practices used by Syrian refugee women in Turkey. Methods A survey was carried out among Syrian refugee women in the Turkish province of Hatay, which has experienced heavy immigration. The study sample consisted of 75 married Syrian women over the age of 18. Questionnaires were completed during face-to-face interviews and took approximately 60 min. Results All the women (100%) reported using a traditional health method in pregnancy; almost all had used a traditional health method during childbirth and the postpartum period (both 98.7%), and to treat a vaginal infection (92.0%) and induce an abortion (93.3%); most used a traditional method of contraception (85.3%). Conclusion Some of the reported known and used methods are harmless or beneficial to women's health. Some, however, can negatively affect women's health in terms of infection, bleeding and toxicity. In order to eliminate potentially harmful traditional health practices, it is recommended that Syrian refugee women receive health education.

The Syrian civil war has caused thousands of deaths and the displacement of millions since 2011. Turkey currently serves as the new home to over 3.6 million refugees. Resettlement is particularly challenging for Syrian women. In addition to their patriarchal-assigned gender roles, women refugees encounter multidimensional difficulties. Unlike their male counterparts, they face overwhelming language barriers due to culturally imposed restrictions to their education in Turkey. Previous studies indicate women refugees have low levels of well-being and life satisfaction, as well as increased risk of depression. This chapter examines the types, practices, and benefits of leisure participation among Syrian refugee women in Turkey. Its findings reveal that throughout the resettlement process, leisure plays many roles, such as relieving trauma, increasing well-being and mental health, and supporting their integration into society and the labour market. Despite the abundance of learning opportunities, research on the outcomes of their participation is limited. Therefore, future studies should also focus on the effects of their participation in education to address the needs of Syrian women refugees. However, further research should be conducted on participation constraints to establish ways of encouraging refugee women's involvement in educational activities.

The diversification of gender‐based priorities and the necessities of refugees have led refugee NGOs to launch activities specifically for women, or urged women‐only NGOs to take action particularly for refugee women in Turkey. Drawing upon a qualitative research in Gaziantep in Turkey, which host a large population of Syrian refugees, this study seeks to answer the question “How effective are NGOs in empowering Syrian refugee women in Turkey?” It is argued that NGOs working in the provision of assistance to refugees cannot be treated as a homogeneous group in terms of the degree and form of their influences on the empowerment of refugee women, and the individual NGO’s standpoints may shape their effects. Data from interviews with NGO representatives and Syrian women who have received support from NGOs indicate that the NGOs’ perceptions of women’s issues and their contribution to the empowerment of women are closely linked to their type.

This study aims to determine for Syrian refugee women in Turkey the effectiveness, feasibility, and acceptability of culturally adapted cognitive behavioral therapy (CA-CBT). Participants were randomly allocated to receive either CA-CBT (n = 12) or treatment-as-usual (TAU; n = 11). We used the Harvard Trauma Questionnaire (HTQ) and the Hopkins Symptom Checklist-25 (HSCL) to assess posttraumatic stress symptoms and anxious-depressive distress. CA-CBT was delivered through seven weekly group sessions. CA-CBT had a large effect on PTSD (HTQ d = 1.17) and nearly medium effect sizes for anxious-depressive distress (HSCL d = .40). There were also low drop-out rates and an absence of adverse events. Because CA-CBT greatly reduced PTSD symptoms as compared with TAU and had a low drop-out rate, no adverse events, and was deliverable in a short treatment frame (seven sessions) and in a group format, we conclude that the treatment is effective, acceptable, and feasible and has the potential for scalability. Clinical Impact Statement: A Syrian version of CA-CBT was effective (large effect sizes for the HTQ), feasible, and potentially scalable (easy application, conducted with trained facilitators, short-term therapy, group format), and acceptable (as evidenced by very low drop out and no adverse events). Thus, the Syrian version of CA-CBT appears to be a valuable psychological intervention for traumatized Syrian refugees, particularly given the lack of effective treatments for this group. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Introduction: Depression is a common psychological response to trauma and stress, and research suggests that depression may play a role in the development of menstrual irregularities in women, including oligomenorrhea. Aim: The aim of this study was to investigate the gynecological symptom of oligomenorrhea as a consequence of traumatic events and its relation with depression and sexual dysfunction in Syrian refugee women in Turkey. Materials and Methods: The study was held in one of the refugee camps in Turkey (Cevdetiye, Osmaniye) in April 2013. A total of 404 Syrian refugee women were interviewed during their medical visits at the gynecology and obstetrics outpatient clinic located in the refugee camp for menstrual cycle irregularities, depression and sexual dysfunction in regard to the parameters such as the level of linguistic communication skills, ethnic origin, marital status, active involvement of husband or loss of any first degree relative in civil war. Results: A total of 404 refugee women of different ethnicities (Turkish n=310 and Arabic n=94) were interviewed. Out of 404 participants, 200 (49.5%) had secondary oligomenorrhea (study group) and 204 (50.5%) had normal menstrual cycles (control group). Oligomenorrhea was found to be significantly associated with decreased sexual function, active involvement of husband in civil war and higher depression scores. Conclusion and suggestion: Depression is one of the major component of post-traumatic events and one of the known reasons of menstrual irregularities in women. Menstrual irregularities, particularly oligomenorrhea, may be an objective and initial gynecological sign in refugee women alerting the clinicians to refer the women for further psychiatric evaluation

This paper sheds light on Syrian refugee women’s negotiation strategies in language learning classrooms and in their broader social contexts from an intersectional perspective. Drawing on in-depth interviews and focus groups complemented by participatory observation in language classes, we use a post-structuralist approach to examine gendered language socialization. Our research combines an intersectional framework and a Bourdieusian perspective on symbolic capital to show how women perform gender and negotiate their roles in classrooms, within families and vis-à-vis the host society. The findings demonstrate that being a woman and a migrant presents particular challenges in learning language. At the same time, learning language allows for the re-negotiation of gender relations and power dynamics. We find that gender structures women’s access to linguistic resources and interactional opportunities as they perform language under social pressure to conform to prescribed roles as mothers, wives and virtuous, and shy women. Yet, these roles are not static: gender roles are also reconstituted in the process of language learning and gaining symbolic capital.

Following the outbreak of war in Syria, many people had to move to neighbouring countries and beyond. Hence Turkey received a large number of Syrians as refugees since 2011. Syrian refugee women faced challenges arising from them being refugees and women. These experiences are not dissimilar to other refugee women’s experiences around the world. This study aimed at analysing the news about Syrian refugee women in Turkish newspapers. Four well established Turkish newspapers with nationwide distribution (i.e. Habertürk, Cumhuriyet, Hürriyet and Internethaber) were screened between 2015 and 2019. It was found that Syrian women refugees faced gender-based violence in Turkey. Their experiences as concubines, and in prostitution as well as sexual assaults were mentioned in the news articles we have analysed.

SYRIAN REFUGEES IN TURKEY. THE SPECIFICITY OF DEALING WITH THE SITUATION OF FORCED MIGRATIONThe article addresses the research question: “How do Syrian refugee women in Turkey cope with the problems related to the forced migration?”. The research findings are based on qualitative semi-structured interviews conducted in Hatay province, south-east Turkey. While presenting main categories of problems and coping strategies authors pay a special attention to the role of religion and culture in coping process. The theoretical framework of the study is based on such concepts as coping with stress (Lazarus and Folkman), religious coping (Pargament) and meaning-making (Park). Discussing the research findings authors also present the categories they found most representative to the Islamic cultural context.

By bringing reflexivity and reciprocity into conceptual dialogue in a discussion about the ethical framework of care in research, this article discusses how ‘reflexive reciprocity’ can be a research tool in migration studies. Taking reciprocity—the dynamics of giving and receiving—as an aspect contextually bound to the refugee experience, I propose that a relationship of giving and receiving helps undermine the inevitable power asymmetries in knowledge production. Reciprocity becomes all the more essential when researching refugee communities where narratives are prompted in a way that mirrors how refugees are elicited to give information within mechanisms of refugee governance, where they narrate their neediness, perform their vulnerability, and justify their deservingness in return for legal and humanitarian protection in traumatic processes that can be a distortion of the norms of reciprocity. This article invites researchers to address reciprocity in research, premised on the idea that an ethical framework of care should go beyond paying lip service to protect vulnerable and marginalized participants. Reflecting on my case study research with Syrian refugee women in Turkey, Ankara, I argue that reflexive reciprocity is both a tool for more rigorous data collection in a qualitative inquiry and a practical application of an ethical framework of care. In exploring instances where I could link reflexivity to action-oriented reciprocity through ‘everyday acts of caring’, I demonstrate that reflexive reciprocity can somewhat balance out the extractive nature of research and thereby contribute to the ongoing discussion about the ‘reflexive turn’ in migration studies.

Mobile health (mhealth) technology presents an opportunity to address many unique challenges refugee populations face when accessing healthcare. A robust body of evidence supports the use of mobile phone-based reminder platforms to increase timely and comprehensive access to health services. Yet, there is a dearth of research in their development for displaced populations, as well as refugee perspectives in design processes to improve effective adoptions of mhealth interventions. This study aimed to explore healthcare barriers faced by Syrian refugee women in Turkey, and their perceptions of a maternal-child health mobile application designed to provide antenatal care and vaccine services. These findings guided development of a framework for enhancing acceptability of mobile health applications specific to refugee end-users. Syrian refugee women who were pregnant or had at least one child under the age of 2 years old at the time of recruitment (n = 14) participated in semi-structured in-depth interviews. Participants had the opportunity to directly interact with an operational maternal-child health mobile application during the interview. Using a grounded theory approach, we identified critical factors and qualities mhealth developers should consider when developing user-friendly applications for refugees. It was observed that a refugee's perception of the mobile health application's usability was heavily influenced by past healthcare experiences and the contextual challenges they face while accessing healthcare. The in-depth interviews with refugee end-users identified that data security, offline capability, clear-user directions, and data retrievability were critical qualities to build into mobile health applications. Among the features included in the maternal-child health application, participants most valued the childhood vaccination reminder and health information features. Furthermore, the application's multi-lingual modes (Arabic, Turkish, and English) strengthened the application's usability among Syrian refugee populations living in Turkey. The inclusion of refugee perceptions in mhealth applications offers unique developer insights for building more inclusive and effective tools for vulnerable populations. Basic upfront discussions of the mobile application's health goals and its personal value to the user may improve their long-term use. Further prospective research is needed on retention and use of mobile health applications for refugee women and other displaced populations.

A negative birth experience affects the woman’s subsequent pregnancy, and delivery processes negatively, decreases patient satisfaction, and the high anxiety/stress experienced during pregnancy/delivery is transferred to the next generations by epigenetic transmission. In this study, women’s birth experiences of Syrian refugees in Turkey aimed to describe in-depth. It was designed as a descriptive phenomenological qualitative study. Fifteen refugee women included in the sample gave birth in Turkey, living in Turkey’s southern city. In-depth interviews were conducted with women. Six themes were formed in the results: “quantitatively enough but unsatisfactory service,” “not providing autonomy,” “think that she was neglected,” “no respect to privacy,” “feeling loneliness/fear in the delivery room,” and “prejudice.” The factors that negatively affect the pregnancy and birth experiences of Syrian refugee women are language/communication barriers, the provision of care services that are incompatible with their religious and cultural values, and their prejudice regarding discrimination.

This article attends to the connections between neo-liberal and neo-developmentalist labour regimes, asylum and immigration management, and the exploitation of undocumented, refugee, and migrant women, based on the experiences of Syrian refugee women in Turkey. The concept of precarity is explored as a selectively applied strategy by states to people who lack “status” or who are unable to benefit from “membership rights.” Forced migrants, illegal migrants, and asylum seekers are directly implicated in highly precarious work experiences at the bottom end of labour markets across the Global South, becoming trapped in forced labour and human trafficking arrangements. The article establishes a link between extreme forms of migrant labour exploitation in precarious life worlds and gender-based profiling of life chances.

Seroprevalence of Toxoplasma gondii infections in Syrian pregnant refugee women in Turkey

SUMMARYOBJECTIVE:The aim of this study was to compare the rates of and indications for cesarean delivery among Syrian refugee women and local Turkish women.METHODS:The study included 74,864 pregnant women, of whom 52,145 were Turkish and 22,719 were Syrian refugee women and who gave birth at our hospital between January 2013 and December 2021. In this study, the pregnant women were divided into two groups: Syrian refugee women and Turkish women, and primary cesarean delivery rates were calculated separately for each group. Cesarean delivery rates for Syrian refugee women and Turkish women were compared separately for each year. Indications for cesarean delivery were determined separately for each group and compared between the groups.RESULTS:The overall cesarean delivery rate was 56% among Turkish women and 32% among Syrian women (p<0.05). The primary cesarean delivery rate was 18.4% for local Turkish women versus 10.7% among Syrian refugee women (p<0.05). The most common indication for cesarean delivery among both Syrian refugee women and local Turkish women was previous cesarean delivery, followed by acute fetal distress and cephalopelvic disproportion.CONCLUSION:Indications for cesarean delivery were similar for Syrian refugee women and local Turkish women, but both overall and primary cesarean delivery rates were higher among local Turkish women compared with Syrian refugee women.