Abstract
BackgroundYoung women in conflict-affected regions are at risk of a number of adverse outcomes as a result of violence, economic deterioration and the breakdown of community structures and services. This paper presents the findings of a systematic review of quantitative literature reporting how key sexual and reproductive health (SRH) outcomes among young women under the age of 20 years are affected by exposure to armed conflict; namely, sexual debut, first marriage and first birth. Increases in these outcomes among young women are all associated with potential negative public health consequences. It also examines and documents possible causal pathways for any changes seen.MethodsTo fit with our inclusion criteria, all reviewed studies included outcomes for comparable populations not exposed to conflict either temporally or spatially. A total of 19 studies with results from 21 countries or territories met our inclusion criteria; seven presented findings on marriage, four on fertility and eight on both of these outcomes. Only one study reporting on sexual debut met our criteria.ResultsFindings show clear evidence of both declines and increases in marriage and childbirth among young women in a range of conflict-affected settings. Several studies that showed increases in marriage below the age of 20 years reported that such increases were concentrated in the younger teenagers. Trends in fertility were predominantly driven by marriage patterns. Suggested causal pathways for the changes observed could be grouped into three categories: involuntary, gender and psycho-social and economic and material factors.ConclusionThe review reveals a paucity of literature on the impact of conflict on SRH outcomes of young women. Further quantitative and qualitative studies are needed to explore how conflict influences SRH events in young women over both the short- and longer-term.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2868-5) contains supplementary material, which is available to authorized users.
Highlights
Young women in conflict-affected regions are at risk of a number of adverse outcomes as a result of violence, economic deterioration and the breakdown of community structures and services
In order to explore this issue we carried out of a systematic review of quantitative literature that reported how three key sexual and reproductive health (SRH) outcomes among young women under the age of 20 years sexual debut, first marriage and first birth - are affected by exposure to armed conflict in a number of countries and settings
Description of the articles We identified 21 articles, representing 19 unique studies, which presented SRH outcome data over a period of armed conflict
Summary
Young women in conflict-affected regions are at risk of a number of adverse outcomes as a result of violence, economic deterioration and the breakdown of community structures and services. In order to explore this issue we carried out of a systematic review of quantitative literature that reported how three key sexual and reproductive health (SRH) outcomes among young women under the age of 20 years sexual debut, first marriage and first birth - are affected by exposure to armed conflict in a number of countries and settings These three indicators are all known to have potential negative health and social consequences when they occur at an early age, and a knowledge of whether the incidence of these events changes in this context is important for guiding programmes designed to protect and support women in conflict and postconflict environments. In addition to physical and socio-economic risk, early childbearing, outside marriage, may lead to stigmatisation and isolation in some contexts [11]
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