Understanding the unique experiences, perspectives and sexual and reproductive health needs of very young adolescents: Somali refugees in Ethiopia

Luis Ortiz-Echevarria,Courtland Robinson,Linnea Zimmerman,Tenaw Bawoke,Jennifer Schlecht,Meghan Greeley

doi:10.1186/s13031-017-0129-6

Abstract

BackgroundKobe Refugee camp hosts roughly 39,000 refugees displaced from Somalia during the 2011–2012 Horn of Africa Crisis. Sexual and reproductive health, as with the greater issues of health and well-being for adolescents displaced from this crisis remain largely unknown and neglected. In 2013, the Women’s Refugee Commission, Johns Hopkins University, and International Medical Corps in Ethiopia, implemented qualitative and quantitative research to explore the factors and risks that impact the health of very young adolescents (VYAs), those 10–14 years of age, in this setting. This paper presents findings from the qualitative effort.MethodsFocus group discussions (FGD), incorporating community mapping and photo elicitation activities, were conducted with 10–12 and 13–14 year-olds to obtain information about their own perspectives, experiences and values. FGDs were also implemented with 15–16 year-olds and adults, to consider their perspectives on the sexual and reproductive health needs and risks of VYAs.ResultsThis research identified several factors that were found to influence the health and well-being of VYAs in Kobe refugee camp, including newfound access to education and security, combined with gender divisions and parental communication around early SRH and puberty that remained intact from traditional Somali culture. Girls were found to face an additional risk of child marriage and early pregnancy exacerbated since displacement, which significantly limited their ability to access education and achieve future aspirations.ConclusionFindings from this study could help to inform future programs in Kobe and similar contexts involving long-term displacement from conflict, focusing on the health and development needs of VYAs. Future programs should consider the determinants of positive VYA health and development, including access to education, gender equity, and safety.By better understanding the unique experiences, perspectives and needs of VYAs, practitioners, policy makers and donors can invest in the individual and community assets that reinforce positive behaviors established in early adolescence, in order to achieve long-term SRH impacts.

Highlights

Kobe Refugee camp hosts roughly 39,000 refugees displaced from Somalia during the 2011–2012 Horn of Africa Crisis
There are salient factors in early adolescence, beyond those addressed by traditional Sexual and reproductive health (SRH) programming, that are connected with health and development outcomes in later adolescence, including improved contraceptive use and delayed sexual debut [2]
There is increasing global consensus that the antecedents of high-risk behaviors are often established in early adolescence, and greater attention placed on programming targeting very young adolescents (VYAs) will demonstrate long-term, positive SRH impacts [5,6,7]

Summary

Introduction

Kobe Refugee camp hosts roughly 39,000 refugees displaced from Somalia during the 2011–2012 Horn of Africa Crisis. In 2013, the Women’s Refugee Commission, Johns Hopkins University, and International Medical Corps in Ethiopia, implemented qualitative and quantitative research to explore the factors and risks that impact the health of very young adolescents (VYAs), those 10–14 years of age, in this setting. There are salient factors in early adolescence, beyond those addressed by traditional SRH programming, that are connected with health and development outcomes in later adolescence, including improved contraceptive use and delayed sexual debut [2]. Some of these factors include safety and security, gender socialization, education, decision-making, physical and mental health [2]. There is increasing global consensus that the antecedents of high-risk behaviors are often established in early adolescence, and greater attention placed on programming targeting VYA will demonstrate long-term, positive SRH impacts [5,6,7]

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