Refugee Settings Research Articles

Implementation of Healthy Men Healthy Communities: A Health Promotion and Gender-Based Violence Prevention Program for Male South Sudanese Refugees in Uganda.

Men living in refugee settings are often exposed to violence, poverty, and social instability, which impacts physical and mental health and increases the risk of perpetrating sexual and gender-based violence. Healthy Men Healthy Communities was developed as a male-led health promotion program to address men's physical and mental health and their role in creating healthy relationships and families. Three community leaders from the settlements were trained to facilitate the program, which was implemented among six groups consisting of twelve men in each group. Pre/post surveys and feedback were collected among the facilitators and participants. Facilitators suggested culturally appropriate ways to present physical activities as a stress reduction technique and the importance of spacing out births. The small group setting facilitated open conversations on topics such as birth spacing and healthy partner communication. Participants experienced an increase in knowledge and confidence in practicing the program content, such as stress-reduction techniques and healthy communication strategies. Participants recommended additional topics such as fertility and sexually transmitted infections. The Healthy Men Healthy Communities program has the potential for wider implementation among male South Sudanese refugees to promote their health as well as the health of their families.

Male Survivors’ Disclosure of Conflict‐Related Sexual Violence in Mental Health Care Settings: Results from a Phenomenological Study with Clinical Experts in Germany

Conflict‐related sexual violence (CRSV) can severely impair survivors’ mental health and prompt their need for mental health care. Male survivors face gender‐related barriers to disclosing experiences of sexual violence, yet the understanding of factors impeding or promoting disclosure is limited. This knowledge gap is even more pronounced regarding male disclosure in refugee settings. The high prevalence of CRSV experiences in male refugees in European host countries points to the urgency of understanding male disclosure processes along with its barriers and facilitators, in order to provide for adequate mental health care. 10 clinical experts working with male survivors of CRSV in Germany were interviewed adopting an explorative phenomenological approach and using the Problem‐Centered Interview. Qualitative content analysis yielded five themes describing male disclosure of CRSV: 1. Experiences of CRSV commonly remain nonverbalized, 2. Disclosure of CRSV is a dialogical and iterative process, 3. The process of (non‐)disclosure is a negotiation of agency, 4. Disclosure of CRSV affects the survivor’s psychoemotional state, and 5. Disclosure and recovery are interdependent processes. Additionally, seven categories describing barriers to and facilitators of male disclosure were extracted: 1. trauma characteristics, 2. survivor variables, 3. clinician variables, 4. interpreter variables, 5. interpersonal variables, 6. contextual variables, and 7. sociocultural variables. Clinical experts emphasize the effectivity of a gender‐specific communicative taboo for male refugee survivors that intersect with socio‐cultural norms. Variables characterizing survivors who are at risk of not disclosing CRSV are identified. A discussion of clinical approaches to address the taboo surrounding CRSV and to support male refugee survivors in agentic disclosure and recovery is provided.

Implementing a Non-Specialist Delivered Psychological Intervention for Young Adolescents in a Protracted Refugee Setting: a Qualitative Process Evaluation in Lebanon

There has been an increase in the evaluation and implementation of non-specialist delivered psychological interventions to address unmet mental health needs in humanitarian emergencies. While randomized controlled trials (RCTs) provide important evidence about intervention impact, complementary qualitative process evaluations are essential to understand key implementation processes and inform future scaling up of the intervention. This study was conducted as part of an RCT of the Early Adolescents Skills for Emotions (EASE) psychological intervention for young adolescents with elevated psychological distress (predominantly with a Syrian refugee background) in Lebanon. Our aims were firstly to conduct a qualitative process evaluation to understand stakeholder experiences and perceived impact of the intervention and identify barriers and facilitators for implementation, and secondly to explore considerations for scaling up. Eleven key informant interviews and seven focus groups were conducted with 39 respondents including adolescent and caregiver participants, trainers, providers, outreach workers, and local stakeholders. Data were analyzed using inductive and deductive thematic analysis. Respondents perceived the intervention to be highly needed and reported improvements in adolescent mental health and wellbeing. Key implementation factors that have potential to influence engagement, adherence, and perceived impact included the socio-economic situation of families, mental health stigma, coordination within and between sectors (particularly for scaling up), embedding the intervention within existing service pathways, having clear quality and accountability processes including training and supervision for non-specialists, and sustainable funding. Our findings provide important context for understanding effectiveness outcomes of the RCT and highlights factors that need to be considered when implementing a mental health intervention on a larger scale in a complex crisis.

Associations between grip strength, cardiorespiratory fitness, cardiovascular risk and mental health in forcibly displaced people from a Greek refugee camp

Muscular strength represents a specific component of health-related fitness. Hand grip strength is used as a simple and dynamic marker of maximum voluntary force of the hand and to estimate overall strength. Today, little is known about the relationship between grip strength and health in forcibly displaced populations. In the present study, we examined whether grip strength is associated with various health outcomes in a sample of forcibly displaced people living in a Greek refugee camp. The present analyses are part of a larger pragmatic randomized controlled trial. In this paper, cross-sectional baseline data of 143 participants (71 men, 72 women) will be presented. In addition to grip strength, the following physical and mental health outcomes were assessed: body weight and body composition, blood pressure, total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides, blood glucose levels (HbA1c), post-traumatic stress disorder (PTSD) symptoms, depressive and anxiety symptoms, pain, and quality of life. Linear regression analyses were carried out to examine how grip strength is associated with the health outcomes, separately for absolute and normalized grip strength scores. Grip strength was positively and strongly associated with percentage muscle mass (normalized grip strength: Stand. B = 0.58, p < .001), whereas a negative association existed for percentage body fat (normalized grip strength: Stand. B = − 0.58, p < .001). No statistically significant associations occurred between grip strength and the other cardiovascular risk markers. In contrast, we found that participants with higher normalized grip strength reported higher levels of PTSD (normalized grip strength: Stand. B = 0.36, p < .05) and depressive symptoms (normalized grip strength: Stand. B = 0.29, p < .05). No significant association occurred between grip strength, anxiety, pain and quality of life. Measuring grip strength in forcibly displaced people can be a useful way to assess their overall muscle strength. Grip strength tests are easy to implement, and results can be used to assess the effects of specific intervention measures. Nevertheless, our results question the usefulness of grip strength as a marker of cardiovascular health and mental wellbeing in a refugee camp setting.

Characteristics of hemoglobin distributions in preschool children and non-pregnant women of reproductive age and their implications for establishing quality control criteria for hemoglobin data in field surveys: evidence from 483 surveys conducted in refugee settings worldwide

BackgroundCurrently, there is a lack of clear guidance on hemoglobin (Hb) data quality parameters and plausible flagging ranges for population-representative surveys. There is a need to determine which properties of Hb data indicate lower data quality and increased measurement error and which represent intrinsic statistical properties of Hb distributions rather than quality problems.MethodsWe explored statistical characteristics of Hb distributions and plausible exclusion ranges in population-representative surveys of non-pregnant women of reproductive age (WRA) (15–49 years, n = 401 surveys) and children (6–59 months, n = 461 surveys) conducted in refugee settings by the United Nations High Commissioner for Refugees (UNHCR). Hb distribution characteristics [standard deviation (SD), skewness and kurtosis] were compared to those from Demographic and Health Surveys (DHS).ResultsOverall, 0.08% of child and 0.14% of WRA Hb values were outside of the previously proposed 4.0–18.0 g/dL plausible range. Surveys conducted in Uganda tended to have unusually high SD compared with surveys from other settings, possibly an indication of problematic measurement quality. We therefore used summary results on SD, skewness and kurtosis excluding surveys from Uganda when comparing with DHS results or proposing plausible ranges. Both WRA and child Hb distributions tended to be left-skewed and had excess positive kurtosis. Mean survey-level SD was greater, mean skewness more negative, and mean kurtosis more positive in WRA surveys compared to child surveys. All these findings were broadly similar to those from DHS surveys. Mean SD in DHS surveys was higher than that in our data for both children (1.48 vs. 1.34) and WRA (1.58 vs. 1.43).ConclusionsWe observed several statistical characteristics of Hb distributions that may not necessarily be indicative of data quality problems and bear strong similarities with the characteristics found in DHS surveys. Hb distributions tended to be negatively skewed and positively kurtotic, and SD in many surveys exceeded 1.5 (previously proposed upper plausible range). Based on our empirical evidence, surveys with skewness above + 0.2 and kurtosis below -0.5 or Hb SD outside the range of 1.1–1.55 g/dL for children (6–59 mo) or 1.1–1.65 g/dL for non-pregnant WRA (15–49 y) may require further quality investigation.

Infant and young child feeding practices in refugee settings across 203 population-based surveys from 2013-2019.

Infant and young child feeding (IYCF) plays a crucial role in early childhood growth and development. This study summarizes recent IYCF practices in multiple refugee settings and compares them to those in the host countries. We analyzed 203 surveys conducted among refugees residing in 15 countries and 120 unique sites and assessed eight IYCF indicators available from those surveys. A total of 146 surveys were conducted in Eastern and Southern Africa (ESA) and 50 in Western and Central Africa (WCA) regions. The median prevalence across surveys of all four indicators describing intake of breast milk was relatively high: 96.6% for ever breastfed, 81.2% for initiation of breastfeeding within 1 h of birth, 76.9% for exclusive breastfeeding 0-5 months, and 75.0% for continued breastfeeding 12-23 months. The median prevalence of early initiation and exclusive breastfeeding was markedly higher in ESA than in WCA (85.0% vs. 37.5% and 83.5% vs. 56.1%, respectively). Conversely, the overall median prevalence of timely introduction of solid and semisolid foods and flesh food consumption was low: 51.8% and 16.1%, respectively. Flesh food consumption was higher in WCA than in ESA (27.4% vs. 11.6%). The median prevalence of mixed milk feeding at 0-5 months and bottle feeding was very low: 2.4% and 3.8%, respectively. Indicators describing breast milk intake were generally either similar or higher in refugees than in the host country populations, whereas the other indicators were generally higher in the host populations than in refugees. The low prevalence of timely introduction of solids and of flesh food consumption in refugees is concerning and requires substantial improvement.

Women's Rights in Refugee and Internal Displacement Settings in Africa: Time to Seriously Invoke the Maputo Protocol

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Participatory approaches for strengthening teacher professional development in refugee settings: successes and limitations

ABSTRACT This article presents critical reflections on a teacher professional development initiative in Kakuma refugee camp and Kalobeyei settlement in Kenya. Drawing on critical development studies, it examines the successes and limitations of efforts to facilitate a community-based participatory process that aims to respond to local refugee teachers’ needs while simultaneously developing training materials as a global good. It points to the influences of global-local dynamics, including the practical constraints of distance and time, and the role of partnerships that help or hinder these approaches. It embraces the often excluded personal and professional dimensions that intersect with our work. It further wrestles with the opportunities and limitations of these approaches to address larger structural constraints in which teacher professional development initiatives are embedded and offers considerations for future engagements.

Between redemption and affirmation: German identity in affective narratives of the ‘refugee crisis’

The German ‘refugee crisis’ produced formidable levels of civil society assistance, involving citizens and locations with no previous experience in refugee support. Grounded in research with citizen volunteers in a rural region in southern Germany conducted at a time when rightwing populism gained strength, this article explores how volunteers reflect on their relations with refugees while negotiating distinctly German identities. Scholarship on volunteering in refugee settings has looked at the emotional aspect of this work largely for its political import. This article expands attention to emotions in volunteering from a form of political practice on the ground to a practice of narrative reasoning. In a close reading of interview-derived narratives as affective practices the relevance of locality, identity and history for refugee reception comes to the fore. Deploying the notions of ‘redemptive’ and ‘affirmative’ Germanness the article shows how volunteers draw on specific historical trajectories to produce moral arguments about the support and incorporation of strangers. This article argues that volunteers’ affective involvement with history and locality needs unpacking if their relations of solidarity are to be understood.

Cross‐sector collaboration for refugee employment: An anthropology of development perspective

AbstractEmployment plays a crucial role in the successful resettlement of migrants. However, there is a paucity of research on how to facilitate refugee employment outcomes and the role of cross‐sector collaborations. Using a qualitative, multi‐layered analysis of primary and secondary data from Australian settlement service providers (SSPs) and the businesses they work with, this study explores how public service organisations co‐create value with stakeholders (i.e., public service logic) through cross‐sector collaborations. By identifying differing notional and strategic logics of both SSPs and employing businesses in supporting refugee migrants, we reveal the dynamics of cross‐sector value co‐creation in refugee management settings. We also identify four main strategic logics that SSPs use to address barriers and connect refugee migrants to employment. Our study offers theoretical contributions and practical implications for public, private, not‐for‐profit and community organisations working together to support refugee employment.

Community-Led Education among Rohingya Refugees and the Politics of Refugee Education in Bangladesh

Abstract The academic literature on refugee education and education in emergencies is understandably preoccupied with how to improve educational tools and learning platforms for refugees. However, political restrictions on education from host governments are among the main obstacles for quality education in many refugee settings. This article contributes to the refugee education literature by exploring ways in which refugees themselves can mitigate the denial of the right to education through a combination of traditional community mobilization and the use of new technologies. Specifically, the article analyses the educational strategies that Rohingya youths and community-based education networks manoeuvre to secure basic education in the refugee camps in Bangladesh, despite severe political restrictions. Based on qualitative interviews in 2019 and 2021 (in person and phone interviews) with 38 community teachers and 16 refugee students, and digital data collection, including reviews of learning tools of 21 online programmes, the article presents new knowledge on the strategies that Rohingya youths and adolescents pursue to access learning tools and education. It also shows how community-based education networks and teachers tackle political restrictions on education. These networks represent an educated wellspring of untapped resources with close ties to the refugee community, and insights into the grievances and aspirations of Rohingya youths, that humanitarian education providers should engage with to improve their response.

Interventions to increase cervical screening uptake among immigrant women: A systematic review and meta-analysis.

Numerous intervention studies have attempted to increase cervical screening uptake among immigrant women, nonetheless their screening participation remains low. This systematic review and meta-analysis aimed to summarise the evidence on interventions to improve cervical screening among immigrant women globally and identify their effectiveness. Databases PubMed, EMBASE, Scopus, PsycINFO, ERIC, CINAHL and CENTRAL were systematically searched from inception to October 12, 2021, for intervention studies, including randomised and clinical controlled trials (RCT, CCT) and one and two group pre-post studies. Peer-reviewed studies involving immigrant and refugee women, in community and clinical settings, were eligible. Comparator interventions were usual or minimal care or attention control. Data extraction, quality appraisal and risk of bias were assessed by two authors independently using COVIDENCE software. Narrative synthesis of findings was carried out, with the main outcome measure defined as the cervical screening uptake rate difference pre- and post-intervention followed by random effects meta-analysis of trials and two group pre-post studies, using Comprehensive Meta-Analysis software, to calculate pooled rate ratios and adjustment for publication bias, where found. The protocol followed PRISMA guidelines and was registered prospectively with PROSPERO (CRD42020192341). 1,900 studies were identified, of which 42 (21 RCTS, 4 CCTs, and 16 pre-post studies) with 44,224 participants, were included in the systematic review, and 28 with 35,495 participants in the meta-analysis. Overall, the uptake difference rate for interventions ranged from -6.7 to 96%. Meta-analysis demonstrated a pooled rate ratio of 1.15 (95% CI 1.03-1.29), with high heterogeneity. Culturally sensitive, multicomponent interventions, using different modes of information delivery and self-sampling modality were most promising. Interventions led to at least 15% increase in cervical screening participation among immigrant women. Interventions designed to overcome logistical barriers and use multiple channels to communicate culturally appropriate health promotion messages are most effective at achieving cervical screening uptake among immigrant women.

Socio-Cultural Barriers Influencing Unplanned Pregnancy in Mugombwa Refugee Camp, Rwanda: Female Adolescents’ Perspectives

Female adolescents experience exacerbated vulnerability to the effects of gender inequities in refugee settings, where there is often a lack of protective societal structures and the politicization of their access to sexual and reproductive health (SRH) services, which result in an increase in teenage pregnancy as compared to non-refugee settings. In the Mugombwa refugee camp in Rwanda, there were 47 adolescent childbirths in 2021 alone. This study explores the perspectives of female adolescents on the barriers underpinning adolescent unplanned pregnancy in the Mugombwa refugee camp. Focus group discussions were conducted with 16 adolescent girls between the ages of 10 and 19. The findings were analyzed using inductive and deductive thematic analysis. Barriers at the individual, interpersonal, communal, and institutional levels underpin unplanned adolescent pregnancy. Socio-cultural barriers of poverty and transactional sex, poor knowledge of contraceptives, negative peer influence, sexual coercion, poor parent–adolescent communication, negative health worker attitudes, selective SRH community outreach, and the inaccessibility of contraceptives emerged as themes influencing the sexual behavior of adolescents and unplanned pregnancies. The socio-cultural barriers and systemic facilitators of gender inequality associated with being an adolescent female in a refugee camp must be prioritized to alleviate adolescent unplanned pregnancy.

Dynamics of refugee settlements and energy provision: the case of forest stocks in Zambia

PurposeThis article aims to investigate the impact of (1) the establishment of a refugee settlement, (2) the energy demand of a host and refugee population, (3) the residence time of refugees and (4) interventions in the energy sector on sustainable utilization of the forest.Design/methodology/approachRefugee movements from the Democratic Republic of Congo and settlement construction in a Zambian host society provide the setting. An agent-based model is developed. It uses survey data from 277 Zambian households, geographic information system coordinates and supplementary data inputs.FindingsThe future forest stock remains up to 30 years without an influx of refugees. Refugee developments completely deplete the forest over time. The settlement construction severely impacts the forest, while refugees' energy needs seem less significant. Compared with the repatriation of refugees, permanent integration has no influential impact on forest resources. Interventions in the energy sector through alternative sources slow down deforestation. Once a camp is constructed, tree cutting by hosts causes forest covers to decline even if alternative energy is provided.Practical implicationsThe analysis is useful for comparable host–refugee settings and United Nations High Commissioner for Refugees interventions in settlement situations. Forest and energy sector interventions should involve host and refugee stakeholders.Originality/valueThis article adds value through an agent-based model in the Zambian deforestation–refugee context. The study has a pilot character within the United Nation's Comprehensive Refugee Response Framework. It fills a gap in long-term assessments of refugee presence in local host communities.

“We Feel Powerless”

Gender-based violence (GBV), especially sexual violence with a 90% prevalence rate, is a top concern in humanitarian settings. This qualitative study explored the challenges and experiences of social workers in addressing Gender-based Violence (GBV) in Ethiopian refugee settings. In-depth interviews were conducted with eight social workers between the ages of 26-37 years who have had five to twelve years of experience in GBV prevention among refugees. Data were analyzed thematically using a codebook and Nvivo12 software. Three major themes emerged: power and political interest, institutional barriers, and strategic barriers. The Social-Ecological Model (SEM) was used to guide the discussion of the findings. Most of the challenges experienced by social workers were structural barriers emanating from the unbalanced power relationship and political interest between and within institutions, strategic/policy gaps, and organizational resource limitations. It is imperative that social workers are trained to function in a politically-sensitive practice setting and are prepared to embrace political activism to overcome structural challenges. Adopting anti-oppressive and integrated developmental approaches is recommended to resolve the complex socio-economic and political factors behind the widespread GBV acts in Ethiopian refugee settings.

Community-Based Research in Fragile Contexts: Reflections From Rohingya Refugee Camps in Cox’s Bazar, Bangladesh

This commentary examines community-based research in fragile settings based on the authors’ experience working with Rohingya and host community researchers in Cox’s Bazar, Bangladesh. This iteration of a community-based approach to research focuses on putting community researchers at the center and emphasizes their involvement at each stage of the research process – from design to implementation to analysis – alongside external researchers. Community researchers contribute their expertise to increase understanding of nuances that might otherwise be lost to external researchers. Integral to this approach is building and nurturing the trust of researchers, respondents and community members through innovative means such as an informal “trust network.” Also central to the community-based approach, especially in fragile 1 settings, is a sustained emphasis on community researchers’ learning and skills-building. The commentary article describes methods developed by the Centre for Peace and Justice, Brac University (CPJ), implemented with Rohingya refugees and host community researchers in Cox’s Bazar. The article suggests: Putting community members at the heart of learning and research approaches helps to amplify marginalized voices and emphasize their needs and choices. The political and economic atmosphere of a refugee setting can change rapidly. In such circumstances, community-based research can be vital to policymakers that seek to understand emerging concerns and issues. Community-based experiential education and research approaches hold potential to promote grassroots leadership among refugee youth in situations of protracted displacement. Strengthening the capacities of community researchers is crucial to this approach. Community researchers often lack language skills, especially writing and reading, and translating from local dialects to English or any other preferred language. The acquisition of research skills can also pave a durable and critical pathway toward meaningful youth engagement. Trust and familiarity between refugee interlocutors and researchers require long-term engagement. Creating a culture of mutual respect and dignity is of utmost importance. The community expects researchers to respect their religious beliefs and cultural values. The two-way exchange between community researchers and respondents enhances the learning process and can help discover areas for further inquiry.

Utilization of sexual and reproductive health services among young people in refugee settings in Uganda.

There is a considerable high level of unmet need for reproductive health services among refugees. Yet, there is limited research about the provision and utilization of sexual and reproductive health (SRH) services among young people in refugee settings. Drawing on a sample of 575 young refugees (15-24 years) from a cross-sectional survey, this study aims to fill this gap by identifying the factors associated with SRH utilization among young people living in refugee settings in Northern Uganda. The utilization of SRH services at the health facilities was significantly different between female and male young people after adjusting for all other variables (aOR = 2.46, 95% CI, 1.58, 3.84). Young people who were not living in a marital union (aOR = 0.38, 95% CI, 0.20, 0.71), or held inequitable gender norms about services (aOR = 0.28, 95% CI, 0.12, 0.66) had about a third of the odds of utilizing SRH services. Young women with comprehensive knowledge about contraception, modern contraceptives, and HIV and STI prevention, had more than twice the odds of utilizing SRH services (aOR = 2.23, 95% CI, 2.67, 6.90). There is need to integrate social norm measurements and social norm change strategies in strategies for promoting utilization of SRH services among refugees in low-income countries especially in Uganda.

Considerations for assessment of measurement quality of mid-upper arm circumference data in anthropometric surveys and mass nutritional screenings conducted in humanitarian and refugee settings.

Despite frequent use of mid-upper arm circumference (MUAC) to assess populations in humanitarian settings, no guidance exists about the ranges for excluding implausible extreme outliers (flags) from MUAC data and about the quality assessment of collected MUAC data. We analysed 701 population-representative anthropometric surveys in children aged 6-59 months from 40 countries conducted between 2011 and 2019. We explored characteristics of flags as well as changes in survey-level MUAC-for-age z-score (MUACZ) and MUAC means, SD and percentage of flags based on three flagging approaches: ±3 and ±4 MUACZ z-scores from observed MUACZ survey mean and a fixed interval 100-200 mm of MUAC. Both ±4 and 100-200 flagging approaches identified as flags approximately 0.15% of records; about 60% of all surveys had no flagsand less than 1% of surveys had >2% of flags. The ±3 approach flagged 0.6% records in the data setand 3% of surveys had >2% of flags. Plausible ranges (defined as 2.5th and 97.5th percentiles) for SD of MUACZ and MUAC were 0.8-1.2 and 10.5-14.4 mm, respectively. Survey-level SDs of MUAC and MUACZ were highly correlated (r = 0.68). The average SD of MUACZ was 0.96 using the±4 flagging approach and 0.94 with ±3 approach. Defining outliers in MUAC data based on the MUACZ approach is feasible and adjusts for different probability of extreme values based on age and nutrition status of surveyed population. In assessments where age is not recorded and therefore MUACZ cannot be generated, using 100-200 mm range for flag exclusion could be a feasible solution.

'A prospective case control study to evaluate shock index for identifying patients at risk of clinically important malaria in refugee settings'.

Bidibidi Refugee Settlement's 223,000 refugees are vulnerable to malaria due to crowded conditions and limited healthcare access. Early identification and referral of suspected cases is key to reduce morbidity and mortality. We evaluated the shock index (heart rate/ systolic blood pressure) for detection of abnormal vital signs, calculated by the CRADLE Vital Signs Alert device, which can be used in routine patient blood pressure and heart rate assessment by non-medically trained Voluntary Health Team workers. The single most frequent diagnosis causing shock was malaria, and thus the device was useful to detect severe cases (as well as discovering other cases), after calculating appropriate shock indices.

Children Immunization App (CIMA): A Non-randomized Controlled Trial Among Syrian Refugees in Zaatari Camp, Jordan

Approximately 20 million children are not vaccinated, especially among refugees. There is a growing access to smartphones, among refugees, which can help in improving their vaccination. We assessed the impact of an app for the vaccination follow-up visit among refugees in Jordan. We developed an app and tested it through a non-randomized trial at the Zaatari refugees camp in Jordan. The study was conducted during March – December 2019 at three vaccination clinics inside the camp. The study included two study groups (intervention and control groups) for refugees living at the camp. The intervention group included parents who own an Android smartphone and have one newborn that require between one and four first vaccination doses and they accepted to participate in the study, during their regular visit to the vaccination clinics. The control group was for the usual care. We compared both study groups for returning back to one follow-up visit, using Kaplan-Meier survival analysis. We recruited 936 babies (n = 471; 50.3% in the intervention group, both study groups were similar at baseline). The majority of mothers were literate (94.2%) with a median age of 24. The majority of the babies had a vaccination card (n = 878, 94%). One quarter (26%) of mother-babies pairs of the intervention group came back within one week (versus 22% for control group); When it comes to lost-follow-up, 22% and 28% did not have a history of returning back (intervention and control groups respectively, p = 0.06) (Relative risk reduction: 19%). The Kaplan-Meier Survival Analysis showed a statistically significant progressive reduction in the duration of coming back late for the follow-up vaccine visit. We tested a vaccination app for the first time, in a refugee population setting. The app can be used as a reminder for parents to come back on time for their children’s vaccine follow-up visits.