Syrian Mothers Research Articles

Refugee Children’s Resilience: A Qualitative Social Ecological Study of Life in a Camp

Abstract A social ecological theory of resilience shows that the process of resilience not only depends on an individual child’s personal traits but also on the capacity of the child’s environment to provide the resources required for the child to use these traits to achieve psychological and physical wellbeing in contexts of adversity. The aim of this study is to investigate how refugee mothers influence their children’s developmental outcomes despite exposure to the large number of risk factors they experience living in a refugee camp. Ten Syrian mothers of children aged 5–7-years-old participated in both semi-structured interviews and focus groups conducted while they were living in a refugee camp in Turkey. Using an inductive thematic analysis, findings show that participants found unconventional ways to build their children’s social capital, provide an education and maintain culturally grounded values and beliefs when facing with multiple distal and proximal challenges. These findings highlight the importance of understanding resilience as a psychosocial and interactive process occurring at multiple systemic levels (in this case, child, mother, and camp). Improving the functioning of larger systems may be an efficacious way of creating stable and nurturing environments for children to experience greater resilience.

Breastfeeding attitudes of refugee women from Syria and influencing factors: a study based on the transition theory.

This review was designed to systematically examine studies that determine the breastfeeding attitudes of Syrian mothers, and factors influencing their breastfeeding behavior. Studies published between 2010 and 2020 were examined using 'Syria OR Syrian mother OR Syrian refugee AND breastfeeding OR breastfeeding practices OR intention OR attitudes OR exclusive breastfeeding' as keywords on PubMed, GoogleScholar, MEDLINE, Scopus, ProQuest, National Thesis Center, Web of Science, ScienceDirect and CINAHL; and five publications meeting the inclusion criteria were included in the study. The researchers independently used JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies and JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses, developed by Joanna Briggs Institute, to assess the methodological quality. A total of 6546 studies were accessed as a result of the literature review. Five studies meeting the inclusion criteria were included in the study. Women who are in this process experience a developmental and situational transition according to the framework of Meleis' theory. Factors affecting their breastfeeding attitudes were grouped under three main and four sub-themes. It was determined that personal factors (socioeconomic factors, cultural beliefs, the significance of breastfeeding practice, preparation), factors related to the immediate environment and social factors affect these women's attitudes toward breastfeeding. It was found that most of the Syrian women had positive attitudes toward breastfeeding; however, the breastfeeding duration was less than 6 months for most of the refugees. Furthermore, according to the results of the studies, refugee women from Syria who did not receive social support from their spouses and relatives stopped breastfeeding.

Iodine Status and Thyroid Functions of Turkish and Syrian Mother-Newborn Dyads in a County of Istanbul

Background: Inappropriate iodine intake can result in thyroid disorders in mothers and newborns in addition to their adverse effects on prenatal and postnatal developmental processes. Determination of median urinary iodine concentration (MUIC) is an established tool for monitoring of iodine nutrition. Aim: The aim of this cross-sectional study was to investigate iodine status by measuring the MUIC and serum TSH and free T4 levels of Turkish and Syrian mother-newborn dyads in a county of Istanbul. Methods: In a tertiary care center, in the Turkish and Syrian, low-risk, term-pregnant mothers and their newborns, urine samples were collected from mothers and newborns within first 24 hours after birth. For the measurements of TSH and free T4, blood samples were obtained from mothers at admission to labor and delivery unit and from newborns on day 5 of neonatal life. Results: In the study population of mothers, mild iodine deficiency was more prominent with an incidence of about 18%, followed by moderate and severe forms with an incidence of about 5% and 0.5%, respectively. Turkish and Syrian mothers had similar incidence of mild, moderate, and severe iodine deficiencies. The incidence of iodine deficiency of newborns were 41%. Overall, in the Turkish and Syrian participants, there were no prominent correlations between the MUICs of mothers and newborns. Regarding serum TSH and free T4 levels, the median TSH concentration of Turkish mothers was significantly lower (p 0.05). Considering TSH values of newborns, in 40 of them, there was higher TSH values requiring attention during neonatal follow-up. They had mild and moderate but not severe form of TSH elevation. Conclusion: Despite the mandatory salt iodization and official health care support for all mothers and newborns, daily iodine supplementation during pregnancy and breastfeeding seems to be a helpful measure to prevent the adverse effects of iodine deficiency to newborns and children. Funding Statement: This study was supported by a grant of Turk Pediatri Kurumu Dernegi (the Association of Turkish Pediatrics Institution). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Association of Turkish Pediatrics Institution. Declaration of Interests: The authors declare that they have no conflict of interest. Ethics Approval Statement: The study was approved by the Human Research Ethics Committee (Registry No. 464). All participants provided written informed consent.

The Effect of Perceived Social Support of Syrian Mothers on Their Infant Feeding Attitudes

PurposeThis study was conducted to investigate the effect of perceived social support of mothers who were Syrian refugees in Turkey on attitudes toward feeding their babies. Design and methodThis study used a cross-sectional design and investigated the demographic characteristics, perceived social support, and infant feeding attitudes of the mothers who migrated from Syria and came to the Health Education Center for Immigrants to receive healthcare services. ResultsThe mean age of the mothers (n = 150) who participated in the study was 24.51 + 5.84 years, and the mean duration of their stay in Turkey was 4.12 ± 1.57 years. The mean number of pregnancies of the mothers was 2.62 ± 1.4, and the mean number of children was 2.33 ± 1.28. As a result of the analysis, we have determined that thesub-dimension of perceived social support from a special person significantly affects the continuation of breastfeeding of mothers during the first six months (p < 0.05). The perceived social support of mothers and other variables in the model were found to explain 14.6% of the breastfeeding attitude. Conclusions and implications for practiceThe attitudes of Syrian mothers toward feeding their babies were affected by perceived social support from a special person. It is recommended to aidsocial support systems for immigrant women to develop positive attitudes toward breastfeeding.

Refugee women's well-being, needs and challenges: implications for health policymakers.

Refugees face circumstances where their health and well-being are compromised. In this qualitative study, the aim was to understand Syrian refugee women's needs for care and the predisposing and enabling factors to healthcare access and utilisation. Out of 945 Syrian mothers who gave birth in our university hospital between 2014 and 2018, 195 were reached; out of which, 47 women were included. Semi-structured in-depth interviews were conducted and were later analysed using a qualitative content analysis approach. Depression was assessed by the Patient Health Questionnaire-9 at the end of the interview. Social isolation and maternal depression, language barrier and challenges while navigating the healthcare system emerged as the main themes of the study. Low educational and occupational status of the women, poor social resources, limited Turkish proficiency and unfamiliarity with the host healthcare system were identified as the predisposing factors for poor healthcare services utilisation. Recommendations include bridging language gaps, improving the navigation of the healthcare system by visual support or in-person interpretation, and psychosocial support. Providing hospital-based language courses to mothers and social integration programs for families will improve the mothers' well-being and indirectly care of the child.

A test of the epidemiological paradox in a context of forced migration: low birthweight among Syrian newborns in Lebanon.

Background Studies on immigrants revealed an epidemiological paradox whereby low-socioeconomic status (SES) immigrant mothers exhibit favourable birth outcomes compared with native-born mothers. We tested the epidemiological paradox in a context of forced migration, comparing associations of low birthweight (LBW) and maternal SES between Syrian and Lebanese newborns in Lebanon. Methods We used data from the National Collaborative Perinatal Neonatal Network (NCPNN) of 31 Lebanese hospitals, including 45 442 Lebanese and 4910 Syrian neonates born 2011-13. We assessed associations between LBW and maternal SES for both groups. Logistic regression models examined interactions between maternal origin and SES. Results Syrian births increased exponentially between 2011 and 2013, along with the group's forced migration into Lebanon. Although Syrian mothers are more socioeconomically disadvantaged compared with Lebanese mothers, Syrian LBW (6.2%) was only marginally higher than Lebanese LBW (5.6%; P = 0.059). Only 20-24-years-old Syrian women [odds ratio (OR) = 1.70 (1.22-2.36)] and those with ≥ university education [OR = 2.02 (0.98-4.16)] exhibited higher odds of delivering an LBW baby compared with Lebanese women of the same age and education. Conclusions The findings do not provide strong evidence for the epidemiological paradox in a forced migration context. However, the relatively advantageous LBW profile among Syrian neonates, despite their mothers' low SES and exposure to acute and chronic psychological stress, points to protective mechanisms. One of these mechanisms may be a collective response by the displaced population to improve neonatal outcomes as a way of recovering from loss and death.

The Promotive Effects of Social Support for Parental Resilience in a Refugee Context: a Cross-Sectional Study with Syrian Mothers in Lebanon

Exposure to war trauma increases the risk of negative individual and family-level outcomes. However, not all trauma-exposed individuals exhibit mental health or family dysfunction, and some function better than expected given their level of trauma exposure. Research with at-risk populations, including refugees, suggests that social support may promote positive mental health and parenting behavior in the face of adversity. We used cross-sectional data from 291 Syrian refugee mothers to test the role of perceived social support in promoting their psychological and parenting resilience, defined here as better than expected mental health and parenting behavior given level of exposure to war trauma. Psychological and parenting resilience were operationalized using the residual approach, which assesses the difference between mothers’ actual score on mental health and harsh discipline measures, and the score predicted by their level of trauma exposure. Linear regression models were used to test for associations between mothers’ perceived social support and their psychological and parenting resilience. Results showed that mothers’ perceived social support was associated with both psychological and parenting resilience, including after controlling for covariates. Exploratory analyses further suggested that emotional support, but not instrumental support, was associated with mothers’ psychological resilience. Social support may have a promotive effect on mothers’ mental health and parenting behavior in a context of ongoing conflict and displacement. Identifying intervention strategies to increase social support for refugees, within the framework of a multi-layered intervention approach, could potentially contribute to children’s psychosocial resilience via improved maternal mental health and parenting.

Retrospective Evaluation of Perinatal and Early Neonatal Outcomes in Infants of Migrant Mothers: A Case-Controlled Study.

Objective:To investigate the incidence of perinatal features and neonatal morbidities in migrant mothers in comparison with native Turkish mothers.Method:A retrospective analysis was conducted using the medical records of 89 infants born to Syrian immigrants and 89 infants born to native Turkish mothers who were consecutively admitted to the neonatal intensive care unit of our hospital between 2015 and 2019. Statistical analyses were used to compare demographic data and perinatal and neonatal outcomes between the two groups.Results:Compared to Turkish mothers, Syrian mothers were significantly younger and adolescent pregnancy rate was significantly higher (p<0.01). The rates of multiple pregnancy, consanguineous marriage, and prolonged premature membrane rupture were also significantly higher in Syrian mothers (p<0.05). The incidence rates of congenital anomalies, respiratory distress syndrome, transient tachypnea of newborn pneumonia/bronchiolitis, sepsis, jaundice, and feeding problems were the same for infants born to Syrian and Turkish mothers (p>0.05). In addition, the two groups did not differ with respect to gestational week at birth, birth weight, sex, types of delivery, Apgar score, duration of hospital stay, and incidence of infant mortality (p>0.05).Conclusion:The immigrant status negatively affects perinatal and neonatal outcomes. However, the incidence rates of infant mortality and neonatal morbidity did not differ between infants born to Syrian and those born to Turkish mothers. This may be due to the recent improvements in the of overall health status of migrant women or of those migrants living in Turkey being able to have access to increased prenatal and postnatal period policies of mother-child health services which have been successfully implemented.

A test of the epidemiological paradox in a context of forced migration: low birthweight among Syrian newborns in Lebanon.

Studies on immigrants revealed an epidemiological paradox whereby low-socioeconomic status (SES) immigrant mothers exhibit favourable birth outcomes compared with native-born mothers. We tested the epidemiological paradox in a context of forced migration, comparing associations of low birthweight (LBW) and maternal SES between Syrian and Lebanese newborns in Lebanon. We used data from the National Collaborative Perinatal Neonatal Network (NCPNN) of 31 Lebanese hospitals, including 45442 Lebanese and 4910 Syrian neonates born 2011-13. We assessed associations between LBW and maternal SES for both groups. Logistic regression models examined interactions between maternal origin and SES. Syrian births increased exponentially between 2011 and 2013, along with the group's forced migration into Lebanon. Although Syrian mothers are more socioeconomically disadvantaged compared with Lebanese mothers, Syrian LBW (6.2%) was only marginally higher than Lebanese LBW (5.6%; P = 0.059). Only 20-24-years-old Syrian women [odds ratio (OR) = 1.70 (1.22-2.36)] and those with ≥ university education [OR = 2.02 (0.98-4.16)] exhibited higher odds of delivering an LBW baby compared with Lebanese women of the same age and education. The findings do not provide strong evidence for the epidemiological paradox in a forced migration context. However, the relatively advantageous LBW profile among Syrian neonates, despite their mothers' low SES and exposure to acute and chronic psychological stress, points to protective mechanisms. One of these mechanisms may be a collective response by the displaced population to improve neonatal outcomes as a way of recovering from loss and death.

Syrian mothers, why to accept or to refuse HPV vaccine for their teen girls

Background: Cervical cancer (CC) ranks the eighth most frequent cancer among Syrian women with crude incidence rates 1.4 per 100, 000 populations per year. This study aimed to test the acceptance of the human papillomavirus (HPV) vaccine among mothers of schoolgirls in sixth-grade class.&#x0D; Methods: A cross-sectional survey was conducted through a structured and self-administrated questionnaire. A total of 400 Syrian mothers of schoolgirls were selected randomly by the cluster sampling method in Aleppo city, Syria, in 2011. Significant variables from univariate analysis were included in an enter technique multiple logistic regression analysis.&#x0D; Results: The response rate was 86%. If the vaccine was free, 282 (81.7%) mothers would accept the vaccine for themselves and 236 (68.4%) for their daughters, respectively. However, the acceptance rate grossly decreased to 24.6% and 15.1%, respectively, if the vaccine was not provided free. The high cost of the HPV vaccine and lack of knowledge were the significant barriers for mothers' acceptance of the HPV vaccine. Protection of daughters and the trust with health authority were the main encouraging reasons to accept the HPV vaccine. Findings from logistic regression analysis revealed that the employed mothers (odds ratio = 2.4; 95% CI: 1.3–4.4), with a positive history of gynecological examination (OR = 2.1; 95% CI: 1.6–2.9) and having sound knowledge (OR = 2.4; 95% CI: 1.0–5.7) are independent factors related to the acceptance of the HPV vaccine for their daughters.&#x0D; Conclusion: The results from this study suggest that mothers from different cultural backgrounds, including Syrian mothers, are holding different beliefs on privacy and health that may affect their willingness to accept the HPV vaccine.

Syrian Mothers Producing Counterstories in Co-Constructed School Spaces: Rethinking the Role of Schools in Engaging Refugee Families

This ethnographically informed field study, drawing on a blend of feminist theories and cultural learning pathways framework, reveals that Syrian mothers show strong presence and readiness to take active roles when opportunities present themselves in alternative spaces in the public schools of Turkey. As mothers produce counterstories in relation to their gendered, religious, and ethnic identities, they talk back to anti-immigrant discourses. Their dialogues with teachers show apparent contradictions between what they hoped for the future of their children and what the school envisioned. Such co-constructed conversations in alternative school spaces have the potential to shape schools’ role in supporting refugee families and children within and beyond the schools.

Mary Hallock-Greenewalt's Spectral Middle East

This essay dialogically examines materials from Mary Hallock-Greenewalt's largely self-curated and reflexively annotated archive, illuminating overlooked facets of her life and work, in particular her bicultural upbringing, elements of syncretism that inform her oeuvre, and her practices of self-mythologizing. The text is divided into interconnected sections that explore the following facets of the spectral Middle East in Hallock-Greenewalt's life and work: the remembrance of the Syrian mother, the activation of pervasive Orientalist discourses, genealogical expansions through the figure of Hallock-Greenewalt as mother-inventor, and archival interventions. It argues that her autobiographical writings engage her mythologized past in service of the construction of hagiographic narratives of female agency.

Factors Associated with Exclusive Breastfeeding Practices among Mothers in Syria: A Cross-sectional Study

Background : Exclusive breastfeeding is the situation where the infant has received only breast milk from his/her mother for the first 6 months after birth. Research had found that factors associated with exclusive breastfeeding practices in different countries are varied. Little is known about exclusive breastfeeding in Syria. Objective: To identify factors associated with exclusive breastfeeding practices among mothers in Syria. Methodology: A cross-sectional study on feeding practices during the first 6 months of infant’s life was conducted in Lattakia City, the northwest of Syria from July through October 2012. A total sample of 334 Syrian mothers of infants aged between 0 and 12 months were studied on socio-demographic variables, reproductive factors, sources of breastfeeding support, and exclusive breastfeeding practices. Results: About 83.5% of mothers were breastfeeding at the time of the study. At 4

Knowledge Towards HPV infection and HPV Vaccines among Syrian Mothers

Cervical cancer is caused by HPV infection and can be prevented by early vaccination. To assess Syrian women's level of knowledge and determinants of good knowledge of cervical cancer, HPV infection and its vaccines. A cross sectional survey was undertaken among mothers with daughters in sixth grade classes enrolled in primary schools in Aleppo city, Syria. Samples were selected through cluster sampling and data collected using a self-administered questionnaire. Less than a third of the mothers had heard of HPV infection and vaccines against cervical cancer and levels of knowledge were generally low. Good knowledge was associated with high education level, higher family monthly income, having few--less than four children, positive history of cervical cancer screening, and working or having relatives working in the medical field. The main source of information was television and few reported health care providers as a source of knowledge on HPV infection and vaccine. Since knowledge of HPV infection and its connection with cervical cancer and its vaccine are low, more efforts must be made to educate Syrians prior to introduction of any HPV vaccination programme. Public health efforts must focus on educating mothers, the public as well as health care providers.