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Conflict and Health
Published in: Conflict and Health 1/2017

Open Access 01-12-2017 | Research

Family planning in refugee settings: findings and actions from a multi-country study

Authors: Mihoko Tanabe, Anna Myers, Prem Bhandari, Nadine Cornier, Sathyanarayanan Doraiswamy, Sandra Krause

Published in: Conflict and Health | Issue 1/2017

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Abstract

Background

To address family planning for crisis-affected communities, in 2011 and 2012, the United Nations High Commissioner for Refugees and the Women’s Refugee Commission undertook a multi-country assessment to document knowledge of family planning, beliefs and practices of refugees, and the state of service provision in the select refugee settings of Cox’s Bazar, Bangladesh; Ali Addeh, Djibouti; Amman, Jordan; Eastleigh, Kenya; Kuala Lumpur, Malaysia; and Nakivale, Uganda.

Methods

The studies employed mixed methods: a household survey, facility assessments, in-depth interviews, and focus group discussions.

Results

Findings on awareness and demand for family planning, availability, accessibility, and quality of services showed that adult women aged 20–29 years were significantly more likely to be aware, to have ever used, or are currently using a modern method as compared to adolescent girls aged 15–19 years. Facility assessments showed limited availability of certain methods, especially long-acting and permanent methods. Despite availability, in all sites, focus group discussion participants—especially adolescents—reported many accessibility-related barriers to using existing services, including distant service delivery points, cost of transport, lack of knowledge about different types of methods, misinformation and misconceptions, religious opposition, cultural factors, language barriers with providers, and provider biases.

Conclusion

Based on gaps, partners to the study developed short and long-term recommendations around improving service availability, accessibility, and quality. There remains a need to scale up support for refugees, particularly around adolescent access to family planning services.
Footnotes
1
Short-acting methods include male and female condoms, oral contraceptives, emergency contraception, and injectables. Long-acting methods include implants and intrauterine devices (IUDs). Permanent methods include tubal ligation and female sterilization.
 
2
For current use of any modern family planning methods, we excluded currently pregnant women and any other missing cases.
 
3
Unmet need for family planning refers to the “Proportion of women currently not using a method and not wanting to have a baby who are at risk for pregnancy (not using a method, not currently pregnant or postpartum, fecund, sexually active in the last 30 days, and do not want a baby in the immediate future) among all women of reproductive age” (Reproductive Health Assessment Toolkit: 50). This indicator provides information on the current need for family planning among women at risk for pregnancy who wish to limit or space future births but who are not using a method.
 
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Metadata
Title
Family planning in refugee settings: findings and actions from a multi-country study
Authors
Mihoko Tanabe
Anna Myers
Prem Bhandari
Nadine Cornier
Sathyanarayanan Doraiswamy
Sandra Krause
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Conflict and Health / Issue 1/2017
Electronic ISSN: 1752-1505
DOI
https://doi.org/10.1186/s13031-017-0112-2

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