Sexual and reproductive health of Syrian refugee adolescent girls: a qualitative study using focus group discussions in an urban setting in Lebanon

• Published in: Reproductive health 2021-06, Vol.18 (1), p.1-130, Article 130
• Main Authors: Korri, Rayan, Hess, Sabine, Froeschl, Guenter, Ivanova, Olena
• Format: Article
• Language: English
• Subjects: Adolescent girls; Child marriage; Displaced persons; Education; Focus groups; Gender; Gender-based violence; Girls; Health aspects; Human rights; Humanitarianism; International conferences; International organizations; Lebanon; Menstruation; Puberty; Qualitative research; Refugee; Refugees; Reproductive health; Sexual and reproductive health; Sexual harassment; Surveys; Syria; Teenage girls; Teenagers; Urban setting; Urban youth; Violence; Womens health; Working groups
• ISSN: 1742-4755; 1742-4755
• DOI: 10.1186/s12978-021-01178-9

Background The war in Syria caused the forced displacement of millions of Syrians to neighboring countries. Lebanon is the host country with the largest overall number of Syrian refugees per capita. Adolescent refugee girls experience a unique level of vulnerability during human emergencies and are at increased risk of suffering from poor sexual and reproductive health (SRH) outcomes. We conducted an exploratory qualitative study to learn about the SRH perceptions and experiences of refugee adolescent girls living in Bourj Hammoud, an urban setting in Lebanon. Methods We employed a qualitative design with eight focus group discussions (FGDs) conducted with 40 Syrian Arab and Syrian Kurdish adolescent girls between January and March 2020. Every FGD consisted of five participants aged 13 to 17 years. A semi-structured guide was used covering multiple themes: menstruation, puberty, SRH awareness, and sexual harassment. FGDs were transcribed and analyzed using thematic analysis. Findings The participants discussed adolescent girls' health and named six elements of good health, such as healthy activities and self-protection. The majority of the FGD participants reported a lack of awareness about menstruation when they experienced it for the first time and the social stigma associated with menstruation. When defining puberty, they indicated its social link to a girl's readiness for marriage and her need to become cautious about sexual harassment. Most FGD participants had very poor knowledge of the female reproductive system. Mothers were the most approached persons to receive information on SRH issues; however, the girls indicated a wish to receive advice from specialists in a comfortable and private atmosphere. All the girls reported that either they themselves, or an acquaintance, had experienced some type of sexual harassment. The girls rarely reported those incidents due to fear of being blamed or subjected to mobility restrictions, or forced to drop out of school. Conclusions The findings show the refugee girls need for satisfactory knowledge on SRH issues and interventions to prevent sexual and gender-based violence that take into consideration the complexity of urban settings. Keywords: Adolescent girls, Refugee, Sexual and reproductive health, Urban setting, Syria, Lebanon, Qualitative research, Focus group discussions