Long acting reversible modern contraceptives should be emphasised for refugees
Several studies have highlighted the low use of modern family planning methods by refugee populations. This can be explained by the fact that in refugee settings people are at a higher risk of various health challenges that include inadequate vaccines, nutritional deficiencies, infectious diseases, psychosocial problems and reproductive health. With these conflicting challenges, there is low prioritisation of reproductive health services especially during the emergency phase of the displacement.
Although the field of humanitarian intervention has matured and expanded from crisis response to include reproductive health in disaster risk reduction and emergency management, there is evidence that many women have difficulty accessing contraception during disaster situations. The services on Modern Family Planning are not of good quality. In post conflict Mali, those living in post conflict areas and those who are internally displaced have poor intervention to essential SRH services that include family planning. This could be because of conflicting needs like food, water, shelter and emergency medical services. Displaced populations 90% depend on humanitarian aid for survival.
We recently carried out a cross sectional mixed method study on the use of modern family planning among refugees in Adjumani District of Uganda’s West Nile sub-region among 663 women of the 15 – 49 year age group. The study found that 2 out of every 10 women were using a modern family planning method. Five out of ten women were using condoms and 3 out of 10 women were using pills. Very few women were using Injections and other long acting reversible. More than half of the women who were currently using a modern family planning method reported that they did not want any more children.
“Family planning methods, Very few are common and present here, we only have condoms, pills, and sometimes injections, and sometimes we even run out of stock” (KI- Midwife)
Out of the six health facilities visited, 4 had condoms, 6 had combined oral contraceptives, 2 had injections and only one had IUDs.
From these results short acting modern family planning methods are common in these refugee populations. However, by the nature of their status they would require long acting reversible methods to prevent unwanted pregnancies since they are vulnerable.
*Blog by Ms Olivia Nakisita who is currently a Masters of Public Health student at MakSPH and one of our 2016 research grant awardees.