Exploring Syrian Refugees' Access to Emergency Contraception in Jordan

Abstract

As of April 2019, there were over 650,000 Syrian refugees residing in Jordan. A combination of economic, social, and moral imperatives related to the Syrian civil war have led to a threefold increase in early marriage rates. Syrian women and girls, particularly those who marry under the age of 18, are at significant risk of sexual and gender-based violence and unwanted pregnancy. In this context, emergency contraception could play a significant role in supporting Syrian refugees prevent pregnancy. In 2016-2017 we conducted six focus group discussions with Syrian women and girls. We conducted 100 structured interviews with pharmacists in different areas of the country regarding EC provision practices. We also interviewed 13 key informants about available sexual and reproductive health services, including EC, and conducting six focus group discussions with Syrian child brides. We audio-recorded and translated all discussions from Arabic to English and conducted content and thematic analyses using deductive and inductive techniques. Most women and girls became pregnant during the first six months of their marriage, face pressure to become pregnant repeatedly, and experience or had experienced physical and sexual violence. None of the women knew of EC but all expressed curiosity and excitement about this method of pregnancy prevention. Our findings suggest that Syrian women and girls in early marriages have significant unmet contraceptive needs. Child brides, specifically those under the age of 15, reported rarely using any type of contraception, largely due to familial pressures to prove fertility. As a result of this research we undertook a multipronged initiative to respond to the sexual and reproductive health, as well as psychosocial needs, of Syrian child brides.