ABSTRACT
Women and girls are more disadvantaged in times of crisis, and their chances of surviving and fleeing are limited. As the Syrian crisis enters its eleventh year, Turkey alone hosts the largest population (over 3.7 million). It aimed to evaluate essential reproductive health services in the shadow of the pandemic that deepens the crisis. The research was conducted in April 2021 with 637 married Syrian refugee women aged 15-49 living in Ankara (mean age: 29.6). The median age at first marriage was 17, and consanguinity with her spouse was 29.8%. 8.6% were illiterate. 36.3% did not/could not benefit from public hospitals free of charge, and 89.8% did not have health insurance. 96.7% had a previous pregnancy (median:4). Since the pandemic's beginning, 35.6% have been pregnant (n = 219), and 14% are still pregnant (n = 86). Of 133 women whose pregnancies ended during this period, 78.2% gave birth (n = 104) and 21.8% miscarried. 12.8% of pregnancy was terminated at home (n = 17, 14 of which could not receive support from anyone). 41.1% of those who became pregnant during the pandemic were not followed up in pregnancy;45.1% of those whose pregnancies ended were not followed up in the puerperium. 29.5% of all the participants stated that they had not used any birth control method. The most common reason for not using family planning is fear of harm to health and their spouse's disapproval. Only 3.3% of those currently using birth control methods stated difficulty accessing birth control methods. The most used information resources about pregnancy, childbirth and contraception methods were hospitals and Migrant Health Centres. This study is funded through the UK Research and Innovation GCRF Research for Health In Conflict (R4HC-MENA), developing capability, partnerships and research in the Middle and Near East (MENA) [ES/P010962/1]. Key messages • In refugee crises, women's health should be structured as a separate heading in the health system and unmet sexual health needs should be met, especially in culture-oriented primary care services. • Women should be empowered with a health system where women can determine their own needs and make decisions about their bodies.
ABSTRACT
Background: Adolescents with cancer have unique emotional needs. Their freedom in social and school life is usually limited. We aimed to investigate their experiences during COVID-19 in addition to their cancer. Methods: Semi-structured interviews were conducted with 14 adolescents receiving chemotherapy. Findings: They expressed their experiences in three dimensions. First dimension described their knowledge, attitude and practice relating to COVID-19. They thought it is highly dangerous to their immune system and ongoing precautions are not sufficient. Thus, they felt the need to isolate themselves not only in their home but also in their room. Personal experiences were second dimension with the following sub-themes: emotions, coping beliefs and expectations from the future. Most are afraid of becoming infected because of additional risks caused by COVID- 19, believed that being in self-control protects themselves and thought that pandemic will influence their future distance toward others. Social experiences were the third dimension with the following sub-themes: attitude of the society, schooling and family and social relations. Some expressed their concern in relation to society's indifference toward vulnerable people, mentioned limited interactions with household and diminished friendship kept only through social media. For those who had postponed education or were home-schooling, COVID-19 made a positive impact by making them feel normal as their peers have to do same due to the lockdown. Conclusion: Despite adolescents with cancer already knowing how-to live-in isolation, they still don't feel safe enough with the precautions and they perceived they need extreme isolation in comparison to general society during the pandemic. It is important to recognize these adolescents' need for extra safety and provide minimum conditions to enable them socialize during such crises.