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. 2024 Apr 23;14(4):e080654.
doi: 10.1136/bmjopen-2023-080654.

Navigating challenges: a socioecological analysis of sexual and reproductive health barriers among Eritrean refugee women in Ethiopia, using a key informant approach

Nejimu Biza Zepro  1   2   3 , Araya Abrha Medhanyie  4 , Nicole Probst-Hensch  5   2 , Afona Chernet  5   2 , Rea Tschopp  5   2 , Charles Abongomera  5   2 , Daniel H Paris  5   2 , Sonja Merten  5   2
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Navigating challenges: a socioecological analysis of sexual and reproductive health barriers among Eritrean refugee women in Ethiopia, using a key informant approach

Nejimu Biza Zepro et al. BMJ Open. .

Abstract

Objectives: The study aimed to explore the experiences and perceptions of healthcare providers (HCPs) regarding the sexual and reproductive health (SRH) challenges of Eritrean refugee women in Ethiopia.

Design: A qualitative exploratory design with the key informant approach.

Setting and participants: The study was conducted in the Afar regional state, North East, Ethiopia. The study participants were HCP responsible for providing SRH care for refugee women.

Results: Eritrean refugee women have worse health outcomes than the host population. The SRH needs were found to be hindered at multiple layers of socioecological model (SEM). High turnover and shortage of HCP, restrictive laws, language issues, cultural inconsistencies and gender inequalities were among the main barriers reported. Complex multistructural factors are needed to improve SRH needs of Eritrean refugee women.

Conclusions: A complex set of issues spanning individual needs, social norms, community resources, healthcare limitations and structural mismatches create significant barriers to fulfilling the SRH needs of Eritrean refugee women in Ethiopia. Factors like limited awareness, cultural taboos, lack of safe spaces, inadequate healthcare facilities and restrictive policies all contribute to the severe limitations on SRH services available in refugee settings. The overlap in findings underscores the importance of developing multilevel interventions that are culturally sensitive to the needs of refugee women across all SEM levels. A bilateral collaboration between Refugees and Returnees Service (RRS) structures and the Asayta district healthcare system is critically important.

Keywords: Health policy; PUBLIC HEALTH; QUALITATIVE RESEARCH; REPRODUCTIVE MEDICINE.

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Conflict of interest statement

Competing interests: The authors declare that they have no competing interests

Figures

Figure 1
Figure 1
A socioecological analysis framework of factors that influence HCPs’ readiness to provide SRH services to Eritrean refugee women in Asayta refugee camp, Ethiopia (adapted). HCP, healthcare providers; SRH, sexual and reproductive health.
See this image and copyright information in PMC

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