Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA.
BMC Womens Health. 2014 Feb 20;14(1):25. doi: 10.1186/1472-6874-14-25.
BACKGROUND: The current conflict in Syria continues to displace thousands to neighboring countries, including Lebanon. Information is needed to provide adequate health and related services particularly to women in this displaced population. METHODS: We conducted a needs assessment in Lebanon (June-August 2012), administering a cross-sectional survey in six health clinics. Information was collected on reproductive and general health status, conflict violence, stress, and help-seeking behaviors of displaced Syrian women. Bivariate and multivariate analyses were conducted to examine associations between exposure to conflict violence, stress, and reproductive health outcomes. RESULTS: We interviewed 452 Syrian refugee women ages 18-45 who had been in Lebanon for an average of 5.1 (± 3.7) months. Reported gynecologic conditions were common, including: menstrual irregularity, 53.5%; severe pelvic pain, 51.6%; and reproductive tract infections, 53.3%. Among the pregnancy subset (n = 74), 39.5% of currently pregnant women experienced complications and 36.8% of those who completed pregnancies experienced delivery/abortion complications. Adverse birth outcomes included: low birthweight, 10.5%; preterm delivery, 26.5%; and infant mortality, 2.9%. Of women who experienced conflict-related violence (30.8%) and non-partner sexual violence (3.1%), the majority did not seek medical care (64.6%). Conflict violence and stress score was significantly associated with reported gynecologic conditions, and stress score was found to mediate the relationship between exposure to conflict violence and self-rated health. CONCLUSIONS: This study contributes to the understanding of experience of conflict violence among women, stress, and reproductive health needs. Findings demonstrate the need for better targeting of reproductive health services in refugee settings, as well as referral to psychosocial services for survivors of violence.
背景:当前叙利亚冲突持续导致数千人逃往邻国,包括黎巴嫩。需要了解情况,以便为流离失所的妇女提供适当的卫生和相关服务。
方法:我们于 2012 年 6 月至 8 月在黎巴嫩进行了一项需求评估,在六家卫生诊所进行了横断面调查。收集了有关生殖健康和一般健康状况、冲突暴力、压力以及叙利亚流离失所妇女寻求帮助行为的信息。进行了单变量和多变量分析,以研究冲突暴力、压力与生殖健康结果之间的关联。
结果:我们采访了 452 名年龄在 18-45 岁之间的叙利亚难民妇女,她们在黎巴嫩的平均时间为 5.1(±3.7)个月。报告的妇科疾病很常见,包括:月经不调,占 53.5%;严重的盆腔疼痛,占 51.6%;生殖道感染,占 53.3%。在怀孕妇女亚组(n=74)中,39.5%的孕妇有并发症,36.8%的孕妇在分娩/堕胎时出现并发症。不良的出生结局包括:低出生体重,占 10.5%;早产,占 26.5%;婴儿死亡率,占 2.9%。在经历过与冲突相关的暴力(30.8%)和非伴侣性暴力(3.1%)的妇女中,大多数人没有寻求医疗(64.6%)。冲突暴力和压力得分与报告的妇科疾病显著相关,并且压力得分可调节暴露于冲突暴力与自我评估健康之间的关系。
结论:本研究有助于了解妇女遭受冲突暴力、压力和生殖健康需求的情况。研究结果表明,在难民环境中需要更好地针对生殖健康服务,并为暴力幸存者提供心理社会服务。
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