Hutchinson Aisha, Waterhouse Philippa, March-McDonald Jane, Neal Sarah, Ingham Roger
Institute for Applied Social Research, University of Bedfordshire, Luton, LU1 3JU Bedfordhire UK.
Centre for Social Development in Africa (CSDA), University of Johannesburg, Johannesburg, South Africa.
Confl Health. 2017 Aug 17;11:15. doi: 10.1186/s13031-017-0117-x. eCollection 2017.
It is assumed that knowing what puts young women at risk of poor sexual health outcomes and, in turn, what protects them against these outcomes, will enable greater targeted protection as well as help in designing more effective programmes. Accordingly, efforts have been directed towards mapping risk and protective factors onto general ecological frameworks, but these currently do not take into account the context of modern armed conflict. A literature overview approach was used to identify SRH related risk and protective factors specifically for young women affected by modern armed conflict.
A range of keywords were used to identify academic articles which explored the sexual and reproductive health needs of young women affected by modern armed conflict. Selected articles were read to identify risk and protective factors in relation to sexual and reproductive health. While no articles explicitly identified 'risk' or 'protective' factors, we were able to extrapolate these through a thorough engagement with the text. However, we found that it was difficult to identify factors as either 'risky' or 'protective', with many having the capacity to be both risky and protective (i.e. refugee camps or family). Therefore, using an ecological model, six environments that impact upon young women's lives in contexts of modern armed conflict are used to illustrate the dynamic and complex operation of risk and protection - highlighting processes of protection and the 'trade-offs' between risks.
We conclude that there are no simple formulaic risk/protection patterns to be applied in every conflict and post-conflict context. Instead, there needs to be greater recognition of the 'processes' of protection, including the role of 'trade-offs' (what we term as 'protection at a price'), in order to further effective policy and practical responses to improve sexual and reproductive health outcomes during or following armed conflict. Focus on specific 'factors' (such as 'female headed household') takes attention away from the processes through which factors manifest themselves and which often determine whether the factor will later be considered 'risk inducing' or protective.
人们认为，了解哪些因素会使年轻女性面临性健康不良后果的风险，以及反过来哪些因素能保护她们免受这些后果的影响，将有助于进行更有针对性的保护，并有助于设计更有效的项目。因此，人们一直致力于将风险和保护因素映射到一般生态框架中，但目前这些框架没有考虑到现代武装冲突的背景。本研究采用文献综述方法，专门针对受现代武装冲突影响的年轻女性，确定与性健康和生殖健康相关的风险和保护因素。
使用一系列关键词来识别探讨受现代武装冲突影响的年轻女性性健康和生殖健康需求的学术文章。阅读所选文章，以确定与性健康和生殖健康相关的风险和保护因素。虽然没有文章明确指出“风险”或“保护”因素，但我们能够通过深入研读文本推断出这些因素。然而，我们发现很难将因素简单地界定为“有风险的”或“有保护作用的”，因为许多因素可能同时具有风险和保护作用（例如难民营或家庭）。因此，我们采用生态模型，利用影响现代武装冲突背景下年轻女性生活的六个环境，来说明风险和保护的动态复杂运作——突出保护过程以及风险之间的“权衡”。
我们得出结论，不存在适用于每一个冲突和冲突后背景的简单公式化风险/保护模式。相反，需要更加认识到保护的“过程”，包括“权衡”（我们称之为“代价高昂的保护”）的作用，以便进一步制定有效的政策和实际应对措施，改善武装冲突期间或之后的性健康和生殖健康状况。关注特定“因素”（如“女性为户主的家庭”）会使人们忽略这些因素表现出来的过程，而这些过程往往决定该因素后来是否会被视为“诱发风险的”或具有保护作用的。
