Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802, Munich, Germany.
Faculty of Interdisciplinary Studies, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
Reprod Health. 2019 Mar 19;16(1):35. doi: 10.1186/s12978-019-0698-5.
BACKGROUND: Humanitarian crises and migration make girls and women more vulnerable to poor sexual and reproductive health (SRH) outcomes. Nevertheless, there is still a dearth of information on SRH outcomes and access to SRH services among refugee girls and young women in Africa. We conducted a mixed-methods study to assess SRH experiences, knowledge and access to services of refugee girls in the Nakivale settlement, Uganda. METHODS: A cross-sectional survey among 260 adolescent girls 13-19 years old was conducted between March and May 2018. Concurrently, in-depth interviews were conducted among a subset of 28 adolescents. For both methods, information was collected regarding SRH knowledge, experiences and access to services and commodities. The questionnaire was entered directly on the tablets using the Magpi® app. Descriptive statistical analysis and multinomial logistic regression were performed. Qualitative data was transcribed and analysed using thematic content analysis. RESULTS: A total of 260 participants were interviewed, with a median age of 15.9 years. The majority of girls were born in DR Congo and Burundi. Of the 93% of girls who had experienced menstruation, 43% had ever missed school due to menstruation. Regarding SRH knowledge, a total of 11.7% were not aware of how HIV is prevented, 15.7% did not know any STI and 13.8% were not familiar with any method to prevent pregnancy. A total of 30 girls from 260 were sexually active, of which 11 had experienced forced sexual intercourse. The latter occurred during conflict, in transit or within the camp. A total of 27 of 260 participants had undergone female genital mutilation (FGM). The most preferred sources for SRH information was parents or guardians, although participants expressed that they were afraid or shy to discuss other sexuality topics apart from menstruation with parents. A total of 30% of the female adolescents had ever visited a SRH service centre, mostly to test for HIV and to seek medical aid for menstrual problems. CONCLUSIONS: Adolescent refugee girls lack adequate SRH information, experience poor SRH outcomes including school absence due to menstruation, sexual violence and FGM. Comprehensive SRH services including sexuality education, barrier-free access to SRH services and parental involvement are recommended.
背景：人道主义危机和移民使女孩和妇女更容易遭受不良性健康和生殖健康（SRH）结局的影响。然而，在非洲，有关难民女孩和年轻妇女的 SRH 结局和获得 SRH 服务的信息仍然匮乏。我们进行了一项混合方法研究，以评估乌干达纳基瓦莱难民营中难民女孩的 SRH 经历、知识和获得服务的情况。
方法：2018 年 3 月至 5 月期间，对 260 名 13-19 岁的青少年女孩进行了横断面调查。同时，对 28 名青少年进行了一组深入访谈。对于这两种方法，都收集了关于 SRH 知识、经历和获得服务和商品的信息。问卷直接在平板电脑上使用 Magpi®应用程序输入。进行了描述性统计分析和多项逻辑回归分析。定性数据经过转录和主题内容分析进行分析。
结果：共访谈了 260 名参与者，中位数年龄为 15.9 岁。大多数女孩出生于刚果民主共和国和布隆迪。在经历过月经的 93%的女孩中，有 43%的女孩因为月经而曾经缺课。关于 SRH 知识，共有 11.7%的女孩不知道如何预防 HIV，15.7%的女孩不知道任何性传播感染，13.8%的女孩不熟悉任何避孕方法。在 260 名女孩中，共有 30 名女孩有过性行为，其中 11 名女孩有过被迫性行为。这种情况发生在冲突期间、过境期间或在难民营内。在 260 名参与者中，共有 27 人进行过女性生殖器切割。获得 SRH 信息的最受欢迎来源是父母或监护人，尽管参与者表示，他们害怕或羞于与父母讨论月经以外的其他性话题。共有 30%的女青少年曾去过 SRH 服务中心，主要是为了检测 HIV 和寻求医疗援助治疗月经问题。
结论：难民少女缺乏足够的 SRH 信息，经历不良的 SRH 结局，包括因月经而缺课、性暴力和女性生殖器切割。建议提供全面的 SRH 服务，包括性教育、无障碍获得 SRH 服务和父母参与。
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