Luckenbill Sara, Baird Sarah, Alheiwidi Sarah, Jones Nicola
Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, D.C., US.
Gender and Adolescence: Global Evidence, Amman, Jordan.
Confl Health. 2025 Jul 25;19(1):48. doi: 10.1186/s13031-025-00690-0.
Access to sexual and reproductive health services is an explicit element of the Sustainable Development Goals, and is critical for achieving family planning goals and broader well-being of young people. Youth (15-24 years) face many barriers to accessible, quality services, and refugees often experience additional barriers due to physical, economic, legal and/or social exclusion. This study explored these barriers in the context of Jordan, a country that has one of the highest proportions of refugees globally.
This concurrent mixed-methods study utilizes the 2022-2023 Gender and Adolescence: Global Evidence survey data collected from 313 married female youth living in Jordan to describe utilization of contraceptives among Jordanians and Syrian refugees, exploring the role of residence (formal refugee camp, host community or informal tented settlement) and factors associated with contraceptive use among Syrian refugees. A multivariable linear probability model and qualitative data from in-depth individual interviews and focus group discussions were used to explore underlying factors driving differences in contraceptive utilization among Syrian refugee youth.
The survey found that 63.4% of Jordanian youth and 42.8% of Syrian refugee youth were recently using contraception, with notable differences in type of contraceptive method used by both refugee status and residence. Among Syrian refugee youth, living in a host community emerged as a key factor associated with contraceptive use, as it was associated with a 19.6 percentage point increase in the likelihood of using contraception compared to those living in refugee camps. Qualitative themes nuance these findings, suggesting that living in a refugee camp where there is more restricted access to healthcare services, more salient social norms, and limited knowledge about reproductive health present barriers to contraceptive use for Syrian refugee youth.
These results highlight that youth-friendly reproductive health services are having mixed efficacy in Jordan. Understanding barriers to contraception should inform family planning services for marginalized groups like Syrian refugee youth. There is a need for evidence-informed efforts to expand provision of family planning counselling and access to contraceptives for young married couples in Jordan, and especially for those living in formal refugee camps.
获得性健康和生殖健康服务是可持续发展目标的一个明确要素，对于实现计划生育目标和促进年轻人更广泛的福祉至关重要。青年（15 - 24岁）在获得可及的优质服务方面面临诸多障碍，而难民由于身体、经济、法律和/或社会排斥往往会遇到更多障碍。本研究在约旦这一全球难民比例最高的国家之一的背景下探讨了这些障碍。
这项同步混合方法研究利用了2022 - 2023年“性别与青少年：全球证据”调查数据，该数据收集自居住在约旦的313名已婚青年女性，以描述约旦人和叙利亚难民中避孕药具的使用情况，探讨居住地点（正规难民营、收容社区或非正规帐篷定居点）的作用以及与叙利亚难民避孕药具使用相关的因素。采用多变量线性概率模型以及来自深入个人访谈和焦点小组讨论的定性数据，以探究驱动叙利亚难民青年避孕药具使用差异的潜在因素。
调查发现，63.4%的约旦青年和42.8%的叙利亚难民青年近期在使用避孕药具，难民身份和居住地点在使用的避孕方法类型上存在显著差异。在叙利亚难民青年中，居住在收容社区成为与避孕药具使用相关的一个关键因素，与居住在难民营的人相比，居住在收容社区使用避孕药具的可能性增加了19.6个百分点。定性主题细化了这些发现，表明生活在难民营中，医疗服务获取受限、社会规范更为突出以及生殖健康知识有限，这些都给叙利亚难民青年使用避孕药具带来了障碍。
这些结果凸显出对青年友好的生殖健康服务在约旦的效果参差不齐。了解避孕障碍应为叙利亚难民青年等边缘化群体的计划生育服务提供参考。有必要开展基于证据的努力，以扩大约旦年轻已婚夫妇，特别是居住在正规难民营的夫妇的计划生育咨询服务并增加其获得避孕药具的机会。
