Contraceptive access in displacement settings: a quantitative study of Syrians displaced to Türkiye

TL;DR

This study explores how displaced Syrian women in Türkiye access contraception, finding that health concerns and limited data hinder their choices.

Contribution

The paper introduces a framework for analyzing contraceptive access in displacement settings and applies it to Syrians in Türkiye.

Findings

Fear of side effects and health concerns are major barriers to contraceptive access for displaced women.

A minority of women using contraception still face barriers to accessing their preferred method.

Current data on reproductive health in displacement is insufficient for understanding contraceptive access.

Abstract

Access to contraception for displaced populations is both lifesaving and a right. This paper argues that displacement demands a separate analytical lens from other mobilities and crisis contexts. I offer a framework, based on established concepts and available evidence, to understand different aspects of contraceptive access in displacement. I then use the case study of Syrians displaced to Türkiye, a population for whom data quality and availability is comparably better than other displacement settings, as a worked example to test the framework using empirical analysis of nationally representative survey data. I analyse contraceptive use and reasons for non-use as a proxy for access among married women, optimising data from the Syrian sample of the 2018 Türkiye Demographic and Health Survey (n = 1736) and the 2006 Syria Multiple Indicator Cluster Survey (n = 13,619). The results show that the most relevant dimensions of the framework that constrained access to displaced women’s preferred methods of contraception were cognitive accessibility and perceived quality of care, specifically fear of side effects and other health concerns. A minority of women who were currently using contraception still faced barriers in accessing their preferred method, suggesting limits to contraceptive autonomy. This case study offers theoretically transferable findings about data and evidence for other displacement settings. Notably, the present data landscape on the sexual and reproductive health of displaced populations does not adequately capture issues around contraceptive access and understandings will remain partial with the currently available metrics.

The number of people forced to leave their homes due to conflict and violence is higher than ever. In displacement, people continue to have everyday needs. These include information and services about contraception, should they wish to use it. Access to these services can vary depending on the context and duration of displacement. This paper offers a framework for contraceptive access in displacement. The framework outlines factors that may help or restrict access, such as cost and awareness of services. I use the example of Syrians displaced to Türkiye, following the escalation of the Syrian conflict in 2011, to analyse different types of access. In this displacement context, fear of side effects and other health concerns can be a barrier to using contraceptives. Some Syrian women in Türkiye who were using contraception could not access their preferred method. This paper focuses on Syrians in Türkiye, but the framework can be applied to other displacement settings. Currently, the availability of information is a barrier to understanding contraceptive access. I provide recommendations for how to strengthen the data.

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