Refugees Need Family Planning

I reminded readers a few days ago that population growth in the Middle East has been a key underlying component of the unrest and violence in that part of the world. The unrest and violence has, of course, created a large refugee population living largely in camps in the region, especially in Jordan, Lebanon, and Turkey. The media stories often emphasize the large proportions of refugees who are women and children. Guess what? Countries with high birth rates have lots of women with children. And, of course, the last thing that any woman in a refugee camp needs is even more children. The Guttmacher Institute has addressed this issue with a new report outlining the need for providing reproductive health care.

Adolescent girls, in particular, are at high risk of sexual and gender-based violence and exploitation, including trafficking; transactional sex for survival; early and forced marriage by relatives; and sexual assault by armed forces, humanitarian workers or others. Moreover, deficiencies exist in other sexual and reproductive health care areas, including safe abortion care; provision of long-term and permanent contraceptive methods; provision of emergency contraception, except in cases of rape; and clinical care and preventive services for victims of sexual and gender-based violence.

And they also note the barriers to providing those needs. Cultural barriers, in particular, can be very important:

Cultural norms and ideological opposition to family planning, abortion and other sexual and reproductive health matters often impede access to services, both before and during a crisis. Relatedly, stigma associated with sex, unintended pregnancy (especially outside marriage) and abortion, and concerns about privacy, may inhibit many from using services, especially survivors of sexual violence. Moreover, for sensitive issues like abortion, providers are often unwilling to offer services, even where abortion is legal.

Even if there were no cultural barriers, lack of sufficient funding would be a major issue. The United States has been a big player in providing funding over the years, but the Trump administration seems to have yanked the rug out from under that with the reinstatement of the global gag rule, as I noted a few days ago. It isn't clear how these things are going to play out, but at the moment everything is going in the wrong direction.