6.2 Background information

Refugees, and in particular female refugees, face various obstacles, difficulties and exceptional complications before, during and after their, often dangerous, flight to the countries of their destination. Fleeing from a politically and economically unstable und unsafe environment to a safer place has demanded a lot of energy from them and has often been life-threatening. Many female refugees suffer from the loss of beloved persons, who have died as a result of the conflicts/civil war in their home country or during the flight itself. Some female refugees had to leave their spouses, children and other relatives behind.

When reaching the country of destination, many refugees will realize, that the living conditions are completely different than in their home countries: from food, language, cultural habits and customs to the public health and educational system. As for some, the new living conditions might definitely be a challenge, but will be experienced in a positive way, for others, especially those who are suffering from PTSR/PTSD (post-traumatic stress reaction/disorder), the changed living conditions might be experienced as an additional burden and therefore will not have an immediate positive impact.

Especially pregnant women and women with babies represent a vulnerable group within the refugee population with poor conditions and a higher demand to healthcare (like regular medical examinations for mothers and babies, ultrasound, etc.) and nutrition (clean water, healthy and sufficient food) than other refugee populations, which often cannot be provided adequately, or even at all, during flight. Additionally, unaccompanied young women and girls are also more susceptible to violence and exploitation. By realizing the difficulties and obstacles young women and girls, pregnant women, women with babies or with young children have to face when arriving in their destination country, we should be aware of and respect their special needs regarding healthcare (both physical and psychological).

Key facts:

• 75% of most refugee populations are women and children including about 30% who are adolescents.
• 25% are in the reproductive stage of their lives, 15-45 years old.
• 20% of women of reproductive age (15-45), including refugees and internally displaced, are pregnant.
• More than 200 million women want to limit or space their pregnancies, lack the means to do so effectively.
• In developing countries, women’s risk of dying from pregnancy or childbirth is 1 in 48. Additionally, it is estimated that every year more than 50 million women experience pregnancy-related complications, many of which result in long-term illness or disability.

As a consequence, four key areas of reproductive health care for refugee and displaced populations have been identified:

• Safe motherhood (antenatal care, delivery care, and postpartum care)
• Family planning
• Prevention and care of sexually transmitted infections (STIs) and HIV/AIDS
• Protection from and response to sexual and gender-based violence.

(Johns Hopkins and Red Cross Red Crescent 2008, 138-41, Inter-agency Working Group on Reproductive Health in Crises 2010)