BackgroundThe current conflict in Syria continues to displace thousands to neighboring countries, including Lebanon. Information is needed to provide adequate health and related services particularly to women in this displaced population.MethodsWe conducted a needs assessment in Lebanon (June-August 2012), administering a cross-sectional survey in six health clinics. Information was collected on reproductive and general health status, conflict violence, stress, and help-seeking behaviors of displaced Syrian women. Bivariate and multivariate analyses were conducted to examine associations between exposure to conflict violence, stress, and reproductive health outcomes.ResultsWe interviewed 452 Syrian refugee women ages 18–45 who had been in Lebanon for an average of 5.1 (± 3.7) months. Reported gynecologic conditions were common, including: menstrual irregularity, 53.5%; severe pelvic pain, 51.6%; and reproductive tract infections, 53.3%. Among the pregnancy subset (n = 74), 39.5% of currently pregnant women experienced complications and 36.8% of those who completed pregnancies experienced delivery/abortion complications. Adverse birth outcomes included: low birthweight, 10.5%; preterm delivery, 26.5%; and infant mortality, 2.9%. Of women who experienced conflict-related violence (30.8%) and non-partner sexual violence (3.1%), the majority did not seek medical care (64.6%). Conflict violence and stress score was significantly associated with reported gynecologic conditions, and stress score was found to mediate the relationship between exposure to conflict violence and self-rated health.ConclusionsThis study contributes to the understanding of experience of conflict violence among women, stress, and reproductive health needs. Findings demonstrate the need for better targeting of reproductive health services in refugee settings, as well as referral to psychosocial services for survivors of violence.
This study used focus group discussions to explore 29 Syrian women's experiences of being displaced refugees in Lebanon. Women reported intimate partner violence (IPV), harassment, and community violence. They experienced difficult living conditions characterized by crowding and lack of privacy, adult unemployment, and overall feelings of helplessness. Most frequently, they used negative coping strategies, including justification and acceptance of IPV and often physically harmed their own children due to heightened stress. Some sought support from other Syrian refugee women. Although the study did not address the root causes of IPV, the results shed light on women's experiences and indicate that training them in positive coping strategies and establishing support groups would help them face IPV that occurs in refugee settings.
Background School feeding programs have the potential to supply children with healthy school food, alleviate short-term hunger, and improve children's educational outcomes. Objective We linked community kitchens to a subsidized school snack intervention and assessed the impact of this intervention on nutritional (diet diversity, hemoglobin, and anthropometry) and educational (attendance and academic performance) outcomes of Palestinian refugee schoolchildren. Methods We collected data from 1362 students (aged 5–15 years) and their parents at baseline, and at an 8-month follow-up in two control and two intervention schools. We conducted linear, logistic and negative binomial regression analyses to assess changes in outcomes of children participating in the intervention schools as compared to children in control schools (intention to treat). We also assessed the impact of the snack intervention among children that participated at least 50% of the time (HP, high-participation) as compared to those who participated less than 50% (LP, low-participation), or who only received nutrition education (control) (per protocol). All the analyses were adjusted for child age and gender, maternal education, household expenditure and school level clustering effect. Results At endline, there were 648 children in the control group, and within the intervention group, 260 children had LP and 454 had HP. There was a significantly greater increase in overall diet diversity score and dairy consumption in the HP group compared to controls. Both LP and HP groups were more likely to consume proteins, and less likely to consume desserts than controls. Furthermore, HP group had a significant increase in hemoglobin and both LP and HP had a significant decrease in school absenteeism compared with controls. Conclusions This community-based school nutrition intervention had a positive impact on diet diversity, hemoglobin, and school attendance of children.
The findings of this research led to the following broad areas of improvement in US Title II food aid products: 1) Improve the formulation of existing FBF products used in Title II programming. This includes the addition of a dairy source of protein to products targeted to children 6 to 24 months of age, pregnant and lactating women, wasted children, and wasted individuals undergoing HIV/AIDS treatment. 2) Upgrade the vitamin and mineral mixes used and diversify approaches to addressing micronutrient needs. Enhance the composition of premixes used to fortify blended foods as well as milled grains and vegetable oil; facilitate shipping offortificant premix with bulk cereals for in-country fortification; and develop micronutrient powders (sachets) and other point-of-use fortification options. 3) Develop or adopt non-cereal-based (e.g., lipid-based) products for the management of nutritional deficiencies. This is an argument for more choice among appropriate tools, not for discarding products that have already shown their value over many years. It also does not reduce the need to maintain a focus on supplying high volumes of quality grains as the main staple in food aid baskets.
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