Refocusing family planning in refugee settings: Findings and recommendations from a multi-country baseline study with a brief film

From May to August 2011, the United Nations High Commissioner for Refugees (UNHCR) and the Women's Refugee Commission, with technical assistance from the Centers for Disease Control and Prevention (CDC), undertook a multi‐country baseline study to document knowledge of family planning, beliefs and practices of refugees, as well as the state of service provision in select refugee settings in Djibouti, Jordan, Kenya, Malaysia and Uganda. The goal of the baseline study was to support program planning and service delivery, and subsequently increase family planning uptake among women, men and adolescents. The studies employed a multi-method approach consisting of qualitative and quantitative methods: in-depth interviews with community leaders; a household survey among women of reproductive age using the adapted CDC Reproductive Health Assessment Toolkit for Conflict‐Affected Women; focus group discussions with women, men, adolescent girls and adolescent boys; and facility assessments to examine service quality. Findings showed that the contraceptive prevalence rates for modern methods in Ali Addeh, Eastleigh, Nakivale, Amman and Kuala Lumpur were found to be 5.1%, 6.8%, 14.6%, 21.4%, 34.2%, respectively. Contraceptive use was generally lower in refugee camps than in surrounding settlements. Further, access to information and services was particularly difficult for adolescents, and the limited availability of long-term and permanent methods was compounded by the general weakness of referral systems. Similar to many less developed countries, findings highlight the need for improved quality and availability of method mix at service delivery points; community sensitization and demand creation strategies; and adolescent-friendly services.