Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Adrienne S. Ettinger

Second Advisor

Jhumka Gupta


Background: The current conflict and humanitarian crisis in Syria continues to displace thousands of Syrians to neighboring countries, including Lebanon. There is a lack of information available to provide adequate health and related services to this displaced population, particularly women and adolescent girls, who comprise the majority of registered refugees. Methods: We conducted a rapid needs assessment from June-August 2012 in Lebanon by administering a cross-sectional survey in six health clinics and conducting three focus group discussions. Information was collected on reproductive and general health status and needs of displaced Syrian women, including exposure to violence and help-seeking behaviors. Results: We interviewed 452 displaced Syrian women ages 18-45 who had been in Lebanon for an average of 5.1 (± 3.7) months. Additionally, 29 women participated in three focus group discussions. Reported gynecologic conditions were common, including: menstrual irregularity, 54%; severe pelvic pain, 52%; and vaginal infections, 53%. Of our sample, 74 were pregnant at some point during the conflict, 40% of the currently pregnant had experienced pregnancy complications, and 37% of those who completed their pregnancies experienced delivery or abortion complications. The prevalence of adverse birth outcomes were: low birth weight, 12%; preterm delivery, 27%; and infant mortality, 3%. Of the entire sample, 31% experienced violence and 3% experienced sexual violence from armed people. Of those exposed to violence, 28% reported physical injury and 71% reported psychological difficulties. The majority of those exposed to violence did not seek medical care (65%). In multivariate models, exposure to violence was associated with menstrual irregularity (p=0.002), severe pelvic pain (p=0.005), and vaginal infections (p=0.002). In focus groups, participants revealed lack of access to basic services (including reproductive health care), high levels of stress in the home, and cases of intimate partner violence. Conclusions: This study contributes to a better understanding of health needs among conflict-affected women. High occurrence of pregnancy-related complications and gynecologic conditions, in addition to barriers to accessing care, indicate a need for better targeting of reproductive health services. The association between violence and reproductive health indicates a need for GBV-related and psychosocial services alongside standard reproductive healthcare.


This is an Open Access Thesis.

Open Access

This Article is Open Access