Family planning knowledge and practices in displacement: exploring barriers among Somali refugee women in Ali Addeh camp

Authors

  • Ahmed M. Barkat Pan African University Life and Earth Sciences Institute (Including Health and Agriculture), Ibadan, Nigeria
  • Adesina Oladokun Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Nigeria
  • Mache T. Adhana School of Public Health, Mekelle University, Mekelle, Tigray, Ethiopia

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20254255

Keywords:

Somali refugees, Reproductive health, Family planning, Ali Addeh Camp, Djibouti

Abstract

Background: The use of modern contraceptives is a key strategy for improving maternal health and enabling informed reproductive choices. This study aimed to assess modern contraceptive use, knowledge, and attitudes among Somali refugee women in Ali Addeh camp, and to explore the factors influencing uptake.

Methods: A cross-sectional study was conducted at Ali Addeh camp including 360 Somali refugee women aged 18-49. Data were collected through structured questionnaires and statistical analysis were performed to examine key patterns and influencing factors.

Results: Although 83.06% of women had heard of at least one modern method, 89.44% were classified as having low knowledge. Poor contraceptive attitudes were scored by 80.83% of respondents, with 56.39% believing contraceptive use is inherently wrong, and 85.83% viewing it as solely the woman’s responsibility. While 96.67% expressed a desire for five or more children, 85% also preferred birth spacing of 2-3 years. Only 31.11% had discussed contraception with their husbands, and just 8.06% scored high spousal engagement. Regression analysis revealed that partner support, education level and income level was significantly associated with favorable contraceptive attitudes (p<0.01). Structural barriers were prevalent, with 94.44% scoring poorly on access.

Conclusion: Contraceptive use in Ali Addeh camp is limited by knowledge gaps, social norms, and access issues, highlighting the need for culturally tailored strategies that involve men.

References

Logie CH, Okumu M, MacKenzie F, Kibuuka-Musoke D, Hakiza R, Katisi B, et al. Social-ecological factors associated with trajectories of adolescent sexual and reproductive health stigma: longitudinal cohort findings with urban refugee youth in Kampala. Sex Health. 2024;21(5):SH24098.

Aksoy C, Ginn TD. Attitudes and policies toward refugees: evidence from low- and middle-income countries. Policy Res Work Pap. 2022;9985.

Bellizzi S, Pichierri G, Menchini L, Barry J, Sotgiu G, Bassat Q. The impact of underuse of modern methods of contraception among adolescents with unintended pregnancies in 12 low- and middle-income countries. J Glob Health. 2019;9(2):020429.

Bakesiima R, Cleeve A, Larsson E, Tumwine JK, Ndeezi G, Danielsson KG, et al. Modern contraceptive use among female refugee adolescents in northern Uganda: prevalence and associated factors. Reprod Health. 2020;17(1):67.

Million S, Gebru Z, Hassen S, Tesfaye S. Unmet need for modern contraceptive methods among displaced married women in their reproductive years in Bishan Guracha Town, West Arsi Zone, Oromia Region, Ethiopia. Int J Reprod Med. 2024;2024:6662117.

World Health Organization. Acceleration towards the Sustainable Development Goal targets for maternal health and child mortality: 154th session, provisional agenda item 12. 2023. Available at: https://apps.who. int/gb/ebwha/pdf_files/EB154/B154_12-en.pdf?utm_ source=chatgpt.com. Accessed on 12 October 2025.

Mona, Suri S. India’s family planning mission puts burden of sterilisation on women at the cost of their health. Observer Research Foundation. 2022. Available at: https://www.orfonline.org/research/ burden-of-sterilisation-on-women-at-the-cost-of-their-health. Accessed on 12 October 2025.

Susuman AS, Chialepeh WN, Bado A, Lailulo Y. High infant mortality rate, high total fertility rate and very low female literacy in selected African countries. Scand J Public Health. 2016;44(1):2-5.

Population Reference Bureau. 2016 World Population Data Sheet with a special focus on human needs and sustainable resources. Washington (DC): Population Reference Bureau. 2016. Available at: https://www. prb.org/wp-content/uploads/2016/08/ prb-wpds2016-web-2016.pdfnlm.nih. Accessed on 12 October 2025.

Ojuolape N. Trusting the process: family planning and contraceptive uptake in Somalia. UNFPA Somalia. 2023. Available at: https://somalia.unfpa.org/en/news /trusting-process-family-planning-and-contraceptive-uptake-somaliablogs.cranfield. Accessed on 12 October 2025.

UNHCR. Baseline study: documenting knowledge, attitudes and behaviours of Somali refugees and the status of family planning services in UNHCR’s Ali Addeh Site, Djibouti. Geneva: UNHCR. 2011. Available at: https://www.unhcr.org/sites/default /files/legacy-pdf/4e8c0b589.pdfnlm.nih. Accessed on 12 October 2025.

Gele A, Musse FK, Shrestha M, Qureshi S. Barriers and facilitators to contraceptive use among Somali immigrant women in Oslo: a qualitative study. PLoS One. 2020;15(3):e0229916.

Hammond L. History, overview, trends and issues in major Somali refugee displacements in the near region (Djibouti, Ethiopia, Kenya, Uganda and Yemen). Bildhaan. 2013;13:55-79.

Abdulahi M, Kakaire O, Namusoke F. Determinants of modern contraceptive use among married Somali women living in Kampala; a cross sectional survey. Reprod Health. 2020;17(1):72.

Zhang Y, McCoy EE, Scego R, Phillips W, Godfrey EA. A qualitative exploration of Somali refugee women’s experiences with family planning in the U.S. J Immigr Minor Health. 2020;22(1):66-73.

Adeoti L, Onyekachi N, Olatinsu O, Fatoba J, Bello M. Static reservoir modeling using well log and 3-D seismic data in a KN Field, Offshore Niger Delta, Nigeria. Int J Geosci. 2014;5(1):93-106.

Gitonga E, Gage AJ. Modern contraceptive prevalence and its predictors among non-refugee and refugee Somali women in Nairobi City, Kenya; a comparative view. Front Glob Womens Health. 2024;5:1328612.

Nyirimanzi JD, Butare B, Iryanyawera MC, Mugisha M, Mutamba D, Kayumba P. The utilisation of modern contraceptives in refugee camps. Rwanda Public Health Bull. 2020;2(4):15-18.

Gebrecherkos K, Gebremariam B, Gebeyehu A, Siyum H, Kahsay G, Abay M. Unmet need for modern contraception and associated factors among reproductive age group women in Eritrean refugee camps, Tigray, North Ethiopia: a cross-sectional study. BMC Res Notes. 2018;11(1):851.

Awawu SG, Ekele OG, Shamsiya I, Olayinka SR, Amos N. Access to contraceptive services in crisis environment: a case study of women in Wassa internally displaced persons camp in the Federal Capital Territory, Abuja. Int J Adv Multidiscip Res Stud. 2024;4(6):420-3.

Kiura AW. Constrained agency on contraceptive use among Somali refugee women in the Kakuma Refugee Camp in Kenya. Gend Technol Dev. 2014;18(1):147-61.

Tadesse K, Seifu W. Why refugee women didn’t use modern contraceptives? Lesson from women in Shedder Refugee Camp, Ethiopian Somali Regional State, Eastern Ethiopia. Gynecol Obstet (Sunnyvale). 2017;7(1):1000432.

Achola R, Atuyambe L, Nabiwemba E, Nyashanu M, Garimoi Orach C. Barriers to contraceptive use in humanitarian settings: experiences of South Sudanese refugee women living in Adjumani District, Uganda; an exploratory qualitative study. PLoS One. 2024;19(3):e0278731.

Tilahun T, Coene G, Temmerman M, Degomme O. Spousal discordance on fertility preference and its effect on contraceptive practice among married couples in Jimma Zone, Ethiopia. Reprod Health. 2014;11(1):27.

Auma I, Nabaweesi D, Orech S, Alege JB, Komakech A. Determinants of male involvement in antenatal care at Palabek Refugee Settlement, Lamwo district, Northern Uganda. BMC Pregnancy Childbirth. 2023;23(1):325.

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Published

2025-12-29

How to Cite

Barkat, A. M., Oladokun, A., & Adhana, M. T. (2025). Family planning knowledge and practices in displacement: exploring barriers among Somali refugee women in Ali Addeh camp. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 15(1), 22–32. https://doi.org/10.18203/2320-1770.ijrcog20254255

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Original Research Articles