Access of Syrian refugee women to reproductive health services in Turkiye during the COVID-19 pandemic

Background: Turkiye hosted more than 3.5 million Syrian refugees, including women who needed reproductive health services during the COVID-19 pandemic. Aim: To assess how the COVID-19 pandemic affected access to and use of essential reproductive health services by Syrian refugee women in Ankara, Turkiye. Methods: From April to December 2021, this descriptive epidemiological study collected data from 637 ever-married Syrian refugee women aged 15-49 years in 2 districts of Ankara, Turkiye. The data were collected using a structured multiple-choice questionnaire and analysed using SPSS version 23. Results: The mean age of the women was 29.6 (SD +/- 8.4) years, with a median first-marriage age of 17 (range 12-45) years. Among them, 8.6% were illiterates and 96.7% had ever been pregnant. Since the beginning of the pandemic, 35.6% of them had been pregnant, with 78.2% livebirths and 21.8% miscarriages. Alarmingly, 12.8% gave birth at home without specialist support. Absence of antenatal care increased from 7.0% before to 41.1% after the pandemic, and missed postpartum assessment increased from 10.6% to 45.1%. Due to the fear of side effects or spousal disapproval, 26.4% never used any contraceptive. Hospitals and migrant health centres were the primary reproductive health information sources. Conclusion: The COVID-19 pandemic severely affected access to reproductive health services for Syrian refugee women in Ankara, Turkiye. The increased rate of missed antenatal and postpartum care and number of home-based pregnancy terminations are causes for serious concern. Urgent policy adjustments and targeted interventions are needed to address these concerns.