AN INVESTIGATION ON THE IMPACT OF INTERNAL DISPLACEMENT ON WOMEN’S REPRODUCTIVE HEALTH.

CHAPTER ONE:

INTRODUCTION

1.1 Background of the study

Annually, a substantial number of individuals around the globe experience displacement from their residences due to wars and calamities, resulting in their internal displacement inside their respective nations (Owoaje, Uchendu, Ajayi, & Cadmus, 2016). According to Oliveira, Botega, Saran, Silva, Melo, and Tavares (2019), the expected number of individuals living in internal displacement at the conclusion of 2018 was 41.3 million. Internally relocated Persons (IDPs) possess health requirements that are equivalent to those of those who have not been relocated. In 2010, the proportion of internally displaced persons (IDPs) who were women was around 50%. Typically, women have the dual role of being the main carers of children and siblings, as well as the sources of family income. This multitude of obligations sometimes poses challenges for them in terms of accessing education and health facilities. Moreover, it is often observed that women and girls are confronted with heightened vulnerability to acts of violence, hence encountering barriers in terms of accessing support services and fulfilling their healthcare requirements (Amodu, Richter, Salami, 2020). Currently, the demographic composition of internally displaced persons (IDPs) is mostly comprised of women and children, accounting for over 80% of the total population. This significant proportion has been acknowledged by international humanitarian organisations, who have duly acknowledged the unique requirements and vulnerabilities associated with this specific group. Addressing the sexual and reproductive requirements of internally displaced persons (IDPs), with a special focus on females, is an integral component of the endeavour to reinstate their forfeited citizenship rights (Amodu, Richter, Salami, 2020). Reproductive health encompasses the holistic well-being, including physical, mental, and social dimensions, pertaining to the reproductive system and its associated activities and processes, rather than only the absence of sickness and infirmity. Numerous studies have provided evidence suggesting that the reproductive health requirements of adolescents have not been adequately addressed owing to resource constraints and prevailing difficulties inside internally displaced persons (IDPs) camps (Abiodun, Olu-Abiodun, Ani, Sotunsa, 2016). The presence of sexual behaviours, including both consenting and forced encounters, among adolescents living in camps, leads to unwanted pregnancies, sexually transmitted infections (STIs), unsafe abortions, and several other dangers to their reproductive health (Abiodun, Olu-Abiodun, Ani, Sotunsa, 2016). The occurrence of these upsetting incidents may be attributed to the many obstacles and issues involved with reproductive health care. The challenges encountered by humanitarian organisations in providing assistance to internally displaced persons (IDPs) include limited access to IDP camps due to political or geographical constraints, inadequate financial resources and personnel, as well as security concerns (Abiodun, Olu-Abiodun, Ani, Sotunsa, 2016). Hence, it is essential to adopt a multi-sectoral strategy that encompasses the protection, security, community, and health sectors in order to adequately address the reproductive health requirements of internally displaced persons (IDPs) during times of disasters and crises (Balinska, Nesbitt, Ghantous, Ciglenecki, Staderini, 2019). Adopting this strategy is necessary in order to identify a comprehensive range of potential difficulties. The organisation of the multi-sectoral approach should take into account the identified problems associated with the provision of reproductive health care in camps for internally displaced persons (IDPs).  The act of displacement inherently violates human rights, and the accompanying consequences such as the loss of homes, lands, livelihoods, personal documents, and separation from family members may significantly impede the capacity of internally displaced persons (IDPs) to exercise and enjoy a wide variety of basic rights. Access to basic sexual and reproductive health services is a critical factor for women and girls, particularly pregnant women, who may encounter birthing issues that pose a significant risk to their lives. Additionally, breastfeeding mothers who are responsible for the care of newborns amidst chaotic circumstances are heavily reliant on such services, as they greatly influence the survival or demise of both mother and child during a crisis.  In the states of Borno, Yobe, and Adamawa, which have been significantly impacted by the insurgency issue, it has been approximated that 53 percent of internally displaced individuals are females, including women and girls. Among this demographic, about 1.73 million fall within the age range of potential childbearing. Furthermore, it is projected that there would be 276,000 pregnancies occurring in these areas in the year 2017 (Sahoo & Pradhan, 2019). In the context of Nigeria, it is observed that about one Nigerian woman experiences mortality every 10 minutes due to pregnancy-related circumstances. These fatalities might potentially be averted if women and girls are provided with opportunities for education and access to reproductive health care, including family planning. The heightened risk of mortality is evident in humanitarian crises that result in the displacement of communities and the erosion of community social support structures. These circumstances restrict the ability of women and girls to access health facilities and get specialised treatment, hence exacerbating their vulnerability to adverse health outcomes (Sahoo & Pradhan, 2019). The prioritisation of accessing sexual and reproductive health care is of utmost importance to many families, women, and teenage girls. However, often, their requirements are overshadowed by other pressing demands, such as sustenance and housing, in light of an impending catastrophe. Considering the adverse impacts experienced by individuals affected by internal displacement, the United Nations has played a crucial role in promoting domestic measures to address this issue. This has been achieved through the provision of humanitarian aid by its specialised agencies, as well as the identification of the legal principles within international law that govern the responses of all nations to displacement situations. both principles serve as a manifestation of the principles of international human rights and international humanitarian law. They reaffirm a broader framework that ensures the rights of displaced individuals, as outlined by both legal frameworks. Therefore, the study investigate the impact of internal displacement on women’s reproductive health.

1.2 Statement of the problem

Nigeria and other developing nations face a serious public health crisis due to high rates of maternal morbidity and death. Maternal mortality and morbidity rates in Nigeria remain high even with the implementation of national initiatives aimed at enhancing maternal and child health (Adimula, 2016). The Nigerian government has recently created a number of programmes and policies centred on health in general and maternal health in particular. These policies identify the shortcomings of the current healthcare system in addressing women's health concerns and recognise maternal mortality as a national problem. Women have diverse reproductive health requirements across all periods of their reproductive life, including but not limited to the provision of comprehensive family planning services, safe abortion treatment, and adequate pregnancy, delivery, and postnatal care. It is important to acknowledge and attend to the requirements pertaining to reproductive health within specific service provisions (Hanson, 2019). The requirements may vary in each humanitarian context. Health considerations pertaining to mothers and babies in the context of catastrophes exist. The primary concerns in this matter are to unplanned pregnancy and the avoidable occurrence of maternal and newborn mortality (Daniel, 2019). The potential consequences of restricted availability of reproductive services may include an increased incidence of unintended pregnancies. The unequal distribution of clean water and healthy food, disruptions in health services, overcrowded shelters and camps, and restricted access to reproductive health care pose potential threats to the well-being of pregnant women (Daniel, 2019), potentially leading to increased rates of maternal and newborn mortality. Hence, the study investigates the impact of Internal Displacement on Women’s Reproductive Health.

1.3 Objective of the study

The broad objective of the study is to investigate the impact of Internal Displacement on Women’s Reproductive Health. The specific objectives is as follows:

i.          Assess the level of reproductive health knowledge of women in internally displaced camps.

ii.        Determine the effect of Internal Displacement on women’s Reproductive Health.

iii.      Examine the challenges of reproductive health management among women  in the internally displaced person camps.

1.4  Research questions

The following questions have been prepared for the study:

i.          What is the level of reproductive health knowledge of women in internally displaced camps?

ii.        What is the effect of Internal Displacement on women’s Reproductive Health?

iii.      What are the challenges of reproductive health management among women  in the internally displaced person camps?

1.5 Significance of the study

The study is significant to policy-makers in other to better promote change and improve reproductive health among women in internally displaced persons camp, it is necessary to provide more insight into the relationship between reproductive health knowledge.

The findings of the study will be significant to the academic community as it will contribute to the existing literature.

1.6 Scope of the study

The study focuses on the impact of internal displacement on women’s reproductive health. Hence, the study will assess the level of reproductive health knowledge of women in internally displaced camps, determine the effect of internal displacement on women’s reproductive health and examine the challenges of reproductive health management among women  in the internally displaced person camps.

1.7Limitations of the study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. Insufficient funds tend to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection (internet, questionnaire, and interview), which is why the researcher resorted to a moderate choice of sample size. More so, the researcher will simultaneously engage in this study with other academic work. As a result, the amount of time spent on research will be reduced.

1.8 Definition of terms

IDP: internally displaced persons

Reproductive health: Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes.