SRH Needs of Syrian Refugees in Jordan Nine Years Post Crisis: with Emphasis on MISP Implementation and Transition into Comprehensive SRH Services
Authors: Amiri Mirwais , Nsour Mohannad Al , Alaloul Enas , Chahien Tala , Kobeissi Loulou Hassan 
Published: November 2021

Abstract
Background: Millions of Syrians have been forcibly displaced since the start of civil war in March 2011. The vast majority of these refugees live in neighbouring countries including Jordan as one of the affected countries in the Middle East. Adolescent girls and women are among the most vulnerable populations in this humanitarian crisis. MISP/SRH interventions and programs have been implemented by various humanitarian organizations, governments, and other health care providers, to prevent and manage the consequences of sexual violence, reduce HIV transmission, minimize maternal/neonatal morbidity and mortality, reduce unintended pregnancies and unmet family planning needs, and plan for comprehensive SRH services as soon as the situation permits. After almost nine years of the protracted Syrian crisis, it is essential to examine available evidence around the effectiveness of SRH interventions for Syrian refugees in Jordan in order to inform the humanitarian community including the government by identifying best practices, essential gaps, bottlenecks, and lessons learnt. Methods: In 2018, an assessment using a previously validated MISP/SRH survey tool and combining both quantitative and qualitative research methods was conducted in four governorates of Jordan (Amman, Irbid, Zarqa and Mafraq) to evaluate the availability of MISP/SRH interventions and programs. Data were obtained from interviews with key informants (KIs). For the analysis SPSS-IBM statistical software was used.Results: Overall, 58 KIs affiliated with a total of 15 different entities/agencies were were selected for this assessment. KIs/respondents had different levels of knowledge and sources of information about the MISP/SRH services and had variable engagement in implementation. The results of this assessment highlighted significant knowledge gaps about the implementation of the different MISP objectives and priorities, even after almost nine years of the initial onset of the crisis. Among the different MISP activities, family planning, maternal health, condom distribution, and newborn health services had the highest level of preparation and implementation, while availability of antiretrovirals (ARVs) for prevention of mother-to-child transmission (PMTCT) and access to safe blood had the lowest level of preparation and implementation. This assessment also showed lack of national coordination in the provision of the different SRH services, lack of a national plan for capacity building, and lack of adequate logistics support systems and funding. Conclusions: Important gaps in the knowledge and implementation of MISP/SRH activities continue to exist in Jordan, almost nine years into the protracted Syrian displacement. Areas in need of focus included: national coordination in the provision of SRH services, developing a national plan for capacity building, improving logistics support systems, and allocating sufficient funding for the provision of MISP/SRH services. Areas, particularly, in need of additional funding included: Capacity building of services provides with specific focus on MISP training activities around the different MISP/SRH services, facilitating emergency preparedness, improving coordination, and improving referral systems.