Sexual and Reproductive Health and Rights (SRHR) for Women Migrants in Greece – a Qualitative Critical Case Analysis

Background
Women migrants face some different risks to their health and wellbeing in times of displacement related to reproductive health and gender inequality. In 2015, approximately one million asylum seekers sought refuge in Europe, most of them migrating from Turkey through Greece. With the closing of nearby land borders and an agreement between the European Union and Turkey, this left many women stranded in Greece seeking asylum, often waiting for years for their claims to be decided upon. With Greece facing its own financial challenges, non-governmental organizations (NGOs) and volunteers tried to assist with basic services including providing access to healthcare, either directly through their organization or indirectly by means of transportation or advocacy. Using the perspective of those supporting migrant women in Greece, this research aimed to answer the following questions: 1) From the experiences of NGO staff and volunteers what are some of the impacts forced migration has had on the sexual and reproductive health and rights (SRHR) of migrant women in Greece? 2) What are some good practices to help support their SRHR?

Methods
This qualitative study uses a case study design to examine the impact of forced migration on the sexual and reproductive health and rights of women and girls, and to gain insight into the experiences of humanitarian actors trying to support refugees in severely constrained situations. It draws upon 28 interviews with NGO staff/volunteers working with refugees/asylum seekers in Greece since 2015. Interviews were conducted in-person in and outside Athens, Thessaloniki, and Lesvos Island from 2018-2022. The analysis uses Braun and Clarke’s (2022) reflexive thematic analysis and a human rights framework, including the International Convention on Economic Social and Cultural Rights (ICESCR), Article 12, General Comment 22, a comprehensive guide on the right to sexual and reproductive health, and the Convention on the Elimination of all forms of Discrimination Against Women (CEDAW).

Results
Rights violations participants spoke of include ambulances refusing to go to refugee camps, women with newborns sent back to live in tents in camps, increased poverty due to children born during displacement, and safety and housing concerns such as sleeping in tents or being afraid to access bathrooms alone. Another challenge was existing patriarchal norms exacerbating a difficult situation without traditional social supports. Many NGO-led reproductive health programs had to stop operating due to lack of funding or government restrictions. This caused a gap in access to contraception, feminine hygiene supplies, previously provided workshops on topics related to reproductive health, and, sometimes, access to healthcare.

Conclusions
Some promising practices are having women’s centers where women gather to relax, connect with others, build on skill development/learning in a comfortable environment, and create their own programming. This research can support NGO, government, and inter-governmental policies that support prioritizing SRHR in settings of displacement, as opposed to it being something ‘extra’ that is added when there is sufficient funding and something quick to be removed when there is not. Designing programs with a SRHR lens can help support migrant women’s health and wellbeing.