566 Compounded crises: reproductive health challenges among refugees women in Kakuma and Kalobeyei, Kenya

Abstract EP2.3, e-Poster Terminal 2, September 4, 2025, 10:05 - 10:30 Crises and its impacts are increasing worldwide. The pandemic alone disrupted essential health services in 92 percent countries. Crises often pose a threat to public health due to collapsed or damaged health systems, lack of medication and supplies, and absence of trained medical staff. Compounded crises are multiple, synchronous crises that reduce people’s ability to recover from destabilizing events like war, famine, pandemics, and natural disasters, since each additional crisis prolongs an existing humanitarian emergency. This 2024 study aimed to understand the impacts of compounded crises on service delivery and barriers refugee women face in accessing reproductive health (RH) in Kakuma and Kalobeyei, Kenya. Our research employed qualitative methodologies, including 4 focused group discussions (FGDs) (n = 28) with healthcare providers and 30 in-depth interviews with refugee women of reproductive age. The study used principles of community-based participatory research. FGDs were conducted in English. Interviews were conducted in Dinka, Nuer, Arabic and Dadinga languages. Homogenous sampling and criterion purposive sampling were used to recruit healthcare workers and refugee women respectively. All transcripts were cleaned and checked for accuracy. Data analysis was conducted on MaxQDA and Microsoft Excel. A codebook with preliminary themes and categories was designed using a deductive and analytic inductive approach. The framework method was used for analysis. Findings show most services listed under minimal initial service package for RH in humanitarian settings (MISP) were available however populations did not prioritize health as an essential need during compounded crises. Compounded crises also forced adolescents and young women to resort to transactional sex for survival. Barriers to reproductive access were primarily due to low rates of health education, existing stereotypes about RH, and due to social, religious, and cultural norms. With growing crises worldwide, this study understands the cross-sectional and layered needs of the populations experiencing the impact of multiple crises.