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Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 5  |  Page : 1390-1391
Ensuring availability of pregnancy and childbirth care services in conflict-affected regions of Syria


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Tamil Nadu, India

Click here for correspondence address and email

Date of Web Publication6-Nov-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Ensuring availability of pregnancy and childbirth care services in conflict-affected regions of Syria. Ann Trop Med Public Health 2017;10:1390-1

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Ensuring availability of pregnancy and childbirth care services in conflict-affected regions of Syria. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Dec 16];10:1390-1. Available from: http://www.atmph.org/text.asp?2017/10/5/1390/196748


Dear Editor,

The conflicts be it civil or armed have accounted for the displacement of millions of people and at the same time millions are left dependent on the humanitarian aid for their survival and well-being.[1] The Syrian conflict began in 2011 and documented evidence is available to suggest that thousands of people have been killed in the ongoing humanitarian emergency.[2]

Owing to the fact that the conflict has now continued for more than four years and there is no near possibility of the resolution of the issue, a very large proportion of people have migrated from the affected regions. And those who were unable to do so lack access to health care and thus are devoid of the basic health services.[2],[3]

Prior to the start of the conflict, the nation had a well-functioning health care delivery system, but subsequently it has become very fragile.[2]

This is predominantly due to the deliberate blockade of the humanitarian assistance in the region, and simultaneous attacks on the health care facilities.[2],[3],[4] There is no doubt that each and every section and population categories have been affected, however girls and women are facing the major brunt of the problem, with their basic human rights being violated at every possible level.[1],[3] Especially, with regard to the basic sexual and reproductive health care services, a wide range of gaps has been observed in areas like family planning, lack of antenatal care, decrease in the number of institutional deliveries, absence of skilled birth attendants during childbirth, sub-standard childbirth practices, and negligible post-natal care services.[1],[2],[3],[4],[5]

Moreover, a strong negative association has been observed between the incidence of conflict-related violence and the number of antenatal consultations. Also, due to the lack of availability of sexual and reproductive health care (in terms of counseling, testing, therapy, follow-up, partner treatment, etc.) and coerced sex, which is a common phenomenon, there is an enhanced risk of acquisition of HIV and other sexually-transmitted infections.[1],[2],[3] In addition, owing to the large number of unattended deliveries, there is a significant rise in both maternal deaths due to uterine rupture-sepsis-bleeding and morbidities like infections or obstetric fistula because of prolonged obstructed labor.[2],[3]

Further, due to the exposure to stressful circumstances throughout the duration of pregnancy, adverse obstetric outcomes have also been observed such as low birth weight, pre-term births and stillbirths.[4] The problem is further complicated by poor awareness among women about their body, type of services available in health establishments, and fear of being attacked in a health care establishment.[2] In an attempt to deal with all the existing challenges in the conflict-affected regions, the United Nation Population Fund has strengthened health care establishments, especially in terms of infrastructure and logistics and even the referral system. This is to ensure that all pregnant women deliver in a health care facility and are offered quality-assured antenatal care, including a comprehensive package of reproductive and sexual health care services.[3]

To conclude, access to skilled care during childbirth is a basic right of each woman. Thus, it is the responsibility of both the health sector as well as the disputed parties to not interfere with the basic health care services by destructing the infrastructure and resources and prevent a woman and her child to have an access to the best possible environment for survival and well-being.

Acknowledgment

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Chi PC, Bulage P, Urdal H, Sundby J. Perceptions of the effects of armed conflict on maternal and reproductive health services and outcomes in Burundi and Northern Uganda: a qualitative study. BMC Int Health Hum Rights 2015;15-7.  Back to cited text no. 1
    
2.
Martin A, Post N, Post N, Martin M. Syria: What should health care professionals do?. J Glob Health 2014;4:010302.  Back to cited text no. 2
[PUBMED]    
3.
UNFPA Caring for the crisis-affected mothers of Quneitra, Syria; 2016. Available from: http://www.unfpa.org/news/caring-crisis-affected-mothers-quneitra-syria. [Last accessed on 2016 July 5].  Back to cited text no. 3
    
4.
Bodalal Z, Agnaeber K, Nagelkerke N, Stirling B, Temmerman M, Degomme O. Pregnancy outcomes in Benghazi, Libya, before and during the armed conflict in 2011. East Mediterr Health J 2014;20:175-80.  Back to cited text no. 4
[PUBMED]    
5.
Hassan G, Ventevogel P, Jefee-Bahloul H, Barkil-Oteo A, Kirmayer LJ. Mental health and psychosocial wellbeing of Syrians affected by armed conflict. Epidemiol Psychiatr Sci 2016;25:129-41.  Back to cited text no. 5
[PUBMED]    

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Correspondence Address:
Saurabh R Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.196748

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