Every crisis tells a story of resilience, but for refugee women, the stakes are even higher. Fleeing war, poverty, and persecution, they carry not just their belongings but the burden of navigating fragmented health systems that often fail to address their sexual and reproductive health needs.[1] In Kenya’s Kakuma Refugee Camp and Kalobeyei Settlement, home to 284,000 refugees mostly from South Sudan, access to contraceptives, maternal care, and essential health services is scarce.[2] Compounded crises—overlapping emergencies like conflict, pandemics, and food insecurity—magnify these challenges, leaving refugee women particularly vulnerable. Rates of gender-based violence (GBV), teenage pregnancies, and unsafe abortions spike as emergencies continue to unfold.

To address these challenges, UCGHI Associate Director Dr. Ndola Prata and her team from the University of California Berkeley’s Bixby Center  and the Human Rights Center led a participatory research project in Kakuma and Kalobeyei camps. Through 30 interviews, four focus group discussions, and health facility assessments across four locations, the team gathered firsthand accounts from refugee women and healthcare workers on reproductive health during compounded crises.

Their research revealed a harsh and volatile environment where refugee women often feel unseen. One unforgettable encounter came when a woman explained that she had waited three years to discuss her reproductive health. “You’ve lifted a burden off me,” she told the researchers.

The project was also transformative for the team. Bhavya Joshi, a DrPH student leading the fieldwork, shared how her upbringing in India, where she witnessed extreme poverty firsthand, shaped her perspective. Yet, working with refugees in Kakuma was an eye-opener. “It was humbling to see people living in day-to-day survival—my first encounter with someone begging for water,” Bhavya reflected, adding new depth to her understanding of hardship.

Bhavya emphasized the importance of decolonizing global health practices. “We must dismantle the elitist tradition of ‘helicopter research’ that many institutions uphold, and instead, genuinely invest in community-led, participatory research,” she said, calling for community-driven solutions that move beyond top-down models.

Although Kakuma provides more stability compared to other refugee camps, life remains harsh and unforgiving. The uptake of family planning methods is critically low, and maternal mortality rates are severely underreported. Data is limited and often inconsistent, but reports show that at least 44% of women and girls in Kakuma have unmet needs for family planning services.[3] Living on only $8 per month in food stipends, many refugees, particularly women, are forced to make heartbreaking choices. One young woman, for instance, resorted to transactional sex—a painful example of the unjust dilemmas they face. [4] Even when contraceptives are available, stigma and fear of family backlash deter many from using them, which exacerbates the risk of unintended pregnancies, sexually transmitted infections, and further overwhelms the already strained healthcare system.

The COVID-19 pandemic intensified these challenges. Women had to shoulder increased caregiving responsibilities, often traveling long distances to collect water or firewood, which exposed them to heightened risks of violence from various perpetrators, including members of the host community and even fellow refugees.[5]

A Model for Change: Community-Driven Solutions

The research team behind “Reproductive Health Services and Needs of Refugee Women in Compounded Crises: A Qualitative Study” adopted a participatory approach that empowered refugee women to take ownership of the research process. By employing them to collect, transcribe, and analyze data, the team ensured that their lived experiences shaped the policy recommendations for crisis planning and management. For many participants, this involvement was empowering. One young woman, now the head of her household after losing her father in the war, expressed gratitude: “I can finally afford sanitary pads.” Her story illustrates how small interventions can restore dignity and hope, offering meaningful change even in the most challenging conditions.

The research findings were shared during stakeholder consultation workshops with local and international stakeholders in Nairobi and Kakuma. Participants included government bodies, NGOs, UN agencies, and community organizations. These sessions ensured that policies were not only practical but rooted in community realities, bridging the gap between research and action. Preliminary findings of this research were also presented at the 9^th African Population Conference in Malawi.

A Policy Shift: Health Equity for Refugee Women

This research reveals the urgent need for comprehensive reproductive care at every stage of displacement. Compounded crises like conflict, pandemics, and food insecurity disrupt health systems and lead to increased GBV, teenage pregnancies, and unsafe abortions. The effects extend beyond immediate health, driving intergenerational trauma that perpetuates cycles of vulnerability.

Policymakers must ensure that health systems are inclusive, adaptable, and responsive to the needs of refugee women. Family planning, safe abortion care, and maternal health services must remain priorities, even in the face of crisis. Through community-driven solutions and collaborative efforts, we can build a future where refugee women no longer have to wait years for essential care and endure tremendous hardships.

With the right support, refugee women can thrive—not just survive—despite the immense challenges they face. Every woman, regardless of her circumstances, deserves not only the opportunity to make informed decisions about her body and future but also the right to live a dignified and empowered life, securing both her survival and her well-being.