Adolescent access to health services infragile and conflict-affected contexts: Thecase of the Gaza Strip

Abu Hamad, Bassam
Jones, Nicola
Gercama, Ingrid
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Background:Enjoyment of physical and mental health is not only recognized as a human right but also as an integral partof development, as reflected in Sustainable Development Goal 3–to ensure healthy lives and promote well-being for all atall ages. The rapid physical and psychosocial changes that take place during adolescence have a strong influence on the restof a person’s life course, so investments in adolescent health services constitute a unique opportunity to reap inter-generational dividends. Yet the evidence base on adolescents’access to health services, particularly in conflict-affectedcontexts, remains thin. This article explores adolescents’access to health services in the Gaza Strip, and their experiences andperceptions of those services.Methods:The article draws on mixed methods research in the Gaza Strip conducted in 2016 and 2017 as partof the Gender and Adolescence: Global Evidence research programme. Data were collected from 240 maleand female adolescents combining in-depth interviews, focus group discussions and a tablet-based survey.This study also draws on a participatory action pilot project engaging 12 boys and 23 adolescent girls aged15–19 years old.Results:The findings underscore that gender norms—especially those pertaining to adolescent girls’sexual purity––shape adolescent health in multiple ways. Girls face increasing restrictions on their mobility, leaving them with limitedopportunities for leisure or exercise, socializing with peers or seeking health services and information. Adolescent boysin Gaza do not face the same restrictions, but given the multiple political, economic and familial stressors, they are athigh risk of substance abuse including smoking and involvement in peer violence. Moreover, our findings suggest thata range of socioeconomic, cultural and structural barriers prevent adolescents in Gaza from accessing quality andappropriate health care. Study participants cited the main challenges being an absence of preventive adolescenthealth initiatives and limited information on sexual and reproductive health, as well as drug shortages, high treatmentcosts, and inappropriate interactions with service providers.Conclusions:The article highlights the importance of designing and implementing conflict-sensitive and age- andgender-appropriate adolescent services and information and promoting preventive services targeted at adolescents.
Adolescence , Gaza , Sexual and reproductive health , Conflict , Gender norms