Barriers to accessing social support at refugee-serving humanitarian organizations: a descriptive phenomenological study of Yemeni refugee women in Addis Ababa, Ethiopia

Abstract

Post-migration challenges increase refugees’ support needs and place their well-being at risk. Social support is a vital tool that can reduce refugees’ challenges. Social support has a positive impact on the well-being of refugee women. The main objective of this study was to examine the barriers Yemeni refugee women encountered when attempting to receive social support from refugee-serving humanitarian organizations in Addis Ababa, Ethiopia. The study employed a descriptive-phenomenological design to achieve its objective. To examine the experiences of thirteen Yemeni refugee women, a semi-structured interview guide was used. Study participants were selected using purposive sampling. Using a descriptive phenomenological analysis, the data was analyzed. The findings revealed that language barriers, lack of availability of knowledge about the support packages, transportation problems, support providers’ unfriendly treatment, unmet survival needs, childcare responsibility, failure to give timely responses by support providers, and community leaders’ unfair recruitment hindered refugee women from accessing social support at refugee-serving humanitarian organizations. These barriers negatively affected refugee women’s well-being. Overcoming barriers to accessing social support would help refugee women have enhanced well-being and thrive instead of merely surviving.

Keywords:

• Yemeni refugee women
• Addis Ababa
• Ethiopia
• social support

REVIEWING EDITOR:

• Grace Spencer, Anglia Ruskin University, Cambridge, UK

SUBJECTS:

• Social Psychology
• Psychological Science
• Anthropology - Soc Sci
• Sociology & Social Policy

Introduction

Throughout the world, individuals are forced to escape their homes due to intimidation, hostilities, or violations of human rights (United Nations High Commissioner for Refugees [UNHCR], 2022a). According to the UNHCR’s (2022a) report, there were 35.3 million refugees worldwide, and more than half of them were women and girls. The outburst of the Yemeni civil war in early 2015 between the Yemeni government and Houthi rebels is one of the main crises that has contributed to the forced displacement of a large number of Yemeni citizens (UNHCR, 2022b). About 4.5 million people in Yemen have been displaced by the civil war, and women and children make up more than three-quarters of those who have been displaced (UNHCR, 2022b). The Ethiopian government recognizes Yemenis as prima facie refugees in response to the Yemen crisis (UNHCR, 2016). More than 2,400 Yemeni refugees were residing in Addis Ababa, which makes them the second-largest urban refugee group next to Eritreans (UNHCR, 2023).

Refugee women face several challenges in their host countries, including limited access to resources, challenges relating to their mental health, economic hardship, and problems integrating into the new community in which they are residing (Haffejee & East, 2016). They also have restricted economic opportunities and are susceptible to food insecurity (Bilgili et al., 2017). The challenges that refugee women face also include isolation, a lack of access to necessities like food and accommodations, poor health, trouble finding employment, and unstable financial situations (Asaf, 2017). Refugee women face more integration challenges than refugee men, especially because they face poor health and lower educational attainment (Liebig & Tronstad, 2018). Furthermore, while all refugees experience human rights abuses living in exile, refugee women are especially susceptible to gender-based violence such as sexual assault (Bartolomei, 2016).

Post-migration challenges increase refugees’ support needs and place their well-being at risk (Schweitzer et al., 2006). Social support is a vital tool that can reduce refugees’ challenges (Das & Chan, 2013). According to Berkman et al. (2000), social support is a complex concept with several conceptualizations. However, it is necessary to understand social support in a contextual and culturally specific way (Wachter et al., 2021). Social support is ‘an interpersonal transaction involving one or more of the following: (1) emotional concern (liking, love, empathy), (2) instrumental aid (goods or services), (3) information (about the environment), or (4) appraisal (information relevant to self-evaluation)’ (House, 1981, p. 39). Social support can be perceived or received. According to Sarason et al. (1990), perceived support encompasses both the perceived availability and adequacy of the assistance, whereas received support is the quantity and quality of supportive behaviors or resources that a person receives (Haber et al., 2007).

Social support is essential to improving the well-being of refugees due to the changes in their lives caused by their forced migration (Stewart, 2014). Studies indicate that social support has a positive impact on the well-being of refugees (Stewart et al., 2008, 2010, 2017). It has the potential to reduce refugee women’s isolation, assist them in coping with stress, reinforce their self-confidence, and enhance their sense of belongingness. According to studies focused specifically on refugee women, social support is essential for reducing loneliness, improving mental health outcomes (Killian et al., 2015; Kingsbury et al., 2018), reducing post-traumatic stress disorder (Ryu & Park, 2018), and improving well-being during pregnancy and the postnatal period (Fellmeth et al., 2021; Kingsbury et al., 2019).

Access to social support is important to secure one’s well-being (Simich et al., 2005). The challenges that refugees face in accessing social support have been studied (Kim et al., 2017; Nara et al., 2020; Schmidt et al., 2018). These studies indicated that refugee women faced language barriers, inadequate knowledge of support programs, insufficient interpreters, transportation challenges, and a lack of culturally appropriate services in their efforts to access support from organizations. Likewise, a qualitative study among Syrian and Palestinian refugee women in Germany indicated that refugee women faced language barriers, inadequate knowledge of services, and the absence of interpreters in their attempts to seek health services (Henry et al., 2020). Munyaneza and Mhlongo (2019) found that refugee women in the Republic of South Africa encountered barriers when seeking medical services, such as medical xenophobia, language barriers, a lack of confidentiality, poor treatment, difficult economic circumstances, an insufficient number of health professionals, and overcrowded public hospitals. Rizkalla and colleagues (2020) further indicated that Syrian refugee women in Jordan experienced poor medical care, stigma, and a shortage of mental health resources in healthcare settings in their pursuit of physical and mental health care.

The social support system for refugee women is reduced as a result of forced migration and resettlement (Wachter & Gulbas, 2018). The loss of social support owing to various barriers has detrimental impacts on the well-being (Gottlieb & Bergen, 2010) and integration (Simich et al., 2010) of refugees. Stress due to one’s inability to access social support may affect psychological and emotional well-being (Hyman & Guruge, 2006). An increased risk of mental illness was related to a lack of social support (O’Mahony & Donnelly, 2013; Puyat, 2013). In comparison to men, women have been observed to experience greater negative mental health outcomes when there are insufficient social networks (Haines et al., 2008).

The challenges that refugee women encountered when attempting to receive assistance from humanitarian organizations were the main subject of this study. We conceptualize humanitarian assistance as a form of social support. In the context of forced displacement, humanitarian organizations offer assistance to foster refugees’ resilience and recovery, as the informal social networks that refugees rely on for support, care, and comfort are limited (Awuah-Mensah, 2016). Humanitarian assistance promotes refugees’ physical, social, mental, and emotional well-being, which are the major aspects of social support.

The barriers that refugee women have to access social support from organizations have been studied globally. While these studies have been valuable, most of them focused on the challenges refugee women face in accessing physical and mental health services in healthcare settings (Bains et al., 2021; Cameron et al., 2022; Henry et al., 2020). There was a paucity of studies on the barriers faced by refugee women receiving social support, particularly from humanitarian organizations. The lack of such studies highlights the need for a study on the issue. Hence, this study examined the barriers that Yemeni refugee women faced in accessing social support at refugee-serving humanitarian organizations in Addis Ababa, Ethiopia.

Methods

Study design

The study employed a qualitative research design. Qualitative research helps the researcher understand the meanings or realities that participants construct in their interaction with their world (Sargeant, 2012), and this is best captured through participants’ narratives of their experiences (Merriam, 2014). We chose a qualitative research design because it enables the researchers to examine contextual factors and helps to explore a topic such as barriers to accessing social support, about which little is known (Padgett, 2017). To uncover the lived experiences of the study participants, we employed a descriptive phenomenological approach (Giorgi, 2009). Descriptive phenomenology is an appropriate research approach to explore the universal experiences of a life problem (Giorgi, 2012).

Study setting

The study was conducted in Addis Ababa. Addis Ababa is the largest city in Ethiopia and the country’s capital. It is also the country’s geographic center and plays a crucial symbolic, political, and economic role in Ethiopia (Ezana, 2021). By 2023, Addis Ababa is a home to more than 5.4 million people (World Population Review, 2023). Addis Ababa is currently hosting over 74,000 refugees (UNHCR, 2023).

Participants and sampling

The inclusion criteria for study participants included being Yemeni refugee women, beneficiaries of the current support provided by refugee-serving humanitarian organizations, residing in Addis Ababa for 1 year or longer, aged 18 years or older, being able to speak and understand Arabic, and having the willingness to participate in the study.

To find refugee women willing to share their experiences of accessing social support, purposive sampling was used. We employed purposive sampling as it enables the researcher to select participants who are pertinent to the research questions being asked (Bryman & Bell, 2018). To identify study participants, we worked with a not-for-profit organization that supports refugees. A few Yemeni refugee leaders’ phone numbers were provided to us by a refugee-serving humanitarian organization. Acting as gatekeepers, the leaders of the Yemeni refugees assisted us in identifying potential participants. The objective of the study was described to refugee women who met the requirements. Refugee women who showed interest in the study were invited to take part. Thirteen refugee women participated in the study.

Instrument

The tool used to collect data was a semi-structured interview. The interview guide began with five socio-demographic characteristics that inquired about age, the highest level of education attained, length of stay in Addis Ababa, marital status, and number of children, if any. This was followed by items that asked about refugee women’s challenges with accessing social support. We used a semi-structured interview as it is an effective data collection instrument to explore participants’ thoughts, feelings, and beliefs about a particular phenomenon (DeJonckheere & Vaughn, 2019). Additionally, a semi-structured interview allowed participants to provide a deeper and richer exploration of their lived experiences. Senior researcher team members (MA and AM) with an understanding of the development of semi-structured interviews and research experience on refugee social support reviewed the wording of the interview questions. The leading author (SA) modified items that were difficult to understand based on suggestions made by the senior research team members.

Data collection procedure

The face-to-face, semi-structured interviews were conducted in Arabic, the mother tongue of the refugee women. The quality of data will be enhanced when the data collector shares a similar background with participants and understands and shares participants’ culturally particular ways of expressing their emotions (Creswell, 2013). Thus, the semi-structured interviews were conducted by a female interviewer with a master’s degree who was bilingual, fluent in the participants’ language, and experienced in qualitative research. A 1-day orientation was delivered for the interviewer on the purpose of the study, the content of the semi-structured interviews, and ethical issues. The interviewer conducted interviews with participants in their homes and at one of the humanitarian organization; eleven were interviewed at home and two at one of the humanitarian organization. Participants were interviewed once. Each interview lasted between 1 and 2 h. The interviewer transcribed and translated the data. Data was collected between 5 July 2022, and 1 September 2022.

Data analysis

The steps set forth by Giorgi (2009) served as a guide for the data analysis. The first step was reading all of the data to get a sense of the whole. To get a sense of the whole, we read the interview transcript several times. We did this with a phenomenological reduction attitude (Giorgi, 2009). We bracketed out prior knowledge of barriers to accessing social support and personal experiences so that whatever was given in the data was what was said about it. While we were reading the interview transcripts, we mentally immersed ourselves in the data, which helped us see what the data was saying. We focused on the phenomenon investigated, which was barriers to accessing social support. The second step was establishing meaning units. We read the transcript from the beginning again to determine where there was a significant shift in meaning within it. In other words, we broke the transcript into parts (meaning units) when we experienced a transition in meaning. We used forward slashes at the end of the statement or phrase to demarcate between two meaning units.

The third step was the transformation of meaning units into psychologically sensitive expressions. While staying true to the participant’s meanings, we re-expressed the meaning units in the third person. By not being emotionally drawn to the participant’s natural attitude, the third-person language helps the researcher stay in the phenomenological attitude without changing the meaning content (Giorgi, 2009). Then, we transformed each meaning unit in its third-person form into a statement that highlights the psychological meanings lived by the participant. The fourth step was identifying the constituent parts and forming the structure. We used the transformed meaning unit expressions as the basis for identifying constituents and forming the structure of the experience. We were able to identify the ‘same’ or ‘shared’ meanings of participants across transcripts. Then, we gave a descriptive word or title to each constituent. The last step was the discussion of the data using the identified constituents. We wrote a narrative that discusses every constituent and their interrelationships through the voices of the participants. To write the constituents, we also took direct quotes from the initial transcripts. Using Giorgi’s five-step process, we successfully generated the constituents presented in the findings section.

Ethical considerations

The study protocol was reviewed and approved by the Ethiopian Society of Sociologists, Social Workers, and Anthropologists Institutional Review Board (ESSSWA’s IRB) (protocol number 010/2022). The study’s participants gave their verbal informed consent after being properly told about the study’s objective. The study’s participants were made aware that participation was voluntary and they could withdraw at any time. Participants were also informed that the study did not pose any harm or risk to them. Confidentiality was maintained by using pseudonyms. With the participants’ permission, the semi-structured interview was recorded using an audio recorder. All of the study participants’ data were anonymized, and confidentiality was maintained at all times.

Trustworthiness of the data

To ensure rigor, we employed different verification strategies throughout the research process. The interviewer gave a verbal summary of the accuracy of the transcripts to the interviewees, and participants were allowed to respond right away to maintain credibility. Before starting the interview, the interviewer took the time to get to know the participants and connect with them, which assisted in establishing trust and put the participants at ease. The authors fully described the procedures used in the study to ensure dependability. An audit trail was set up for the data collection and analysis processes to ensure confirmability.

Findings

The subsequent section included an overview of participants’ socio-demographic characteristics, the types of support that refugee women received, as well as the barriers they encountered in accessing various types of support at refugee-serving humanitarian organizations.

Socio-demographic characteristics of participants

Thirteen refugee women between the ages of 30 and 60 participated in the study. Participants in the study had lived in Addis Ababa for three and a half to 10 years at the time of the interview. The study included thirteen participants: two widows, three married, four divorced, and four single. Nine participants had one child or more, while the remaining participants had none at all. Eight of the refugee women with children were single mothers. Five participants had completed tertiary education; one participant was illiterate, one had completed primary school, two did not finish secondary school, and four participants had completed secondary school.

Context and the type of support that refugee women received

Refugee women were receiving and continue to receive various types of support from refugee-serving humanitarian organizations. Financial support was the first kind of support. Respondents received cash assistance to cover their basic needs, especially house rent. Depending on the size of the family, refugee women receive financial support each month. Refugee women received 2100 birr for the head of the family and 300 birr for every child, for an exchange rate of around $42 (US dollars) and $6 at the time of the interview, respectively. Participants reported that at the time of COVID-19, humanitarian organizations added 1150 birr ($23) to them to purchase hand sanitizers and face masks to prevent virus transmission. The second kind of support was material support. Refugee women received food rations, such as rice, macaroni, spaghetti, cooking oil, and bedding, particularly blankets and mattresses. Additionally, refugee women reported that they received hygienic items, such as laundry soap, sanitary pads, toothbrushes and soap, and underwear, each month. Refugee serving humanitarian organizations also gave milk powder to their infants between the ages of 6 months and 2 years every month.

Skills training support was the third kind of support. Refugee women reported that refugee-serving humanitarian organizations sponsored them to take skill training, such as catering, tailoring, and hairdressing, from government and private colleges. They also received English language, computer, small business management, and entrepreneurial training at humanitarian organizations. The fourth type of support was a medical allowance. Refugee women receive health services at public health centers and hospitals, with the medical expenses covered by humanitarian organizations. Refugee women also reported that they received ambulatory services at humanitarian organizations when they encountered emergency cases. Educational allowance was the fifth type of support. Those refugee women who had children received financial aid to cover the expense of their children’s educational materials, uniforms, and transportation. According to respondents, every student who pursues education, from preschool (kindergarten) to secondary school, is eligible to receive this type of support. Furthermore, refugee women indicated that they received daycare services at humanitarian organizations.

Barriers to accessing various forms of support

The analysis that follows highlights several constituents, including language barriers, lack of availability of knowledge about the existing support packages, high transportation costs, support providers’ unfriendly treatment, unmet survival needs, childcare responsibility, failure to give a timely response by support providers, and community leaders’ unfair recruitment. The constituents help to advance our understanding of barriers to accessing social support at refugee-serving humanitarian organizations in the Addis Ababa context.

Language barrier

One of the barriers for respondents to accessing support from refugee-serving humanitarian organizations was language. Refugee-serving humanitarian organizations in Addis Ababa offered services in Amharic, the country’s official language, and English. Humanitarian organizations also assisted participants in Arabic, which is their mother tongue. Since a few refugee women could not understand the local and English languages, volunteer refugees provided interpretation services to them at humanitarian organizations. However, the volunteer refugees’ numbers were small. When refugee women requested them, interpreters were either unavailable or overloaded.

For example, humanitarian organizations worked with volunteer refugees for interpretation services. To ease refugees’ communication with employees at humanitarian organizations and health professionals at health centers, volunteer refugees do interpretation work for Arabic-speaking refugees, including Yemenis. The number of volunteer refugees working at humanitarian organizations was small at the time of the interview. As per respondents, interpreters could not handle many refugees at a time. Since their numbers were small, refugee women could not access them whenever they wanted to go to government health centers or hospitals to seek services. For refugee women, not being able to understand both Amharic and English was a major barrier to accessing health services. The language barrier made it difficult for refugee women to communicate with health professionals and navigate the system. Additionally, it was difficult for refugee women to communicate their needs to health professionals. Leila indicated:

The problem I had when I went to the health center was a lack of interpreters. I couldn’t find an interpreter. Humanitarian organizations have interpreters. But because they are few, they do not accompany us to health centers when we need them. Interpreters hired by humanitarian organizations interpret for refugees staying in their offices and sometimes at the hospital. They do not provide interpretation services for every refugee by going from hospital to hospital. So I had a problem with an interpreter. Because I did not know the language, I was unable to explain my illness to the doctors. As a result, I’m suffering from diseases.

English language proficiency was required at humanitarian organizations before enrolling in computer training. A couple of refugee women faced a challenge while they were trying to receive computer training at humanitarian organizations. For example, Iman and Leila were not proficient in English which prevented them from participating in the computer training. Leila shared that ‘I wanted to get computer training but failed the entrance exam twice, so I couldn’t get trained. I can use computers in Arabic rather than English’.

As mentioned above, humanitarian organizations provided skills training opportunities for refugee women to enroll in technical and vocational fields at either government or private polytechnic colleges. However, because English was the primary language of instruction in such colleges, refugee women encountered language barriers when pursuing technical and vocational training. Leila stated:

One of the humanitarian organizations sponsored me to be trained in tailoring. The medium of instruction was English. I couldn’t understand what the teacher said. My fellow friends who could understand English and Arabic helped me by translating some words, and I was able to finish the course.

Lack of availability of knowledge about the existing support packages

Some respondents were not aware of some of the support packages that were offered by humanitarian organizations working with refugees. The language barriers exacerbated the lack of availability of knowledge about the existing support packages. This is common for newcomers during the initial period. Even though some participants lived in Addis Ababa for more than 3 years, they were still unaware of some of the support provided by humanitarian organizations. For instance, some refugee women were not aware of technical and vocational training (Iman) and hygiene material support (Afina, Fatim, Halima, Emani, and Abia). Other refugee women were not aware of food rations and bedding (Afina), English language and computer training (Afina and Emani), small business management and entrepreneurial skills (Afina, Fatim, Halima, and Abia), or educational allowance (Emani and Afina). While some participants were aware of the support services offered by refugee-serving humanitarian organizations, they lacked information about how to access them. Halima described:

In this country, I don’t have the information to access the available support. If you go to humanitarian organizations, you can’t find the person who gives you the information. The process may be easy, but we don’t know how to reach it or how to get something we need. Even when I open their website, I can’t get the information. This is a big problem.

Some refugee women were still unaware of their rights and privileges. As a result, they were unable to access the support. For instance, Iman was unaware that humanitarian organizations would pay for her child’s dental implant. Iman thought humanitarian organizations would not pay for medical costs like a dental implant:

When robbers tried to steal my son’s phone, they hit his tooth, and one of his front teeth was broken. He has not yet received treatment. It’s hard to ask humanitarian organizations for a tooth implant. I haven’t taken my son to the hospital yet because I was unaware that humanitarian organizations would pay for tooth implants. If I had this information, I would not have delayed so long.

High transportation cost

Most of the refugee women lived on the outskirts of Addis Ababa as a result of the high rental increase in the inner city. In contrast, refugee-serving humanitarian organizations were located in the city’s center. To go to the city center to seek support from humanitarian organizations, refugee women were required to pay high transportation costs. Some refugee women decided to discontinue receiving some forms of support because they were unable to pay for the cost of transportation. For instance, every month, humanitarian organizations provide milk powder to infants between the ages of 6 months and 2 years. Nevertheless, Afina eventually stopped receiving this support due to the high transportation costs she incurred.

One of the humanitarian organizations gave refugee women who took computer and language classes a transportation allowance. However, Kalah and Halima claimed that the transportation allowance was insufficient to pay for the cost of their transportation. Refugee women stopped attending language and computer classes when the transport allowance and the actual transport costs they incurred did not match. Kalah said:

I started language and computer training at a humanitarian organization earlier. But I gave it up because my house is too far from the organization. The money given to us for transportation and the money I spent on transportation did not match. So, I stopped taking the training.

According to some refugee women (Aisha, Leila, Marya, and Kalah), it was difficult for them to pick up hygiene products from refugee-serving humanitarian organizations every month because of the high transportation cost. The amount of money they spent on transport to receive sanitary items and the money they needed to purchase them on their own were almost the same. Kalah stated, ‘when I go from Kaliti neighborhood to humanitarian organizations to pick up sanitary items, I spend about 60 birr for transportation. I’d rather buy it in the shop by myself instead of going there.’ Similarly, Aisha said:

I used to take sanitary pads from humanitarian organizations, but now I stopped because humanitarian organizations are far from my house. It’s better to buy from a shop by myself than go to humanitarian organizations to get this support. What I spend on transportation and the support they give me are close in terms of money. The difference is very small. If they gave me three or four months of support once, it would not be a problem. But I’d rather not go for that support every month.

Support providers’ unfriendly treatment

Refugee women’s access to support from humanitarian organizations depended on how support providers treated them. Refugee women reported that they valued how support providers treated them. Emani stated, ‘When I go to humanitarian organizations, I always see employees’ faces. Even though they don’t give me anything, if they show me a good face and say something nice to me, I’ll go home happily.’

Some refugee women stated that they did not have access to some types of support provided by humanitarian organizations because of the support providers’ unfriendly treatment. For example, Leila, Nahir, and Marya were not satisfied with the employees who gave them sanitary items at humanitarian organizations. They reported that some employees were not interested in providing them with hygiene products. According to Leila, because of some support providers’ unfriendly treatment, several of her friends stopped visiting humanitarian organizations and receiving sanitary products. Because of this, refugee women were forced to incur unnecessary costs to cover sanitary items by themselves. Iman and Abia, on the other hand, found all humanitarian organizations’ employees, including the ones who provided sanitary products, helpful and kind, and they praised them.

Refugee women could receive medical services at public health centers and hospitals, with the medical expenses covered by a humanitarian organization. However, when Aisha went to a humanitarian organization to collect the money she had paid to the government hospital for her medical treatment, she faced unfriendly treatment. Thus, she stopped using the humanitarian organization’s medical allowance:

When I went to a humanitarian organization with the receipt for my treatment at the government hospital, they did not treat me well. At one time, they told me that the cashier didn’t come in, and another time they told me to come back again. When I went there for the third time, they even didn’t give me attention, let alone refund me the money. From that time on, I did not go to that humanitarian organization and ask them again because they did not give me a good response earlier. I don’t want to go there and beg them.

Unmet survival needs

Although some refugee women were interested in taking language, computer, and vocational training programs at humanitarian organizations, they were unable to do so due to giving priority to unmet survival needs. They placed greater emphasis on meeting their essential needs than on receiving skills training from refugee-serving humanitarian organizations. Some refugee women preferred to engage in income-earning activities rather than pursue training support. Aisha indicated:

I haven’t taken language, computer, or vocational training from humanitarian organizations because I have to work and feed my children. I think it would be better if I went to work and brought some money for my children instead of wasting my time in training. I would love to take such training, but I need to work because I am a mother of children. If I don’t work, I can’t feed my children and cover their educational expenses.

Similarly, Abia stated:

I did not go to humanitarian organizations and take language and computer training. I have to feed my children. If I waste my time with such training, my children will have nothing to eat. Of course, the training is good for refugees like me. Nowadays, such training is not free but paid for.

Childcare responsibility

Given the patriarchal structure of Yemeni culture, it was up to the refugee women to raise the children. This in turn made it difficult for refugee women like Afina to attend language, computer, and vocational training classes provided by refugee-serving humanitarian organizations. As per the respondents, they had limited informal social networks in Addis Ababa because they came from a different country. The difficulty of refugee women’s childcare responsibilities was made worse by the limited informal social networks on which they could rely for child care. Humanitarian organizations offered childcare services for refugees. However, Afina reported that the childcare facility was not in a position to provide children with appropriate services:

I have not been able to take vocational training offered by humanitarian organizations because there is no one to look after my children. One of my children is 4 years old, and the other is 1 year old. For whom do I leave my children to take care of them and take the training? The childcare service at a humanitarian organization is not good. Leaving a newborn child for them is unthinkable.

Failure to give timely response

Participants in the study indicated that failure to give timely responses by support providers was one of the barriers they faced when they received support from refugee-serving humanitarian organizations. To get certain support, refugee women were forced to knock on the door of support providers several times. Not receiving timely responses from humanitarian organizations was time-consuming and tiresome for many refugee women, which discouraged them from using the support. Moreover, failing to give timely responses increased refugee women’s state of vulnerability. Nahir stated, ‘I went to one of the humanitarian organizations to receive milk powder for my granddaughter and asked them twice, and they told me to take it another time. Then, I fed up and stopped going to that humanitarian organization to receive the support.’ In a similar vein, Halima described:

If you want something, you must go to them five or ten times to get assistance. It’s so difficult because of the system. When you see them on the outside, they seem to be helping us. But the system is so difficult. You have to write an application letter so many times to get some assistance here. They added another problem for us.

Community leaders’ unfair recruitment

As per participants, a humanitarian organization provided food rations and bedding to refugees through community leaders. Each refugee nationality had its community leaders. Two Yemeni community leaders were selected by a humanitarian organization for the Yemeni refugee community. Refugee women were told to contact their community leaders by a humanitarian organization to access food rations and bedding. Respondents also indicated that food rations and bedding were given first to those who were most vulnerable (sick and had a large family size). It was through community leaders’ recruitment that refugees were able to get food rations and bedding. However, some participants reported that community leaders did not select refugees based on vulnerability but rather based on friendship. Participants also accused community leaders of being judgmental and choosing refugees based on the type of clothes they wore. The community leaders’ unfair recruitment inhibited refugee women’s access to the available support. For instance, Emani described:

What I have experienced in one of the humanitarian organizations is that recently, food rations, blankets, and mattresses were being given to Yemeni refugees who have relationships with community leaders but not to me. Community leaders only selected their friends and people they knew. When I asked the community leaders, they told me that I would take the support in the next round. It isn’t because someone is wearing beautiful clothes. These community leaders should be reformed. Community leaders should have come and looked at our problems at home and decided who was the most vulnerable refugee. It would be good if the community leaders observed house-to-house for the needy Yemenis. That is why they are our representatives. They have to show our problems to the concerned bodies. For the last five years, none of the community leaders have asked about my problems. Even so, they did not contact me a single day. These representatives should ask us what we are missing or our problems.

Discussion

According to the study’s findings, refugee women accessed various kinds of support from refugee-serving humanitarian organizations, such as financial support, material support, and skill-training support. Refugee women also received medical and educational allowances and daycare services. However, refugee women encountered barriers while accessing support provided by refugee-serving humanitarian organizations.

One of the barriers for refugee women to accessing support was language. Refugee women received support from refugee-serving humanitarian organizations in the local and English languages and in their mother tongues through volunteer refugees. Attempting to provide support to refugee women in their mother tongue is a step forward. However, refugee women were unable to access interpreters due to the small number of volunteer refugees employed by humanitarian organizations. As a result, refugee women faced language difficulties in a variety of settings, including healthcare and educational settings. Similarly, according to previous studies (Arnold et al., 2014; Bains et al., 2021; Jiwrajka et al., 2017; Kim et al., 2017; Makwarimba et al., 2013; Munyaneza & Mhlongo, 2019; Nara et al., 2020; Schmidt et al., 2018; Stewart et al., 2015), refugee women face barriers when trying to access health services in host countries due to their difficulty to understanding the local language. The language barriers might be attributed to the lack of a center that gave local language training to refugee women. To help refugee women overcome language barriers, humanitarian organizations need to offer them language classes in both local and English languages. In a short while, it is necessary to assign sufficient interpreters to provide refugee women with interpretation services.

The study found that information about the existing support packages offered by refugee-serving humanitarian organizations was not available to refugee women. Likewise, previous studies indicated that refugee women were not aware of the available support due to a lack of information (Fellin et al., 2013; Guruge & Humphreys, 2009; Habersack et al., 2011; Henry et al., 2020; O’Mahony et al., 2012; Qutranji et al., 2020; Schmidt et al., 2018). Our study explains the reason behind the lack of awareness of existing support programs and indicates that language barriers were the reason for this. In a similar vein, a qualitative study among resettled Syrian refugee women in Canada revealed that language differences between refugee women and healthcare providers made refugee women more vulnerable to inadequate knowledge of support programs (Cameron et al., 2022). Another explanation is that, as per social capital theory, there are fewer connections or bridging capital between refugee women and humanitarian organizations working with refugees (Putnam, 2007). Refugee-serving humanitarian organizations need to do awareness-raising campaigns using refugee women’s mother tongue to publicize their support programs.

The study’s findings also showed that refugee women encountered high transportation costs while they were trying to access support. Parallel to this study, a qualitative study among Congolese refugee women in the United States revealed that refugee women faced transportation problems as one of the barriers to accessing healthcare services (McMorrow & Saksena, 2017). Our study revealed an explanation for refugee women’s inability to cover the costs of transportation to get available support. This was due to a lack of financial resources. Refugee women attempted to use their own money to compensate for it, as material support nearly matched the costs of transportation that refugee women had to pay to obtain the support. This added another financial burden to the already minimal financial resources of refugee women. To lessen the financial burden of refugee women, humanitarian organizations must either provide adequate material support in advance or transfer the money required to buy the material via bank.

The transport allowance that refugee women received during their skills training did not meet the refugee women’s actual transport costs. As a result, refugee women were forced to discontinue their skill-training courses. Long-term economic self-reliance for refugee women could be achieved through participation in skills training. On the other hand, not taking skills training due to an insufficient transportation allowance would negatively affect refugee women’s economic well-being. Therefore, humanitarian organizations have to give refugee women a sufficient transportation allowance that takes into consideration the current cost of transportation.

The study’s findings also indicated that when refugee women tried to get support, they were treated poorly by those who offered it. Similarly, existing studies indicated that support providers’ unfriendly treatment was one of the barriers for refugee women to accessing social services (Freedman et al., 2020; Munyaneza & Mhlongo, 2019; Nara et al., 2020; Rizkalla et al., 2020; Schmidt et al., 2018). According to Newaz and Riediger (2020), support providers’ unfriendly treatment might be due to language differences and a lack of cultural competence among support providers. Humanitarian organizations need to provide their employees with sensitization training that emphasizes cultural sensitivity, promoting empathic understanding, how to be responsive, and how to approach refugee women unconditionally. Additionally, offering an adequate interpretation service may enhance communication between support providers and refugee women.

The findings of the study also showed that when refugee women sought support, support providers did not respond promptly. This made refugee women less likely to get support from humanitarian organizations, further exacerbating their precarious situation. In line with this study, a study conducted by Stewart et al. (2008) among refugees and immigrants in Canada revealed that newcomers experienced unmet support needs due to service providers’ bureaucratic constraints. Service untimeliness (Eruyar et al., 2022) and administrative barriers (Lloyd et al., 2023) might be contributing factors to delays in support delivery. Given their state of vulnerability, there is no other option than giving timely responses to refugee women. In addition, the responsiveness of support providers to refugee women’s needs should be improved.

Moreover, the study revealed that unmet survival needs were a major barrier to refugee women’s attempts to access skill-building training from humanitarian organizations. Receiving training support would increase employment opportunities for refugee women in the long run. According to Kim and colleagues (2017), the reason for prioritizing survival needs over training support might be attributed to refugee women’s precarious economic status. In addition to focusing on the long-term goals of refugee women, humanitarian organizations’ programs should be directed toward enhancing their current economic situation by providing for their basic needs.

Childcare responsibility was another factor limiting refugee women’s access to skill training support at refugee-serving humanitarian organizations. This, in turn, negatively affected refugee women’s economic well-being and personal development in the long run. Similarly, existing literature indicated that childcare responsibility affected refugee women’s access to healthcare services (Caulford & Rahunathan, 2019) and the ability to engage in and continue in education (Hatoss & Huijser, 2010; Namak et al., 2022; Senthanar et al., 2020). The reasons why refugee women’s access to skill training support diminished were further examined in our study. According to the study, this is because the informal social networks that refugee women may rely on for childcare tend to be limited. It is therefore necessary to offer appropriate childcare services that consider refugee women’s needs. It’s also essential for strengthening the informal social networks that refugee women can rely on for child care.

According to the study’s findings, refugee women were disadvantaged as a result of discriminatory practices made by community leaders. This might be due to a lack of open communication between community leaders and refugee women. Hence, the responsibility of recruiting the most vulnerable should be placed on the humanitarian organization. Community leaders should also be open and honest with refugee women regarding their recruitment criteria.

In general, the findings of the study revealed that, although refugee-serving humanitarian organizations provided free support, refugee women in Addis Ababa encountered multiple barriers when attempting to obtain it. This has been exacerbated by gaps in the system and refugee women. Furthermore, by highlighting the barriers to accessing social support, the study’s findings filled in gaps in knowledge regarding social support from humanitarian organizations.

Additionally, the study’s findings help us better understand the concept of social support in the context of refugees. The study advances our understanding of social support to the extent that it designates humanitarian assistance as a form of social support. House (1981) defined social support as an interpersonal transaction that involves emotional concern, instrumental assistance, information, or appraisal. This support comes from one’s social networks, such as family members, friends, and neighbors. However, in the case of forced displacement, refugees may not have family members, friends, and neighbors with the information and means to help them. In addition, the support from their social networks may be inadequate to cope with adaptation challenges. During this time, refugees might seek social support from humanitarian organizations. In our study, we found that refugee women sought support from humanitarian organizations. Refugee-serving humanitarian organizations develop and carry out programs that offer services and in-kind assistance to refugee women, which used to be provided by refugee women’s social networks. This kind of humanitarian assistance is regarded as social support. Hence, the study enriches our understanding of social support. Moreover, the study provided a different viewpoint on how to use a social support lens to plan, carry out, and evaluate humanitarian assistance programs.

Limitation of the study

We only relied on the data collected through semi-structured interviews. We did not use alternative data collection methods, such as focus group discussions and key informant interviews, to triangulate the findings. Future studies need to consider employing different kinds of instruments to collect data. Additionally, we solely used data collected from refugee women. We did not conduct semi-structured interviews with support providers to ask about the barriers that refugee women faced to accessing social support. Moreover, the type of support provided by refugee-serving humanitarian organizations may not be limited to the support included in this study. We only relied on the reports of refugee women about the support they received.

Conclusion

The lives of refugee women were impacted in a variety of areas, such as health and education, by their difficulty communicating with support providers both in the local and English languages. Refugee women encountered challenges in accessing the existing support packages at refugee-serving humanitarian organizations due to a lack of availability of knowledge about the support. Additionally, because of the high cost of transportation, refugee women were unable to get some form of support, which hurt both their short- and long-term lives. Furthermore, because of the unfriendly treatment and delayed responses from support providers, refugee women stopped receiving some forms of support from humanitarian organizations. These diminished the financial capacity of the refugee women and made them incur unnecessary expenses. Due to unmet survival needs and childcare responsibilities, refugee women did not receive skill training that would ultimately negatively affect their economic well-being. Lastly, refugee women became vulnerable and disadvantaged by the unfair recruitment practices of community leaders. All these barriers negatively affect refugee women’s well-being. Overcoming barriers to accessing social support would help refugee women have enhanced well-being and thrive instead of merely surviving.

Acknowledgements

We appreciate the data and time that the study participants provided. We are also thankful to Addis Ababa University and Wolaita Sodo University for their financial support. Moreover, we are grateful to one of the humanitarian organizations for permitting us to interview study participants within its organization.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The study was funded by Wolaita Sodo University and Addis Ababa University. The study’s design, data collection, analysis, manuscript preparation, and the decision to submit the manuscript for publication were made without the involvement of funders.

Notes on contributors

Samuel Amare

Samuel Amare is an academic staff member of Wolaita Sodo University in Ethiopia. He is a PhD candidate at Addis Ababa University, studying social work and social development. Studies on migration and refugees are his areas of interest.

Margaret E. Adamek

Margaret E. Adamek is a Professor of social work in the School of Social Work at Indiana University in the United States. She is Director of the PhD Program at Indiana University. Her research interests include aging, leadership, migration, and refugees.

Abebaw Minaye

Abebaw Minaye is an Associate Professor of Social Psychology at Addis Ababa University in Ethiopia. He is a research chair for Forced Displacement and Migration Studies at Addis Ababa University. His area of research interest includes human trafficking, migration, and refugees.