"I'm not afraid to talk about this, we are suffering": A thematic analysis exploring the sexual and reproductive health challenges faced by women and girls displaced from Sudan to South Sudan

Introduction: The Sudan conflict has caused one of the world's largest displacement crises and devastated health systems. Women and girls who have been displaced from Sudan to South Sudan face severe sexual and reproductive health challenges. In this study we explore how conflict-driven displacement and structural inequalities influence sexual and reproductive health risks and service access among displaced populations. Methods: A cross-sectional, mixed-methods study was conducted in July 2024 using a sensemaking approach among migrants crossing from Sudan to South Sudan at Aweil North and nearby informal borders. Participants aged 13 and older shared micronarratives about migration experiences and completed sociodemographic questions. Qualitative data was screened manually, and narratives related to sexual and reproductive health were then analyzed thematically. Results: There were 170 narratives included. Thematic analysis revealed three primary sexual and reproductive health concerns: (i) Sexual health challenges linked to conflict-related sexual violence; (ii) maternal and neonatal health concerns; and (iii) menstrual health and Water, Sanitation, and Hygiene gaps. These findings reflect broader gaps in essential sexual and reproductive health service access in displacement settings. Conclusions: Our findings highlight severe sexual and reproductive health challenges among women and girls displaced from Sudan to South Sudan. These challenges are driven by broader structural conditions, including conflict-related sexual violence and limited access to healthcare services, and require sustained investment in community-based care, grounded in sexual and reproductive health as a matter of rights, equity, and gender justice.