The Impact of Birth on Women’s Health and Wellbeing

Author(s):  
Susan Ayers ◽  
Alexandra Sawyer
2021 ◽  
Author(s):  
◽  
Rose Namoori-Sinclair

<p>This research examines in-depth the health and wellbeing experiences of 30 Kiribati migrant women navigating their way to achieve New Zealand permanent residency under the Pacific Access Category (PAC) policy. The political and economic rationality underpinning PAC was to meet New Zealand’s labour demand for industrial growth. It also provides successful applicants with the opportunity to work, live and study in New Zealand indefinitely. The purpose of the research was two-fold. Firstly, to assess the health and wellbeing experiences of migrant women who travelled to New Zealand under the PAC scheme, using Kiribati women as a case study to comment on issues of responsibility for healthcare and wellbeing. Secondly, to identify gaps in personal and policy-related aspects of healthcare and wellbeing, and determine how access to appropriate healthcare and social services for PAC migrant women can be facilitated. The experiences of these migrant women indicated shortcomings in provision of health and social services that this thesis terms the ‘PAC gap’. Although the PAC policy offers them the opportunity to live permanently in New Zealand, the current state of the PAC policy features gaps in service provision that result in gender and health inequality, financial hardship and stress, poor housing, unemployment and poverty. The health and wellbeing impact of the existing conditions of the PAC policy was exacerbated by the contrasting influence of neoliberalism as a policy, ideology, and a form of governmentality in the New Zealand environment (Larner, 2000a; Suaalii, 2006), and the markedly different maneaba system that is central to the social and political life in Kiribati (Tabokai, 1993; Uakeia, 2017; Whincup, 2009). Te maneaba is a traditional meeting hall, where communal meetings take place, and unimane (male elders) make decisions for the governing and wellbeing of the village people (Tabokai, 1993). It is a form of governmentality that shapes and influences how an I-Kiribati thinks and acts (Foucault, 1991). This system is at odds with a neoliberal approach that stresses self-responsibility and individualism. These contrasting forms of governmentality ‘talk past each other’ or are totally different (Metge & Kinloch, 1984). I recruited 30 I-Kiribati women who were successful PAC migrants: six from Auckland, six from Hamilton, and eighteen from Wellington. These women were selected in different years from 2012 through to 2015. To identify the PAC gaps, I employed an indigenous research method called te maroro/talanoa (to exchange ideas and experience freely and openly), complemented by the use of the feminist oral history method that transfers the needs and voices of women from the margin to the centre. This thesis draws on Foucault’s governmentality theory, a critical discourse on neoliberalism, and research on migration and the colonial history of Kiribati. It also draws on work by both Pacific and non-Pacific scholars that articulate how health and wellbeing are rooted in our lived culture and values. This thesis also stresses the need for cultural competency and integration of policy, service provision and community engagement. These materials have all guided my analysis to unpack the women’s health and wellbeing experiences. The research findings on the drawbacks of neoliberal governmentality and maneaba governmentality, and understanding of te maneaba system in a new way, strengthen Pacific studies. These contribute to the literature on Kiribati’s indigenous knowledge and cultural values and Kiribati migration as well as to the impact and effectiveness of the PAC policy for Kiribati and Pacific migration. This thesis demonstrates the need to extend the engagement of Pacific indigenous knowledge and values to the design and implementation of policies at national, regional and global levels. This thesis recommends a hybrid neoliberal-maneaba residential model to address the issues of the current system, such as stress and difficulty finding a job offer, and close PAC gaps. The new model entails a more open and transparent communication between both the New Zealand and Kiribati governments when designing a cultural competent and coherent strategic framework. By working in the best interests of all parties (i.e. New Zealand and the Kiribati governments and PAC migrant groups) this would support future successful PAC applicants to settle well in New Zealand. This would contribute to improved health outcomes for these women, their utu and kainga, without undermining the richness and values of Kiribati’s culture rooted in te maneaba system. These stories articulate a consistent requirement for a hybrid neoliberal-maneaba system, to create a residency model that works for successful PAC applicants, the government of New Zealand and Kiribati, and Kiribati families living in both countries. This would avoid repeating the stress and pain most of these PAC migrant women had experienced because of lack of government support as perceived under te maneaba system. The recommended residency model would also benefit other eligible countries (Fiji, Tonga, and Tuvalu) participating in the PAC scheme.</p>


2020 ◽  
Vol 18 (2) ◽  
pp. 113-114
Author(s):  
R. Poudel ◽  
G. Dangal ◽  
D. Caagbay

COVID-19 has significantly impacted the world and Nepal is no exception. The pandemic has caused a reduction in health service delivery, especially for women’s health conditions, resulting in an increase in challenges for an already vulnerable group. Maternity care, reproductive health services, preventive interventions, nutritional advice and mental health care are not being addressed and with an increase in domestic violence, the health and wellbeing of women in Nepal is precarious and needs to be addressed immediately.


2021 ◽  
Author(s):  
◽  
Rose Namoori-Sinclair

<p>This research examines in-depth the health and wellbeing experiences of 30 Kiribati migrant women navigating their way to achieve New Zealand permanent residency under the Pacific Access Category (PAC) policy. The political and economic rationality underpinning PAC was to meet New Zealand’s labour demand for industrial growth. It also provides successful applicants with the opportunity to work, live and study in New Zealand indefinitely. The purpose of the research was two-fold. Firstly, to assess the health and wellbeing experiences of migrant women who travelled to New Zealand under the PAC scheme, using Kiribati women as a case study to comment on issues of responsibility for healthcare and wellbeing. Secondly, to identify gaps in personal and policy-related aspects of healthcare and wellbeing, and determine how access to appropriate healthcare and social services for PAC migrant women can be facilitated. The experiences of these migrant women indicated shortcomings in provision of health and social services that this thesis terms the ‘PAC gap’. Although the PAC policy offers them the opportunity to live permanently in New Zealand, the current state of the PAC policy features gaps in service provision that result in gender and health inequality, financial hardship and stress, poor housing, unemployment and poverty. The health and wellbeing impact of the existing conditions of the PAC policy was exacerbated by the contrasting influence of neoliberalism as a policy, ideology, and a form of governmentality in the New Zealand environment (Larner, 2000a; Suaalii, 2006), and the markedly different maneaba system that is central to the social and political life in Kiribati (Tabokai, 1993; Uakeia, 2017; Whincup, 2009). Te maneaba is a traditional meeting hall, where communal meetings take place, and unimane (male elders) make decisions for the governing and wellbeing of the village people (Tabokai, 1993). It is a form of governmentality that shapes and influences how an I-Kiribati thinks and acts (Foucault, 1991). This system is at odds with a neoliberal approach that stresses self-responsibility and individualism. These contrasting forms of governmentality ‘talk past each other’ or are totally different (Metge & Kinloch, 1984). I recruited 30 I-Kiribati women who were successful PAC migrants: six from Auckland, six from Hamilton, and eighteen from Wellington. These women were selected in different years from 2012 through to 2015. To identify the PAC gaps, I employed an indigenous research method called te maroro/talanoa (to exchange ideas and experience freely and openly), complemented by the use of the feminist oral history method that transfers the needs and voices of women from the margin to the centre. This thesis draws on Foucault’s governmentality theory, a critical discourse on neoliberalism, and research on migration and the colonial history of Kiribati. It also draws on work by both Pacific and non-Pacific scholars that articulate how health and wellbeing are rooted in our lived culture and values. This thesis also stresses the need for cultural competency and integration of policy, service provision and community engagement. These materials have all guided my analysis to unpack the women’s health and wellbeing experiences. The research findings on the drawbacks of neoliberal governmentality and maneaba governmentality, and understanding of te maneaba system in a new way, strengthen Pacific studies. These contribute to the literature on Kiribati’s indigenous knowledge and cultural values and Kiribati migration as well as to the impact and effectiveness of the PAC policy for Kiribati and Pacific migration. This thesis demonstrates the need to extend the engagement of Pacific indigenous knowledge and values to the design and implementation of policies at national, regional and global levels. This thesis recommends a hybrid neoliberal-maneaba residential model to address the issues of the current system, such as stress and difficulty finding a job offer, and close PAC gaps. The new model entails a more open and transparent communication between both the New Zealand and Kiribati governments when designing a cultural competent and coherent strategic framework. By working in the best interests of all parties (i.e. New Zealand and the Kiribati governments and PAC migrant groups) this would support future successful PAC applicants to settle well in New Zealand. This would contribute to improved health outcomes for these women, their utu and kainga, without undermining the richness and values of Kiribati’s culture rooted in te maneaba system. These stories articulate a consistent requirement for a hybrid neoliberal-maneaba system, to create a residency model that works for successful PAC applicants, the government of New Zealand and Kiribati, and Kiribati families living in both countries. This would avoid repeating the stress and pain most of these PAC migrant women had experienced because of lack of government support as perceived under te maneaba system. The recommended residency model would also benefit other eligible countries (Fiji, Tonga, and Tuvalu) participating in the PAC scheme.</p>


Author(s):  
Elizabeth A. Ochola ◽  
Susan J. Elliott ◽  
Diana M. S. Karanja

Neglected Tropical Diseases (NTDs) trap individuals in a cycle of poverty through their devastating effects on health, wellbeing and social–economic capabilities that extend to other axes of inequity such as gender and/or ethnicity. Despite NTDs being regarded as equity tracers, little attention has been paid toward gender dynamics and relationships for gender-equitable access to NTD programs in sub-Saharan Africa (SSA). This paper examines the impact of NTDs on women’s health and wellbeing in SSA using Kenya as a case study. This research is part of a larger research program designed to examine the impact of NTDs on the health and wellbeing of populations in Kenya. Thematic analysis of key informants’ interviews (n = 21) and focus groups (n = 5) reveals first that NTDs disproportionately affect women and girls due to their assigned gender roles and responsibilities. Second, women face financial and time constraints when accessing health care due to diminished economic power and autonomy. Third, women suffer more from the related social consequences of NTDs (that is, stigma, discrimination and/or abandonment), which affects their health-seeking behavior. As such, we strongly suggest a gender lens when addressing NTD specific exposure, socio-economic inequities, and other gender dynamics that may hinder the successful delivery of NTD programs at the local and national levels.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Foluso Ishola ◽  
U. Vivian Ukah ◽  
Arijit Nandi

Abstract Background A country’s abortion law is a key component in determining the enabling environment for safe abortion. While restrictive abortion laws still prevail in most low- and middle-income countries (LMICs), many countries have reformed their abortion laws, with the majority of them moving away from an absolute ban. However, the implications of these reforms on women’s access to and use of health services, as well as their health outcomes, is uncertain. First, there are methodological challenges to the evaluation of abortion laws, since these changes are not exogenous. Second, extant evaluations may be limited in terms of their generalizability, given variation in reforms across the abortion legality spectrum and differences in levels of implementation and enforcement cross-nationally. This systematic review aims to address this gap. Our aim is to systematically collect, evaluate, and synthesize empirical research evidence concerning the impact of abortion law reforms on women’s health services and outcomes in LMICs. Methods We will conduct a systematic review of the peer-reviewed literature on changes in abortion laws and women’s health services and outcomes in LMICs. We will search Medline, Embase, CINAHL, and Web of Science databases, as well as grey literature and reference lists of included studies for further relevant literature. As our goal is to draw inference on the impact of abortion law reforms, we will include quasi-experimental studies examining the impact of change in abortion laws on at least one of our outcomes of interest. We will assess the methodological quality of studies using the quasi-experimental study designs series checklist. Due to anticipated heterogeneity in policy changes, outcomes, and study designs, we will synthesize results through a narrative description. Discussion This review will systematically appraise and synthesize the research evidence on the impact of abortion law reforms on women’s health services and outcomes in LMICs. We will examine the effect of legislative reforms and investigate the conditions that might contribute to heterogeneous effects, including whether specific groups of women are differentially affected by abortion law reforms. We will discuss gaps and future directions for research. Findings from this review could provide evidence on emerging strategies to influence policy reforms, implement abortion services and scale up accessibility. Systematic review registration PROSPERO CRD42019126927


2021 ◽  
pp. 105758
Author(s):  
Vittorio E. Bianchi ◽  
Elena Bresciani ◽  
Ramona Meanti ◽  
Laura Rizzi ◽  
Robert J. Omeljaniuk ◽  
...  

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