scholarly journals Reducing Sexual and Reproductive Health Inequities Between Natives and Migrants: A Delphi Consensus for Sustainable Cross-Cultural Healthcare Pathways

2021 ◽  
Vol 9 ◽  
Author(s):  
Pedro Candeias ◽  
Violeta Alarcão ◽  
Miodraga Stefanovska-Petkovska ◽  
Osvaldo Santos ◽  
Ana Virgolino ◽  
...  

The increasing number of international migrants (ranging from 153 million in 1990 to ~272 million in 2019) brought to attention the wide variation of national contexts concerning the policy measures to protect migrants' rights and ensuring their equal access to basic and essential services, namely in health. Sexual and Reproductive Health (SRH) is a key component to the overall health and quality of life and is impacted by power inequities inherent to society's institutions, environment, economics, and culture. In Portugal, guidelines for intervention in SRH are insufficient, a gap that is more pronounced with migrant populations due to the absence of culturally sensitive indicators to assess and monitor SRH. The aim of this work was 2-fold: to identify good practices in the SRH field, with a particular focus, whenever possible, on migrant populations, and to identify relevant and inclusive indicators to monitor SRH in Portugal. A Delphi panel (via online survey) with 66 experts (researchers, teachers, and health professionals) and 16 stakeholders (non-governmental organizations, civil society, and governmental organizations) was implemented in two rounds. Panelists were asked to state their level of agreement (5-point Likert-type scale) regarding four different SRH areas: Sexual Health, Reproductive Health, Social-Structural Factors, and Good Practices. Items were based on literature review and a World Café with 15 experts and stakeholders. Participation rate was 68% and response rate was 97% on the first round. From the initial list of 142 items, a total of 118 (83%) items were approved by consensus. Findings may provide extended opportunities for the healthcare system to engage in better informed decisions and more inclusive and integrative strategies regarding SRH, contributing to build political measures toward sexual and reproductive justice.

2020 ◽  
Author(s):  
Tinashe Dune ◽  
David Ayika ◽  
Jack Thepsourinthone ◽  
Virginia Mapedzahama ◽  
Zelalem Mengesha ◽  
...  

Abstract Background: 1.5 generation migrants in Australia (those who migrate as children) often enter a new cultural and religious environment, with its own set of constructs of sexual and reproductive health (SRH), at a crucial time in their psychosexual development—puberty/adolescence. 1.5 generation migrants may thus have to contend with constructions of SRH from at least two cultures which may be at conflict on the matter. This study was designed to investigate the role of culture and religion on sexual and reproductive health indicators and help-seeking behaviour amongst 1.5 generation migrants.Methods: 111 participants completed an online survey which included questions about their cultural connectedness, religion, sexual and reproductive health and help-seeking behaviour. Kruskall-Wallis tests were used to analyse the data. Results: There was no significant difference between ethnocultural groups or levels of cultural connectedness in relation to sexual and reproductive health help-seeking behaviours. The results do suggest differences between religious groups in regards to seeking help specifically from young peoples’ parents. Notably, youth who reported having ‘no religion’ were more likely to seek help with sexual and reproductive health matters from their parent(s). Conclusions: Managing cross-cultural experiences are often noted in extant literature as a barrier to sexual and reproductive health help-seeking. However, while cultural norms of migrants’ country of origin can remain strong it is religion that seems to have more of an impact on how 1.5 generation migrants seek help for SRH issues. This suggests that while 1.5 generation migrants may need to adapt to a new ethnocultural environment little about their religious beliefs or practices may require adaptation in Australia. Given that religion can play a role in young peoples’ sexual and reproductive health religious organisations are well placed to encourage young people’s help-seeking behaviours.


2020 ◽  
Author(s):  
Bupe Mwamba ◽  
Pat Mayers ◽  
Jawaya Shea

Abstract BackgroundGlobally and in South Africa, university students’ knowledge of sexual and reproductive health (SRH) is low. This study was conducted in response to the dearth of information about the sexual and reproductive health knowledge of postgraduate students. Research conducted to explore the SRH knowledge of undergraduate students suggests that the level of SRH knowledge among undergraduate students is low. The aim of this study was to determine the SRH knowledge of postgraduate students with regards to contraceptives, sexually transmitted illnesses (STI), human immunodeficiency virus (HIV), Pap smear and clinical breast examination at University of Cape Town (UCT), in South Africa. MethodA cross sectional survey design was utilized, using an adapted and pretested online questionnaire. All postgraduate students enrolled in the first semester of 2017 (9444) were invited to anonymously complete the online survey.ResultsFour hundred and six (406) students completed the online survey, of whom 293 were female and 107 males. The age range of respondents was between 18 years and 57 years, with the median age for both male and female respondents being 24 years. Six survey responses were excluded from the statistical analysis because of incomplete data. Post graduate students from the African continent comprised 90.75% of the respondents. Most respondents were white (51.50%) from both Africa and abroad. The results indicated that respondents knew about sexually transmitted infections, and human immunodeficiency virus (HIV) & acquired immune deficiency syndrome (AIDS). Female respondents were more aware of breast examination, and the role of Papanicolaou smear (Pap smear) in SRH. Almost half of the respondents in this study (49%) stated that they had no need for more information about contraceptives. Lecturers were identified as one of the top five sources of information, which suggests that the university environment provides students with important SRH-related information.ConclusionMost postgraduate students had knowledge of sexual and reproductive health with regards to contraception, Pap smear, clinical breast examination, STIs, HIV and AIDS. Further research should focus on the relationship between SRH knowledge and usage among this population. As university lecturers were identified as an important source of information across faculties, the University should consider the incorporation of SRH education in the broader curriculum and as an integral component of student health services.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19180-e19180
Author(s):  
Vicente Guillem ◽  
Carlos Camps ◽  
Miguel Angel Climent Duran ◽  
Aránzazu Gonzalez del Alba ◽  
Martín Emilio Lázaro Quintela ◽  
...  

e19180 Background: To promote the continuous improvement of kidney cancer healthcare by proposing quality care measures (with respective indicators and standards) for its diagnosis, treatment and follow-up care that can be used by the corresponding professionals and that can be applied across the Spanish healthcare system. Methods: 1. a) Bibliographic review of international research (previous 5 years) on the quality of kidney cancer care; b) Multidisciplinary nominal group (9 oncology experts from the ECO Foundation –Excellence and Quality in Oncology Foundation – and 2 university methodologists – Francisco de Vitoria University Faculty of Medicine) to identify and select possible quality measures that can be applied in Spain; c) Modified Delphi Consensus (two rounds, remotely) by a panel of 55 oncologists subspecialized in kidney cancer, selected by a geographically stratified snowball sample. The ASCO (American Society of Clinical Oncology) /QOPI (Quality Oncology Practice Initiative) model is followed for the drafting of each item: definition of measures, indicators, information sources, exclusions, clarifications, categorization, acceptable standards. Results: The nominal group proposed 43 possible quality measures to the Delphi panel. Consensus participation rate = 84.5% (47 specialists). A unanimous consensus was achieved for 40 quality measures, grouped into the following areas: 4 structural, 33 regarding treatment process and 3 regarding clinical results. Conclusions: The level of consensus among Spanish oncologists subspecialized in kidney cancer on the proposed care measure for the management of said cancer is very high (93%). These results indicate widespread acceptance and applicability of said measures in the Spanish National Healthcare System and, with this in mind, they will henceforth be a valuable tool for the comparative evaluation of the quality and fairness of the oncological care of kidney cancer patients in Spain.


2020 ◽  
Author(s):  
Luis Bahamondes ◽  
Montas Laporte ◽  
Deborah Margatho ◽  
Helder de Amorin ◽  
Cinthia Brasil ◽  
...  

Abstract Background: Guaranteeing the sexual and reproductive health and rights (SRHR) of populations living in fragile and humanitarian settings is essential and constitutes a basic human right. Compounded by the inherent vulnerabilities of women in crises, substantial complications are directly associated with increased risks of poor SRHR outcomes for displaced populations. The migration of Venezuelans, displaced due to current economic circumstances, is one of the largest in Latin America’s history. This study aims to provide an overview of the sexual and reproductive health (SRH) issues affecting migrant Venezuelan women in the state of Roraima, Brazil.Methods: Face-to-face interviews were conducted from 24 to 30 November 2019. Data collection covered various issues involving access to and use of SRH services by 405 migrant Venezuelan women aged 18-49 years. The Minimum Initial Service Package readiness assessment tools, available from the Inter-Agency Working Group on Reproductive Health in Crises, were used in the data collection.Results: Most commonly, the women reported unmet family planning needs. Of these, a significant proportion reported being unable to obtain contraceptive methods, particularly long-acting reversible contraceptives, either due to the woman’s inability to access them or their unavailability at healthcare centres. Although a significant proportion of women were largely satisfied with the attention received at the maternity hospital, both before and during childbirth, 24.0% of pregnant or postpartum women failed to receive any prenatal or postnatal care. Conclusion: Meeting the essential SRHR needs of migrant Venezuelan women in Roraima, Brazil is a challenge that has yet to be fully addressed. Given the size of this migrant population, the Brazilian healthcare system has failed to adapt sufficiently to meet their needs; however, problems with healthcare provision are similar for migrants and Brazilian citizens. Efforts need to be encouraged not only in governmental health sectors, but also with academic, non-governmental and international organisations, including a coordinated approach to ensure a comprehensive SRHR response. Given the current high risks associated with the SARS-CoV-2 pandemic, meeting the SRHR needs of migrant populations has become more critical than ever.


Author(s):  
Tinashe Dune ◽  
David Ayika ◽  
Jack Thepsourinthone ◽  
Virginia Mapedzahama ◽  
Zelalem Mengesha

In Australia, 1.5 generation migrants (those who migrated as children) often enter a new cultural and religious environment, with its own set of constructs of sexual and reproductive health (SRH), at a crucial time in their psychosexual development—puberty/adolescence. Therefore, 1.5 generation migrants may thus have to contend with constructions of SRH from at least two cultures which may be at conflict on the matter. This study was designed to investigate the role of culture and religion on sexual and reproductive health indicators and help-seeking amongst 1.5 generation migrants. An online survey was completed by 111 participants who answered questions about their cultural connectedness, religion, sexual and reproductive health and help-seeking. Kruskall-Wallis tests were used to analyse the data. There was no significant difference between ethnocultural groups or levels of cultural connectedness in relation to sexual and reproductive health help-seeking attitudes. The results do suggest differences between religious groups in regard to seeking help specifically from participants’ parents. Notably, participants who reported having ‘no religion’ were more likely to seek help with sexual and reproductive health matters from their parent(s). Managing cross-cultural experiences is often noted in the extant literature as a barrier to sexual and reproductive health help-seeking. However, while cultural norms of migrants’ country of origin can remain strong, it is religion that seems to have more of an impact on how 1.5 generation migrants seek help for SRH issues. The findings suggest that 1.5 generation migrants may not need to adapt their religious beliefs or practices, despite entering a new ethnocultural environment. Given that religion can play a role in the participants’ sexual and reproductive health, religious organizations are well-placed to encourage young migrants to adopt help-seeking attitudes.


2021 ◽  
Vol 10 (2) ◽  
pp. 63
Author(s):  
Violeta Alarcão ◽  
Miodraga Stefanovska-Petkovska ◽  
Ana Virgolino ◽  
Osvaldo Santos ◽  
Andreia Costa

Identifying the opportunities and barriers of promoting and fulfilling the sexual health rights of migrants remains a challenge that requires systematic assessment. Such an assessment would include estimating the influence of acculturation processes on sexual and reproductive health, and mapping intersectional inequities that influence migrants’ sexual and reproductive health in comparison with the native population. The aim of this research was to locate, select, and critically assess/summarize scientific evidence regarding the social, cultural, and structural factors influencing migrants’ sexual and reproductive health outcomes in comparison with native population. An umbrella review of systematic reviews and/or meta-analyses, following preferred reporting items for systematic reviews and meta-analysis (PRISMA) standards was undertaken. Medline, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews were searched from their start date until June 2019. The quality of the included articles was determined using the assessment of multiple systematic reviews tool (AMSTAR 2). From the 36 selected studies, only 12 compared migrant with native populations. Overall, the findings indicated that migrants tend to underuse maternal health services and have an increased risk of poor sexual and reproductive health outcomes. Specific intersectional inequities were identified and discussed.


2021 ◽  
Vol 5 ◽  
pp. 145
Author(s):  
Fannie Kachale ◽  
Imelda Mahaka ◽  
Fatima Mhuriro ◽  
Mary Mugambi ◽  
Joseph Murungu ◽  
...  

Background: Though substantial progress has been made to curb the HIV epidemic, high rates of new HIV infections persist among adolescent girls and young women (AGYW) in sub-Saharan Africa, reflecting critical gaps in reaching them with integrated HIV prevention and sexual and reproductive health (SRH) services. With the scale-up of oral pre-exposure prophylaxis (PrEP) and multiple novel HIV prevention products on the horizon, countries have a unique opportunity to expand innovative approaches to deliver comprehensive, integrated HIV/SRH services. Methods: This article is a comparative analysis of findings from rapid landscaping analyses in Kenya, Malawi and Zimbabwe to highlight cross-country trends and context-specific realities around HIV/SRH integration. The analyses in Kenya and Zimbabwe were completed by Ministries of Health (MOH) and the HIV Prevention Market Manager project and include 20 health facility assessments, 73 key informant interviews and six community dialogues. In Malawi, the analysis was completed by the MOH and Georgetown University Center for Innovation in Global Health and includes 70 key informant interviews and a review of national policies and program implementation in Blantyre. Findings were validated through a review of literature and policies in each country. Results: The policy environment in all three countries is conducive to HIV/SRH integration, though operationalization continues to present challenges, with most policies preceding and not accounting for oral PrEP rollout. National coordination mechanisms, youth-friendly health services and prevention of mother-to-child transmission programs are promising practices, while siloed and resource-constrained health systems, limited provider capacity, lack of support for demand generation and structural factors exacerbate barriers to achieving integration. Conclusions: As new HIV prevention products are introduced, demand for integrated HIV/SRH services is likely to grow. Investing in HIV/SRH integration can help to ensure sustainable, government-led responses to the HIV epidemic, streamline service delivery and improve the health outcomes and lives of AGYW.


2020 ◽  
Author(s):  
Luis Bahamondes ◽  
Montas Laporte ◽  
Deborah Margatho ◽  
Helder de Amorin ◽  
Cinthia Brasil ◽  
...  

Abstract Background: Guaranteeing the sexual and reproductive health and rights (SRHR) of populations living in fragile and humanitarian settings is essential and constitutes a basic human right. Compounded by the inherent vulnerabilities of women in crises, substantial complications are directly associated with increased risks of poor SRHR outcomes for displaced populations. The migration of Venezuelans, displaced due to current economic circumstances, is one of the largest in Latin America’s history. This study aims to provide an overview of the sexual and reproductive health (SRH) issues affecting migrant Venezuelan women in the state of Roraima, Brazil.Methods: Face-to-face interviews were conducted from 24 to 30 November 2019. Data collection covered various issues involving access to and use of SRH services by 405 migrant Venezuelan women aged 18-49 years. The Minimum Initial Service Package readiness assessment tools, available from the Inter-Agency Working Group on Reproductive Health in Crises, were used in the data collection.Results: Most commonly, the women reported unmet family planning needs. Of these, a significant proportion reported being unable to obtain contraceptive methods, particularly long-acting reversible contraceptives, either due to the woman’s inability to access them or their unavailability at healthcare centres. Although a significant proportion of women were largely satisfied with the attention received at the maternity hospital, both before and during childbirth, 24.0% of pregnant or postpartum women failed to receive any prenatal or postnatal care. Conclusion: Meeting the essential SRHR needs of migrant Venezuelan women in Roraima, Brazil is a challenge that has yet to be fully addressed. Given the size of this migrant population, the Brazilian healthcare system has failed to adapt sufficiently to meet their needs; however, problems with healthcare provision are similar for migrants and Brazilian citizens. Efforts need to be encouraged not only in governmental health sectors, but also with academic, non-governmental and international organisations, including a coordinated approach to ensure a comprehensive SRHR response. Given the current high risks associated with the SARS-CoV-2 pandemic, meeting the SRHR needs of migrant populations has become more critical than ever.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Evalin Karijo ◽  
Sylvia Wamugi ◽  
Samuel Lemanyishoe ◽  
Jenny Njuki ◽  
Faith Boit ◽  
...  

Abstract Background Cases of the Corona Virus Disease of 2019 (COVID-19) in Kenya have continued to increase rapidly, since the first case in the country was confirmed in March 2020. In the wake of the pandemic, the health and socio-economic challenges experienced by the youth in Kenya are likely to be elevated. We assessed knowledge, practices, perceived risk of infection, adoption of recommended behaviour and the effects of COVID-19 among the youth in Kenya. Methods A cross sectional descriptive study was conducted between April 30th to May 7th, 2020 through a combined online survey and phone interviews. A total of 2156 youth across all 47 counties in Kenya completed the responses to the study questions. All survey responses analyzed using Stata version 15 were tabulated by gender, age, and education level to generate basic descriptive tables and tested for differences by category using chi-square tests. Where applicable, linear and logistic regression analysis model was conducted using covariates such as employment status, gender, and education level. Results Knowledge on symptoms of COVID-19 was generally high. Female respondents were more likely to identify more symptoms correctly compared to men (p < 0.001). However, youth reported very low levels of anyone being at risk of infection (7.1%). Most youth have adopted behavior necessary to slow down the infection. There were generally very low reported levels of inability to access health services related to sexual and reproductive health. About 50.0% of respondents reported significant decline in income during the pandemic period, nearly a third reported living in fear while 26.5% reported feeling stressed. Conclusion There was high knowledge of COVID-19 symptoms, preventive strategies, and high adoption of preventive practices. Strategies to sustain behaviors positively adopted among young people will be critical to reduce the spread of COVID-19. Despite the low reported rates of inability to access sexual and reproductive health, response measures should include strategies that facilitate continuity of services among young people. The reported social effects of the pandemic show the need for interventions to meet the health and socio-economic needs of the youth and minimize the long-term consequences of the pandemic.


Sign in / Sign up

Export Citation Format

Share Document