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Refugee women face several health and well-being risks in conflict settings. Intimate partner violence (IPV), military violence, poor sexual and reproductive health (SRH), early marriage, and unemployment are some of the competing challenges that refugee women face globally. IPV has been associated with mental health problems,1–3 unwanted pregnancy, pregnancy complications, STIs, and unsafe abortion practices,4 HIV,5–8 long term disabilities, chronic pain, and increased mortality and morbidity in refugee settings.9–12 Likewise, low, inconsistent, and ineffective use of modern spacing methods (MSM) of contraceptive has been linked to unplanned pregnancies, risk of abortions and unsafe abortions, maternal, infant and child morbidity and mortality, human immunodeficiency viruses (HIV), sexually transmitted infections (STIs), and obstetric complications as well as high fertility and poverty. Similarly, low economic engagement and/or unemployment of refugee women has proven to cause significant social, economic and health cost.13 Refugee women’s health and well-being are associated with individual, interpersonal, and societal level factors such as their age, education, social norms around fertility, household size, and age at marriage, contraceptive use, decision-making agency, socio-economic conditions, access to and affordability of health services and care, and acculturation in host countries among other factors. This dissertation examines how some of these multi-level factors influence women’s IPV experiences, contraceptive use, and economic engagement in income-generating activities. The first dissertation paper examines the prevalence of lifetime IPV among a sample of 191 health-care seeking women refugees and asylum seekers in Malaysia. Using Bronfenbrenner’s socio-ecological framework and integrated theory of gender and power, I examine multilevel factors associated with lifetime IPV. I also examine the relationship between contraceptive use and lifetime IPV. About one-third (28.30 %) of refugee women reported having experienced lifetime IPV. My hypotheses were partially supported in this study. There were significant associations between marital status, household size, contraceptive use, and food insecurity and lifetime IPV experiences in the bivariate analysis. Age, education, gender-based violence, time spent in Malaysia, and clinic were women were recruited from were not significant in the bivariate analysis. There were no associations between socio-demographic variables like age, education, household size, time spent in Malaysia and the clinic in the unadjusted as well as adjusted models. However, there were significant relationships found between marital status, contraceptive use, and food insecurity and lifetime IPV experiences in the adjusted model. Widowed, separated, and divorced refugee women were significantly more likely to report lifetime IPV experiences relative to women who reported themselves as married at time of survey [OR: 2.56, 95% CI: 1.09, 6.03] compared to women did not report lifetime IPV experience in the adjusted multivariable logistic model, rejecting my hypothesis. Also, in line with my hypothesis, women who reported using permanent methods of contraceptives were significantly more likely to report lifetime IPV experiences than no contraceptive use [0R: 8.70, 95% CI: 1.95, 38.64] compared to women who did not report lifetime IPV experiences in the adjusted multivariable logistic model. In line with my hypothesis, women who reported themselves as being food insecure were more likely to report lifetime IPV experiences than no food insecurity [OR: 0.40, 95% CI: 0.18, 0.89] compared to women who did not report lifetime IPV experiences in the adjusted multivariable logistic model. The second dissertation paper examines the prevalence of types of MSM of contraceptive use (female controlled MSM of contraceptives such as intrauterine devices (IUDs), implants, injectables, oral contraceptives (OC); male involved MSM of contraceptives such as condoms; and no contraceptives) among a sample of 307 married Syrian refugee women in Jordan. Using Bronfenbrenner’s socio-ecological framework and integrated theory of gender and power, I examine multilevel factors associated with MSM of contraceptive use. I also examine the relationship between early marriage and contraceptive use and the relationship between past-year IPV and contraceptive use. About two-fifth (38.44%) of women reported using female controlled MSM (IUDs, injectables, pills, and implants), a little more than one-tenth (11.73%) reported using male involved contraceptives (male condoms), and half of them (49.84%) reported using no contraceptives (includes natural methods and no forms of contraceptive methods). My hypotheses were partially supported in this study. Socio-demographic variables such as age, head of household, and reproductive health care services received in the past six months were significant in the bivariate association between socio-demographic variables and types of MSM of contraceptive use. And early marriage, education, children under the age of five, past-year IPV experience, Syrian governorate, and time in Jordan (acculturation) were not significant in the bivariate analysis. Women who were married prior to the age of 18 years were significantly more likely to report female controlled MSM of contraceptive use than no MSM of contraceptive use at time of survey [RRR: 1.83, 95% CI: 1.07, 3.13] compared to women who were married past 18 years of age in the adjusted multinomial logistic model. Women with children under the age of five were less likely to report male involved MSM of contraceptive use than no MSM of contraceptive use [RRR: 0.32, 95% CI: 0.12, 0.84] compared to women with children older than five years of age in the adjusted multinomial logistic model. Women who reported reproductive health care services received in the past six months were significantly more likely to report female controlled MSM of contraceptive use than no MSM of contraceptive use [RRR: 2.21, 95% CI: 1.98, 3.80] compared to women who reported not receiving reproductive health care services in the past six months in the adjusted multinomial logistic model. Contrary to my hypothesis, women who reported themselves as head of household were less likely to report female controlled MSM of contraceptive use than no MSM of contraceptive use [RRR: 0.40, 95% CI: 0.18, 0.89] compared to women who reported their husbands or family members as head of households in the adjusted multinomial logistic model. No associations between socio-demographic variables like age, education, past-year IPV, Syrian governorate, time spent in Jordan and MSM of contraceptive use in the adjusted multinomial logistic regression model were found. The third dissertation paper examines the prevalence of husbands’ no opposition to wives’ economic activity among a sample of 344 married Syrian refugee women living in non-camp settings in Jordan. Using Bronfenbrenner’s socio-ecological framework and integrated theory of gender and power, I examine multilevel factors associated with husbands’ no opposition to wives’ economic activity. I also examine the association between no lifetime IPV and husbands’ no opposition to wives’ economic activity and the association between head of the households and husbands’ no opposition to wives’ economic activity. I further examine if the relationship between no lifetime IPV and husbands’ no opposition to wives’ economic activity is moderated by women’s agency measured by if they reported themselves as head of the household. About one-third (65.12 %) of women reported husbands’ no opposition to wives’ economic activity. My hypothesis was partially supported in bivariate and multivariable logistical regression analysis. Age, education, previous work experience, head of the household, no lifetime IPV, and time in Jordan were significant in the bivariate analysis between multi-level/socio-demographic variables and husbands’ no opposition to wives’ economic activity. Of the less than half (44.77%) of women who did not experience lifetime IPV, more than one-third (70.8 %) of women reported husbands’ no opposition to wives’ economic activity relative to those who reported lifetime IPV experience (70.78 % versus 29.22 %; P=0.05). Of the more than one-fifth (22.97 %) of women who reported themselves as head of household, more than four-fifth (83.54 %) of women reported husbands’ no opposition to wives’ economic activity relative to those who did not report themselves as head of the households (83.54 % versus 16.46 %; P=0.000). In line with my hypothesis, in unadjusted (OR=1.58 95% confidence interval, CI=1.00-2.48) and adjusted (aOR=1.60, 95% CI=0.98-2.563) models, not experiencing lifetime IPV were associated with increased odds of husbands’ no opposition to wives’ economic activity. Similarly, in both the unadjusted (OR=3.44 95% confidence interval, CI=1.80-6.54) and adjusted (aOR=2.65, 95% CI=1.33-5.29) models, women who reported themselves as head of the households were associated with increased odds of husbands’ no opposition to wives’ economic activity, supporting my hypothesis. Likewise, in both the unadjusted (OR=7.97 95% confidence interval, CI=2.40-26.40) and adjusted (aOR=5.82, 95% CI=1.66-20.40) models, women who reported no IPV experiences as well as who reported themselves as head of the households were associated with increased odds of husbands’ no opposition to wives’ economic activity relative to women who reported lifetime IPV experiences and who did not report themselves as the head of the households, supporting my hypothesis. Age and education were also significant in the adjusted model. These findings affirm that IPV, contraceptive use, and women’s economic engagement are serious health and well-being issues. Results fill in the literature gaps on multilevel factors associated with IPV, contraceptive use, and women’s economic engagement. The first study contributes to the literature on how contraceptive behavior, refugee women’s marital status, and food insecurity, measured as a proxy of poverty influences refugee women’s IPV experiences. The second study contributes to the literature on how marrying at an early age, having children in the households, and receiving reproductive health services influences refugee women’s contraceptive behavior. Third paper contributes to the literature on how refugee women’s lack of IPV experiences and their improved agency/household decision making power influences their economic engagement in the host country. These findings have potential to inform health, sexual and reproductive health, social norms, and economic empowerment interventions. The implications of these findings for social policy, practice, and future research for each paper are discussed in relevant sections as well as in the conclusion section.

This thesis examines the media representation of refugees in the Finnish national news companyYLE by comparing media discourses from two different refugee situations. The cases comparedare the 2015 refugee crisis and the inflow of Ukrainian refugees in 2022. The material of theanalysis consists of YLE’s news articles about the two refugee situations. The articles areanalyzed with the help of tools from critical discourse analysis, and the results are theorizedthrough the concepts of securitization and victim-pariah nexus. The findings suggest that in themedia discourse of 2015 refugees were portrayed more as a threat, but the differences were not sosignificant as what could be assumed from the previous research concerning the topic. Thefindings, together with the theoretical framework, show that the 2015 media discourse representsmore clearly the traditional victim-pariah nexus found in previous research, while the 2022discourse represents a new discourse normalizing refugees.

The purpose of the study is to investigate lived experiences of refugees when accessing healthcare services in Pretoria, South Africa. A qualitative phenomenological research approach was followed which assisted in exploring and describing the day-to-day lives of refugees living in Pretoria regarding their health outcomes. Face-to-face interviews were conducted on purposively selected participants, representing refugees from different African countries ranging from age 27 to 58 years. Collected data were transcribed, coded, and relevant themes were extracted and analysed by employing Colaizzi's seven-step analysis framework. Main findings demonstrated that the public healthcare services accessed by refugees, compared to private healthcare services, can be described as mostly dysfunctional. Also, healthcare providers from public healthcare services are often hostile towards refugees of African descent. Failure to speak a local language, unofficial documentation as viewed by a healthcare provider on duty, being a foreigner, and failure to pay undue consultation fees led to refugees being denied access to healthcare or receiving negative treatment in the public healthcare sector. Recommendations for programmes to promote human rights and refugee awareness in healthcare facilities could subsequently contribute to alleviating complications around access to healthcare services, which would denote improved health outcomes for the refugees. / Health Studies / M. P. H. (Health Studies)

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This thesis examines the role of international organizations (IOs) at the domestic level. While International Relations (IR) offers an extensive literature on IOs, with understandings of IOs ranging from instruments of states to autonomous actors, it tends to ignore the role of IOs working at the domestic level, with an 'on-the-ground' presence of their own, and what this means for the IO's relationship with the state. The thesis develops a heuristic framework for understanding what is called IO 'domestication', which outlines a range of ways an IO can work domestically. It then focuses on one type domestication in particular: surrogate statehood, or cases where an IO substitutes for the state by providing services, executing functions of governance, and assuming authority in a given locale. The framework identifies indicators of surrogacy, the conditions for IO surrogacy, and reasons why it is sustained. It also considers the various types of relationship that can emerge from IO surrogacy between the IO and the state, ranging from states that willingly choose to abdicate responsibility to the IO, to states that partner with the IO. Empirically, the thesis examines these relationships through the case studies of the United Nations High Commissioner for Refugees (UNHCR) in Kenya, Tanzania and Uganda, which present a spectrum of UNHCR’s surrogacy over time. Ultimately, the thesis puts forth a counterintuitive claim: IOs that take on surrogate state properties actually have less influence on the states in which they are working. The analysis draws on two mechanisms to help explain this outcome: marginalisation of the state, and responsibility shifting.

A Research Report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements of the Degree of Master of Arts, Applied Ethics for Professionals. Johannesburg, 2017 / Many asylum seekers and refugees in South Africa reportedly find it difficult to access basic health care services. The issue about foreign nationals in relation to health care can be considered from different angles. The concept of access, though, points to gate-keeping. Gate-keeping is the practice that guides decision making about who has access to what and to what extent they might enjoy benefits. In this essay, the question of whether gate-keeping is a morally justifiable practice in South Africa in relation to asylum seekers and refugees’ right to basic health care services is explored. It is concluded that carefully considered and consistently implemented gate-keeping might be a morally justifiable practice that could contribute to ensuring that resources are distributed fairly. It is also argued that the kind of gate-keeping often observed is inconsistent with human rights and Ubuntu precepts. These moral frameworks seem to be the main ones shaping the view of most South Africans as well as our institutional arrangements. Considering the current South African context in which asylum seekers and refugees have difficulty in accessing basic health care services, patriotic bias claims are considered. However, it is concluded that partiality towards compatriots ought not to hold sway when any human being’s basic needs are at stake. / MT2018

This thesis makes a historically grounded theoretical contribution to an emerging “critical” approach to refugee studies. Utilising the insights of Michel Foucault and Hannah Arendt, it seeks to reconceptualise academic and policy understandings of what has come to be known as “the refugee problem" through an examination and critique of its (implicit) conceptual foundations. The thesis proceeds through a series of historically-informed moves oriented by the relationship between power, subjectivity, and agency, and argues that the key to reconceptualising the refugee problem lies in understanding how these three concepts rely upon and reinforce one another in a particular historically contingent configuration. The objectives of this thesis are threefold and connected. First, it unpacks a deceptively unproblematic term, “the refugee problem” to reveal the complicity of understanding the “refugee (as) problem” in perpetuating the plight of increasing numbers of the world's population, despite the alleviation of the difficulties these people face being the professed goal of the refugee regime. Second, in so doing it contributes to a growing body of literature seeking to counter the voicelessness and abjection into which refugees and asylum seekers are cast. And third, on the basis of this, to begin a conversation about rethinking the nature of the “solutions” we seek to a reframed “refugee problem.” Engaging in a (Foucaultian) genealogical analysis of “the refugee problem”, the first half of the thesis charts the historically-contingent development of a distinct “refugee problem discourse”, revealing that the construction of refugees as passive victims of political forces is the effect both of such discourse and of the international refugee regime as a classificatory regime of truth and subjectivity, rather than an expression of any essential nature of “the refugee.” The thesis then turns to Hannah Arendt's work as a theoretical lens through which to reframe our understanding of the “refugee problem” and to investigate how to identify and open up creative forces for re-subjectification processes and “solutions” not tied to the classificatory and subjectivising logic of the refugee regime or sovereign state system.  Practices of rights claiming, and the City of Sanctuary movement in the UK are examined as two such processes, with the potential of posing “counter-narratives” of problems and solutions which challenge the technocratic, or population-management, approach of the refugee regime.

Kenya like many other countries offers asylum to refugees in fulfillment of the provisions of the 1951 UN Refugee Convention as well as the 1969 OAU Refugee Convention. The country, with the assistance of UNHCR, confers refugee status on refugees who meet the qualifications stated by the two treaties as well as the Refugee Act 2006. Rwandan refugees make up part of the refugee community in Kenya. Though refugee status was created to enhance refugee protection in countries of asylum, it was never intended to last a lifetime. The United Nations envisioned an end to refugee status when the reasons for flight as well as persecution no longer continued to exist. The cessation clause marks the end of refugee status and thus facilitates re-establishment in the country of origin. This study endeavours to explore the impact that the cessation clause will have on Rwandan refugees residing in Kenya specifically based on the widespread concern about the human rights situation in Rwanda. There is accordingly a need to explore the nature of the cessation clause, the reasons for its creation and further the qualifications entailed in its application. After understanding what the cessation clause is, there is the need to understand the genesis of Rwandan refugees. This will enhance the understanding of why Rwandan refugees continue to reside in Kenya even after the end of the Rwandan conflict. The study will then expound on the reasons for and against invocation of a cessation clause to provide an analysis of whether the country is indeed safe for return. To enhance this analysis, the study will provide a comparative study with Liberia and Angola, which recently implemented cessation clauses. Through this comparative assessment, the study will seek to ascertain the viability of the concerns raised in reference to Rwanda and further speculate on the outcome of the cessation clause pertaining to the concerns raised. This study will therefore be able to advise on whether the cessation clause applies to Rwandan refugees and thereafter offer recommendations as to whether implementation in the Rwandan context is feasible. It will also endeavor to provide an analysis of whether there is a need to amend the invocation procedure with regard to cessation clauses in general. / Thesis (LL.M.)-University of KwaZulu-Natal, Durban, 2013.

Thesis (MTech (Public Relations Management))--Cape Peninsula University of Technology, 2017. / This research analysed the use of interpretation services to address the communication challenges faced by Congolese asylum seekers at the refugee reception office in Cape Town. It examined the language challenges of Congolese asylum seekers, the role of the interpreters in addressing these challenges and the perceptions of refugees and home affairs officials about the quality of services provided by interpreters. It also discussed the implications for the outcome of Congolese applications for asylum. This project was framed around Bell and Reiss’s theories of translation and the general communication model. Community interpreting and interpreting studies complimented these theories because all of them focus on the intricacies of interpreting messages and the implications for meaning making, especially in the case of oral accounts. The research design was a case study and its unit of analysis was a company called Zeenab, Remy, Gerald, and Buba (ZRGB) Interpretation, Translation and Social Services, which has for years been the main provider of interpretation services to the department of home affairs in Cape Town. Since this project was a case study, it adopted a qualitative approach and used qualitative methods such as interviews, observations, focus group discussions and document analysis to collect data from respondents. These methods were suitable for this project because they provided unrestricted space for Congolese refugees and home affairs officials to express their views about the interpretation services and the implications thereof. All interviews took place in Cape Town between June and July 2016. The duration of interviews ranged from 25-65 minutes and the total number of respondents was 18. The researcher used a thematic analysis approach to organise, analyse and interpret the data collected from participants. This process involved coding, defining and naming and penetrating themes, searching for multiple meanings embedded in the data. After interpreting the data, this research revealed firstly that the main challenge of Congolese asylum seekers was to communicate their experiences consistently and accurately in English language. Secondly, asylum seekers blamed the rejection of their applications for asylum on the poor quality of interpretation services provided by ZRGB. Thirdly, asylum seekers had different impressions of the role of interpreters in the refugee determination process. In terms of scholarly contributions, this study hopes to shed light on the communication challenges that francophone asylum seekers and refugees face during the application and interviewing process. In addition, it can contribute to the existing body of knowledge on the politics of asylum and the acquisition of refugee identity in post-apartheid South Africa.