Introduction: Sexual and gender-based violence (SGBV) is a violation against human rights with severe implications for the health of women globally. Migrant women may be exposed to a heightened risk of SGBV as well as obstacles that impair their ability to respond to violence and access care. The aim of this meta-synthesis is to explore healthcare providers’ perceptions and experiences of caring for migrant women affected by SGBV in North America and Europe, in order to identify facilitating factors and strategies used to overcome existing barriers to the provision of care. Methods: Systematic searches were conducted between February and April 2019 by using the databases PubMed, Scopus, Applied Social Sciences Index & Abstracts (ASSIA) and Proquest Social Science Premium Collection. Data was analysed using thematic analysis. Results: The ten studies included illustrate perceptions and experiences of healthcare providers from multiple professional backgrounds in the United States, Great Britain and Sweden. Three themes derived from the analysis; (a) Providing a patient-centred care; (b) Knowledge and training-key factors affecting screening and response; and (c) Working under psychologically demanding conditions. Conclusion: Healthcare providers address violence screening and response by adopting a patient-centred approach to care, facilitated by trust-building strategies and external support. However, barriers grounded in a lack of knowledge and training, underline a need of context specific guidelines and screening tools. Further, emotional distress and health issues bring attention to the importance of support mechanisms when caring for migrant women affected by SGBV.

For several decades, a national shortage of licensed clinical social workers has been growing in the United States. Licensed social workers provide counsel and advocacy for those affected by mental illness, addiction, abuse, and discrimination, among other economic difficulties, and are the largest group of providers of mental and behavioral health services. The research questions for this project addressed what challenges unlicensed social workers in central Florida identify as barriers to pursuing clinical licensure. This study also explored strategies that unlicensed social workers in central Florida reported to address these barriers and encourage the pursuit of clinical licensure. The purpose of this research was to identify both the barriers that social worker's report in seeking their licensure and effective strategies to address the barriers. The theoretical framework to inform the project was systems theory. An action research design was used including a focus group of 5 unlicensed social workers, selected through purposive sampling. Thematic analysis was used to analyze the data. Study outcomes showed that social workers in central Florida chose not to pursue licensure because of the cost and time associated with the process. Changes recommended as part of this research may bring about social change through an increase in the number of licensed social workers to assist Floridians who seek such services.

Despite the passage of the Patient Protection and Affordable Care Act (PPACA) in 2010, the Centers for Disease Control and Prevention identified persistent disparities in health care resources as the primary causes of mortality among minority populations. An underexplored resource for affected African American populations is the church, which is not a recognized stakeholder in the implementation of current health care policy. The purpose of this phenomenological case study was to gather perspectives from African American parishioners who lacked sufficient health care insurance on the roles the church could play. Qualitative data management software was used to organize the data (transcripts of interviews) for coding. The purposeful sample of 12 church attendees came from urban, suburban, and rural African American churches. The Andersen behavioral model and Hochbaum's health belief model were used as the conceptual framework for thematic analysis of health care disparities. Kingdon's multiple-stream framework provided theoretical grounds for policy development and revision. Key findings revealed several interrelated health care disparity themes: the significance of insurance coverages, premium costs, financial barriers, family and personal issues, empowerment strategies, religious beliefs, and roles the church could play in promoting quality community health. The study has implications for positive social change: The results include guidance for the development of a bipartisan health care policy that includes the church as a stakeholder. A- partnership between the church and the legislators of health care reform could be a catalyst for improved metrics, trust, accountability, transparency, and opportunities to create tailored health care interventions and thus help alleviate societal health crises.

Kangaroo Mother Care (KMC) is an evidence-based intervention, recommended by the World Health Organization, with the potential to prevent neonatal deaths and morbidity among low-birthweight and preterm babies. In Bangladesh, where the number of neonatal deaths is high, KMC is identified as a priority intervention to be scaled up in the country. Our aim was to explore the experiences of caregivers and healthcare providers (HCPs) of KMC in Bangladesh. We conducted semi-structured interviews in two hospitals in Dhaka, where KCM service was provided. In Study I, we interviewed fifteen caregivers. The results showed conducive conditions for caregivers to perform KMC at the hospital and at home, but support is needed from both healthcare providers and their families. Caregivers felt empowered and motivated when they observed improvements in the child's well-being. However, there are challenges to KMC implementation due to the struggle to keep the baby skin-to-skin, pain after caesarean section, delayed initiation of KMC, and routines that promote an initial separation between the mother and baby. In Study II, we interviewed eleven HCPs. The results showed that HCPs experienced KMC as a continuous process that requires both support and counselling, adapted to caregivers’ needs. Commitment, supervision, and training are necessary. However, there are structural conditions that challenge KMC implementation, including clinical routines that promote the initial separation of the mother and baby, staff shortages, and incomplete follow-up. In conclusion, the findings from this exploratory research can inform the design of interventions for scaling up KMC in Bangladesh. Caregivers' and HCPs' experiences show that continuous support, counselling, and family involvement are essential in the care, and that providing KMC empowers caregivers. Their experiences also indicate that KMC is sub-optimally implemented due to structural conditions and routines that need to be addressed to scale up KMC in the country by avoiding the initial separation of mother and baby, meeting the mothers' needs for care and support, and strengthening the follow-up. Our results also suggest a need to update clinical practices in line with the new WHO recommendations. / <p></p><p></p><p></p>

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