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The importance of including femalegenital mutilation into medical education : A qualitative study on Swedish universities midwifery programJansson, Elin January 2021 (has links)
This thesis will investigate to what extent the midwifery programme atselected Swedish universities is including the issue of female genitalmutilation (FGM) into their education and curriculum. This is an importantsubject to do research on since a lot of existing literature on the topic showsthat midwives in Sweden are seriously lacking in knowledge regarding thepractice of FGM. According to a study done by Tamaddon et al. (2006) lessthan 30% of the Swedish midwives believed that they had adequateknowledge of FGM. Another study of the issue of FGM showed thatSwedish midwives felt that their knowledge of FGM was lacking and that itwas a marginalized issue on their place of work (Widmark et al. 2002).The reason to why the focus of my research will be on midwifery studentsand teachers within the midwifery program is because the healthprofessionals who is most likely to meet circumcised women are midwives.According to Dawson et al. (2015) “Midwives are often the first providerswomen will see for their maternal health needs and therefore play a criticalrole in providing quality care and preventing the practice” (Dawson et al.2015 p 230).The chosen research topic fits smoothly into the broader peace anddevelopment area due to what has been mentioned earlier, the increase inpeople movement in the world today makes some issues a global challenge.Which has been the case of the practice of FGM, it is now time to understandthat this is no longer an issue only in the countries were FGM is traditionallypracticed, it is an issue and especially a challenge even in high incomecountries.The method to be used in this research is semi-structured interviews with acareful sampling process of participants, done by a purposive sampling. Itwill be a qualitative study based on a cross-sectional design.
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Social Determinants of Health and Psychophysiological Stress in Pregnant Women: Correlates with Maternal Mental HealthHerbell, Kayla 31 August 2018 (has links)
No description available.
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A comparison of psychodynamic measures of level of oedipal functioning and of object relations in bulimic versus drug dependent womenAber, Diana January 2016 (has links)
A dissertation submitted to the Faculty of Arts, University of the Witwatersrand, in partial fulfilment of the requirements for the Degree of Master of Arts, Clinical Psychology. Johannesburg, September 1992 / No abstract provided.
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Worry and the traditional stress modelGagné, Marie-Anik. January 1998 (has links)
No description available.
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The division of labor and women's well-being across the transition to parenthood.Goldberg, Abbie Elizabeth 01 January 2001 (has links) (PDF)
No description available.
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Upplevelser av hur fysisk aktivitet påverkats av fysioterapeutiska åtgärder hos kvinnor med kvarstående bäcken- och/eller ländryggssmärta postpartum : En kvalitativ intervjustudieEinarsson, Emma, Reinhed Liljeqvist, Emma January 2023 (has links)
Bakgrund: Graviditetsrelaterad bäcken- och/eller ländryggssmärta drabbar många kvinnor och ett stort antal har kvarstående besvär postpartum. Många kvinnor tenderar dessutom att bli fysiskt inaktiva under och efter graviditet. Fysioterapeutiska åtgärder som avser att minska besvär och optimera rörelseförmåga hos denna patientgrupp ges främst ur ett biomedicinskt perspektiv. Nya studier har dock indikerat att fysioterapeutiska åtgärder som beaktar bio-psyko-sociala faktorer är värdefullt. Syfte: Syftet med studien är att undersöka hur kvinnor med graviditetsrelaterad bäcken- och/eller ländryggssmärta postpartum upplever att deras fysiska aktivitetsnivå påverkats av fysioterapeutiska åtgärder. Metod: Studien genomfördes med en kvalitativ, deskriptiv design och data samlades in under sju semistrukturerade intervjuer. Data analyserades genom en kvalitativ innehållsanalys med induktiv ansats. Resultat: Analysen resulterade i fem kategorier: Åtgärder som minskar fysiska besvär ökar förmågan till aktivitet, Individanpassade åtgärder betydelsefullt för ökad aktivitet, Fysioterapeutens kompetens avgörande för aktivitet, Fysioterapeutens bemötande och attityd påverkar behandlingsupplevelsen samt Förståelse för hur aktivitet påverkar besvär främjar rörelse. Slutsats: Resultatet i studien indikerar att fysioterapeutiska åtgärder som integrerar ett bio-psyko-socialt förhållningssätt gynnar ökad fysisk aktivitet hos kvinnor med bäcken- och/eller ländryggssmärta postpartum. Kvinnorna uppgav vidare att fysioterapeutens kompetens samt bemötande och attityd påverkar aktivitetsnivå och huruvida besvären förbättras eller inte. / Background: Pregnancy-related pelvic and/or low back pain affects many women, and a significant number of women have persistent pain postpartum. A lot of women tend to become physically inactive during and after pregnancy. Physiotherapeutic interventions that aim to decrease discomfort and optimize mobility are given foremost from a biomedical approach for this patient group. However, recent studies have indicated that physical therapy interventions that consider a bio-psycho-social approach are valuable. Objective: The purpose of this study is to investigate how women with pregnancy-related pelvic and/or low back pain postpartum experience that their level of physical activity is affected by physiotherapeutic interventions. Method: The study was conducted with a qualitative, descriptive design and data was collected through seven semi-structured interviews. Data were analyzed through a qualitative content analysis with an inductive approach. Results: The analysis resulted in five categories: Interventions to decrease physical discomfort increase the ability to become more active, Individual constructed interventions important for increased activity, The physiotherapist competence is decisive for activity, The physiotherapist approach and attitude affects treatment experience and Understanding how activity affect discomfort promotes movement. Conclusion: This study indicates that physiotherapeutic interventions that integrate a biopsychosocial approach promote increased level of physical activity in women with pregnancy-related pelvic and/or low back pain postpartum. The women further stated that the physiotherapist's competence as well as approach and attitude affect the level of activity and if the discomfort improves or not.
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Exploring racial disparity in stillbirth rates through structural racism and methylation of stress-related genes: From systemic to epigeneticLeisher, Susannah Hopkins January 2023 (has links)
Problem to be addressed: Stillbirth is a major public health problem. The stillbirth burden is on a par with newborn deaths. The stillbirth rate measures not only a substantial portion of the global and national burden of mortality, but also equity and quality of care for women’s and children’s health. Reducing the numbers of these deaths requires an understanding of why they occur, yet approximately one-third of stillbirths are unexplained, even in settings with high-quality autopsy and placental examination, while deaths considered to be explained are usually ascribed to single, proximal causes. An important limiting factor for efforts to reduce the large and inequitable stillbirth burden has been insufficient research into conditions that could inform prevention strategies and reduce inequity.1 2
Substantial evidence exists for associations between structural racism, maternal stress, and adverse pregnancy outcomes, yet research focusing on stillbirth is sparse, particularly at the ends of the causal spectrum—macro-level structural conditions and mechanisms. Several studies have called for research on possible biological mechanisms by which racism, racism-related stress, and stillbirth may be associated, including epigenetic mechanisms.3-6 The most recent review of causes of racial disparities in stillbirth rates in the U.S. recommended that researchers take a multi-domain approach, considering not just individual-level risk factors, which have been relatively well-studied, but also upstream factors such as institutional racism, and biological mechanisms such as epigenetic modification.
The objective of this dissertation was to explore evidence that could help to explain persistent racial disparities in stillbirth. The specific aims were:
1. To review the literature on racial disparity in stillbirth rates;
2. To assess whether structural racism can help to explain racial disparity in stillbirth rates in New York City; and
3. To assess whether maternal stress is associated with stillbirth, whether stress is associated with methylation of stress-related genes, whether methylation is associated with stillbirth, and whether there is evidence that methylation of stress-related genes mediates associations between stress and stillbirth.
Materials and methods used: For Aim 1, we carried out a scoping review of the literature in five databases (PubMed, Scopus, Cinahl, Embase, PsycInfo) to identify all reports including stillbirth rates stratified by race in the U.S., mapping exposures and effect modifiers (“domains of analysis”) and authors’ comments on racial disparity in stillbirths (“domains of explanation”) into one of eight domains (race, genetic, fetal, maternal, family, community, healthcare system, and structural). We defined Stillbirth Disparity Ratios (SDRs) as the ratio of the stillbirth rate in a racial/ethnic minority group to the stillbirth rate in white individuals. Selected SDRs were extracted from each report, as were all SDRs for Black/white comparisons.
For Aim 2, we modelled associations between four measures of structural racism and stillbirth in all non-Hispanic (NH) Black and white singleton births in New York City between 2009 and 2018. Exposures were four Public Use Microdata Area (PUMA)-level measures of structural racism (Indices of Dissimilarity, Isolation, and Concentration at the Extremes (ICE), and an Educational Inequity Ratio) constructed from U.S. Census American Community Survey data. Using multilevel logistic regression, we first tested for interaction between race and structural racism in relation to stillbirth. For structural racism measures that interacted with race, we estimated odds ratios for stillbirth separately in 221,925 NH Black and 325,058 NH white births. Race-specific models were further stratified by maternal age.
For Aim 3, we assessed associations between maternal stressors and stillbirth in 183 non-anomalous full-term singleton births (63 stillbirths and 120 livebirths) from the U.S. Stillbirth Collaborative Research Network. Measuring maternal stress with two hypothesized stressors, an Index of Significant Life Events and an Index of Disadvantage, we assessed associations between maternal stressors and stillbirth in our sample, and then whether maternal stressors and stillbirth were associated with differential methylation of 1,191 CpGs on five stress-related genes (BDNF, FKBP5, HSD11B2, IGF2, and NR3C1). Finally, we assessed whether methylation mediates associations between stressors and stillbirth.
Conclusions reached: For Aim 1, we found 95 reports presenting stillbirth rates stratified by race/ethnicity in the U.S. We found evidence of increased risk of stillbirth in Black as compared to white births in the majority of the 83 reports with the necessary data. Among the 1143 Black-white SDRs that we extracted, the median SDR was 1.67, with 74% of SDRs showing evidence of disparity. Family and community factors, healthcare system factors, and structural factors were commonly used as domains of explanation (20-38% of reports), but rarely (family/community, structural, 4-5%) or never (healthcare system) used in analysis. The most commonly used domains of analysis—fetal and maternal factors including gestational age, maternal age, education, and prenatal care—do not appear able to explain the observed racial disparities. Gaps in the literature include a paucity of studies examining the possible role of health system, community, and structural factors in Black-white disparity in stillbirth rates, and limited data on other types of racial disparities in stillbirth rates, including Hispanic and Native American births.
For Aim 2, we found that structural racism as measured by ICE and Isolation was associated with stillbirth in NH Black but not NH white mothers. This would seem consistent with our hypothesis that structural racism may help to explain racial disparity in stillbirth rates; however, the associations we observed were not in the expected direction. Specifically, NH Black mothers living in PUMAs with a high concentration of privilege had 90% greater odds of stillbirth in comparison to those living in PUMAs with a high concentration of disadvantage (ICE quintile 5 vs 1), and NH Black mothers living in PUMAs that were the most isolated had 40% lower odds of stillbirth in comparison to those living in PUMAs that were the least isolated (Isolation tertile 3 vs 1). We suggest that while the measures we used (ICE and Isolation) do help to explain the Black-white disparity in stillbirth rates, our results raise questions about the way these measures operationalize structural racism, meriting further investigation.
For Aim 3, we found that having two or more vs no items in the Index of Disadvantage (“Disadvantage”) was associated with more than fourfold greater odds of stillbirth (95% CI 1.58, 12.93). We found no association between the Index of Significant Life Events and stillbirth. We found that 32 out of 1,191 CpGs on five stress-related genes were differentially methylated with respect to stillbirth, and six CpGs were differentially methylated with respect to Disadvantage. Methylation at two CpGs on IGF2 and one on HSD11B2 (cg02097792, cg12283393, and cg19413291, respectively) mediated the association between Disadvantage and stillbirth.
Research on causes is a critical component of stillbirth prevention and reducing the inequitable distribution of this public health burden. Limited understanding of causes at both “ends of the spectrum”, from upstream distal factors to mechanisms, has likely contributed to slow progress on prevention.7 8 This dissertation contributes to science and public health by providing researchers with data to support new lines of inquiry, e.g., into associations between structural racism and stillbirth, and for methylation as a mechanism of effect, that should help to improve our understanding of causes. Our research may also support health policy makers who now have additional data to illustrate the adverse health outcomes of structural racism in the U.S. Finally, it may help the parents and other family members of stillborn babies who continually seek to understand “why”.
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Three Papers on Gendered Inequities of Refugee Women’s Health and Well-being -- Multi-level factors associated with intimate partner violence experiences, contraceptive use, and economic engagement among women refugees living in Malaysia and JordanSingh, Ajita January 2023 (has links)
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.
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[pt] DIFERENTES DIMENSÕES DO ACESSO DE REFUGIADAS CONGOLESAS À ATENÇÃO INTEGRAL À SAÚDE DA MULHER NO MUNICÍPIO DO RIO DE JANEIRO / [en] DIFFERENT DIMENSIONS OF ACCESS OF CONGOLESE REFUGEES TO COMPREHENSIVE WOMEN S HEALTH CARE IN THE CITY OF RIO DE JANEIROTAIANE DAMASCENO DA HORA 23 November 2023 (has links)
[pt] O objeto desta tese consiste na análise das diferentes dimensões do acesso
de refugiadas congolesas à atenção integral à saúde da mulher no município do Rio
de Janeiro. Compreendeu-se que com o princípio da universalidade estabelecido no
Sistema Único de Saúde (SUS) tanto os brasileiros quanto os migrantes e refugiados
que estão no país podem acessar os serviços de saúde sem que sejam impostas
barreiras de acessibilidade, legais, econômicas, físicas ou culturais. A tese traz um
tema ainda pouco explorado nos estudos no que diz respeito as mulheres refugiadas
e migrantes, principalmente em relação aos estudos de: gênero e refúgio, violência
de gênero e a interseccionalidade. Assim, entende-se que as mulheres já vivenciam
várias formas de violações de direitos e são mais afetadas pelas desigualdades
sociais, entretanto isso se agrava com fatores como raça e classe e neste estudo,
acrescenta-se a nacionalidade e sua condição de migrante e refugiada. A pesquisa
foi realizada na Atenção Primária do Rio de Janeiro. A metodologia utilizada é a
abordagem qualitativa. Foram realizadas 12 entrevistas semiestruturadas com
gestores (4), profissionais da Clínica da Família (5) e mulheres refugiadas
congolesas (3). Para analisar os dados coletados foi utilizada a análise de conteúdo
na modalidade temática. A partir da pesquisa identificou-se que no município do
Rio de Janeiro ainda não existe uma política voltada para atendimento à saúde de
mulheres refugiadas, ela segue sendo desenhada, porém, os profissionais realizam
o atendimento nas unidades de saúde. A cultura e a falta de tradutores nas unidades
de saúde são desafios para os profissionais e gestores de saúde, isso aparece
atrelados a outros problemas como a violência contra mulheres e a ausência de uma
política pública para tradutores nas unidades. O contexto de desmonte da Atenção
Primária no governo Crivella interferiu no trabalho que vinha sendo desenvolvido no município do Rio de Janeiro em relação à saúde de refugiados, atualmente há
uma reconstrução ainda em curso. A Atenção Primária é a principal porta de entrada
para as mulheres refugiadas que buscam os serviços principalmente para realizar
pré-natal, a gravidez aparece como uma busca pelo direito de cidadania no Brasil a
partir da visão dos profissionais e também é importante apontar a busca dos
profissionais em fazer com que as mulheres refugiadas compreendam e acessem
seus direitos sexuais e reprodutivos. Cabe apontar que as congolesas utilizam os
serviços de saúde e afirmam que o atendimento foi bom, demostram que no Brasil
a saúde é melhor que na RDC, e embora sejam gratas, elas questionam a demora no
atendimento, o mau atendimento médico e precarização nos serviços. Por fim, nota-se que o contexto de desmonte do SUS também afeta as mulheres refugiadas que
buscam atendimentos de saúde da mesma forma que afeta as brasileiras e outras
migrantes, todavia, é nesse contexto que a política de saúde para refugiados vem
sendo desenhada, já que ainda não foi legitimada e trata-se de um processo de luta
com significativas conquistas nos últimos anos. / [en] The aim of this thesis is to analyze the different dimensions of access by
Congolese refugees to comprehensive women s health care in the municipality of
Rio de Janeiro. It was understood that with the principle of universality established
in the Unified Health System (SUS), both Brazilians and migrants and refugees who
are in the country can access health services without the imposition of legal,
economic, physical or cultural accessibility barriers. The thesis deals with a topic
that has not yet been explored in studies on refugee and migrant women, especially
in relation to studies on: gender and refuge, gender violence and intersectionality.
Thus, it is understood that women already experience various forms of rights
violations and are more affected by social inequalities, however this is aggravated
by factors such as race and class and in this study, nationality and their status as
migrants and refugees are added. The study was carried out in Primary Care in Rio
de Janeiro. The methodology used is a qualitative approach. Twelve semi-structured
interviews were conducted with managers (4), Family Clinic professionals (5) and
Congolese refugee women (3). Thematic content analysis was used to analyze the
data collected. The research revealed that in the municipality of Rio de Janeiro,
there is still no policy on health care for refugee women; it is still being drawn up,
but the professionals provide care in the health units. The culture and lack of
translators in health units are challenges for health professionals and managers, and
this appears to be linked to other problems such as violence against women and the
absence of a public policy for translators in units. The context of the dismantling of
PrimaryCare under the Crivella government interfered with the work that was being carried out in the municipality of Rio de Janeiro in relation to refugee health.
Primary Care is the main gateway for refugee women who seek services mainly for
prenatal care, pregnancy appears to be a search for the right to citizenship in Brazil
from the point of view of the professionals and it is also important to point out the
professionals search to make refugee women understand and access their sexual
and reproductive rights. It is worth noting that the Congolese women use the health
services and say that the service was good, demonstrating that health in Brazil is
better than in the DRC, and although they are grateful, they question the delay in
service, the poor medical care and the precariousness of the services. Finally, it can
be seen that the context of the dismantling of the SUS also affects refugee women
who seek health care in the same way that it affects Brazilians and other migrants.
However, it is in this context that the health policy for refugees is being designed,
since it has not yet been legitimized and it is a process of struggle with significant
achievements in recent years.
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A Qualitative Systemic Review on Maternal Health Disparities in Haitian WomenJean-Louis, Alexandra 01 January 2021 (has links)
Background: It is universally known that pregnancy is a vulnerable time for a woman's health. Women of all backgrounds endure significant physiological and anatomical changes during pregnancy and after childbirth. But the latest research studies have called attention to the unique experience of Black mothers. Compared to other racial and ethnic groups, Black women encounter health disparities at an all-time higher rate. According to research studies conducted in Haiti and the United States, Haitian women are amongst the community of Black women who are experiencing disproportionate maternal outcomes.
Research Aims: The aim of this systematic review is to explore the prenatal and postpartum support lacking for Haitian women residing in the United States and Haiti, resulting in elevated pregnancy-related mortality and morbidity.
Methods: To explore this study's research aims, a qualitative systematic review was conducted. Studies that met the inclusion criteria were found by inserting the following keywords in various research databases: Haitian women, maternal health, maternal disparities, Haitian-immigrant, maternal support, Haitian-American, Haitian pregnant women, Haitian descent, maternal mortality, and maternal morbidity.
Key Findings: Prenatal and postpartum support was lacking in various forms for Haitian women. In Haiti, women noted that a lack of compassion from healthcare providers, personal finances, and hospital funds contributed to unpleasant maternal experiences. While Haitian women residing in the United States encountered an absence of support from their health professionals due to being culturally misunderstood.
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