This project explores the 'maternal migration effect'. Following migration to a high-income country with a low maternal mortality rate, we assume that some immigrant women’s reliance upon maternal practices that respond to a low-income, high-mortality context can adversely affect care-seeking and utilization of treatment facilities. At highest risk in the United Kingdom and Sweden are those from Africa's Horn, particularly Somali women who have experienced diasporic migration. By applying constructivist qualitative methods as proxies for medical anthropology, we propose a framework for identifying socio-cultural factors, and then we explore how these can influence the western facility-based maternity care encounter. Study 1 proposes a conceptual framework to understand why sub-Saharan African immigrants might experience adverse childbirth outcomes in western settings. Analysis was guided by 'naturalistic inquiry method' to explore delay-causing socio-cultural factors to optimal maternity treatment. Delays can result from (a) broken trust underlying women’s late-booking or refusal of treatment interventions, and care provider frustration; (b) over-reliance on poorly-functioning interpreter services that deny women’s access to medical expertise; and (c) mutual broken trust and miscommunication, and limited development of guidelines for treatment avoidance. Limited coherence exists in the perspectives between women and providers about caesarean section and other interventions, refusal of treatment, and coping strategies following adverse birth outcomes. Care providers' held misconceptions about women’s preferences for gender- and ethnic-congruence. Women preferred competent care. Congruent language was identified as the key ingredient for optimal culture-sensitive care. Study 2 applied 'grounded dimensional analysis' and 'functional narrative analysis' to explore pre-migration socio-cultural factors that influence Somali parents' childbearing in Sweden. Women’s delayed care-seeking continues, despite that childbearing is still perceived as life-threatening. Decision-making is shared between the couple. Men more than women trust care providers to fill gaps in their knowledge. The postpartum period showed that fathers play an important role. "Aftercare" concerns include unarticulated sexual aversion combined with loss of traditional kin support. Women's autonomy is enhanced but greater necessity exists for intimate partner communication and reliance upon professional care services. Medical anthropology can provide a complementary instrument for developing qualitative evidence-based strategies that target prevention of adverse childbirth outcomes in European countries.

This thesis examines the impact of the housing experiences of resettled refugees. It reiterates that becoming a refugee was not a matter of choice, but for those in refugee situations it was imperative to seek refugee status for their survival. This study focuses on the housing experiences of the Auckland Somali resettled refugees and seeks to identify the effect of housing policy and provision in Auckland. It also demonstrates the links of housing to employment, education and health. Refugees face considerable resettlement challenges based on differential factors such as ethnocentrism, immigration status, household composition and socio-economic conditions. These barriers are exacerbated by a lack of English language proficiency, a variety of educational backgrounds and unfamiliarity with institutional practices, especially during their early years of adaptation as relative newcomers to New Zealand.The vulnerable position of this group in housing markets requires up to date information to increase the provider's awareness of housing experiences and their impact on the resettlement process. In turn, an increased knowledge allows evidence-based decisions for appropriate intervention, policy, and strategy developments to facilitate optimum resettlement outcomes. Policy formulation and effective implementation must focus on the identification of suitable services to address the specific barriers experienced by this group. The empirical evidence supports previous findings that there were close correlations between the participants housing experiences that are the types of housing they occupied and their income.The study developed and implemented a Participatory Research Design involving a case study approach with multiple data collection methods. The primary field data was collected from focus group participants through a workshop of qualitative discussion and a survey.

The situation of Somali Bantu refugees has been studied in the USA and, to a lesser degree, in the refugee camps of Kakuma and Dadaab, but not in self-settled urban contexts in East Africa. This qualitative study, a needs assessment of the Somali Bantu refugee community in Nairobi, Kenya, contributes towards filling that gap in the literature. Participant observation and semi-structured interviews with both Somali Bantu refugees and staff of refugee-serving NGOs in Nairobi provided rich ethnographic data. Research questions focused on perceived needs and assets of refugees, community support structures, and NGO services available to Somali Bantu refugees. The results of the study showed how systems of marginalization and oppression found within Somalia are reproduced within the urban refugee environment of Nairobi. It also revealed how this marginalization was exacerbated through the systems set up by refugee-serving NGOs. However, the study also demonstrated refugee agency and aspirations, revealing strategies employed by individual refugees to improve their situation as well as multi-local and transnational kinship networks of mutual support.

Thesis (Ph. D.)--Uppsala University, 1993. / Includes bibliographical references (p. 168-175).

Referred to as a graveyard for foreign aid and simultaneously a great example for progress in terms of implementing the New Deal for Engagements in Fragile States, Somalia is recovering from a protracted war, multi-dimensional fragility and deep mistrust. This research analyses how international actors contribute to peace, state and trust building in the Somali region by implementing the New Deal TRUST principles on a national level and by engaging in the peacebuilding process in Galkacyo, Central Somalia on a local level. Through a qualitative approach and case study design, the research relies on data collected through qualitative content analyses of reports, official documents and evaluations as well as data collected through key informant interviews. Informants involve persons working for the European Union, the World Bank, the United Nations Development Programme in New York and Somalia, the Civil Society Platform for Peacebuilding and Statebuilding, Interpeace Eastern and Central Africa Regional Office and the New York University with connection to the New Deal and or peace and statebuilding engagements in the Somali region. The findings, generated from the collected data, are analysed through a theoretical framework based on Wallensten’s (2015) theory on ‘Quality Peace’, Eriksen’s (2017) theory on Statebuilding and Barbalet’s (2009) and Eccles (2015) theory on trust building. The research finds that the implementation of the TRUST principles is scattered in terms of progress. ‘Use and strengthen country systems’ and ‘Strengthening capacities’ are the two principles delivering most progress according to the majority of the informants, whereas ‘Risk sharing’ and ‘Timely and predictable aid’ perform worse. The implementation of the first principle, ‘Transparency’, mainly referring to the sharing of documents, inclusive decision-making and reporting of aid to the Somali Aid Coordination Unit at the Prime Minister’s Office, has made moderate progress. At a local level, Interpeace engages in the Galkacyo peacebuilding process by providing strategic, financial and technical support to local structures, e.g. a joint Peace Committee and joint security force. The research identifies a tendency that the implementation of the New Deal TRUST principles has had limited impact on a local level. The development of the emerging FMSs has added an extra dynamic to the conflict in Galkacyo, a city divided by the two administrative regions Galmudug and Puntland. Furthermore, whether donor behaviour has changed in fragile states as an effect of the New Deal is debated. The engagements on a local level in Galkacyo tend to contribute to peace and trust building among clashing communities, however, limited impact can be identified on the statebuilding process and on peace and trust building vis-à-vis the Federal and State Governments.

In connection to an existing research project, Micro-migration and Integration with relevance for Uddevalla, this study aims to analyse and compare the subjective understandings of Somali women’s experiences in the integration process in the Swedish society. Integration is a multifaceted and ongoing process in which the self-understandings of this notion is bound to change over time in relation to socio-economic and cultural contexts. In light of this, the thesis employs a comparative case study that is based on data collected through focus group discussions with newly arrived women and women who have stayed in Sweden for a longer time. The analytical framework utilizes acculturation theory to study what traces of integration, assimilation, separation and marginalization can be identified in the selfunderstandings and how they develop over time. Some of the conclusions from the study by the interviewees notify language being crucial. Both groups understand that Swedish constitutes a step in the overall process for establishment and the newly arrived women showed an awareness about it being the ultimate factor that can speed up their own integration process. The findings of the research include that there is a deviation of the understandings between the groups when it comes to housing and identity. The group of newly arrived women with the exception of one participant, indicated a clear separation in regard to both aspects above whereas the women who have lived in Sweden for 9-10 years showed clear traces of integration. Hence, in the beginning of the integration process a person might have a theoretical understanding that indicates separation but experience a discursive shift towards the lens of integration.

abstract: As a form of bodily modification, female circumcision has generated unprecedented debates across the medical community, social sciences disciplines, governmental/non-governmental agencies and activists and others. The various terminologies used to refer to it attest to differences in knowledge systems, perceptions, and lived experiences emerging from divergent cultures and ideologies. In the last two decades, these debates have evolved from a local matter to a global health concern and human rights issue, coinciding with the largest influx of African refugees to the Western nations. Various forms of female circumcision are reported in 28 countries in the African Continent; Somalia has one of the highest prevalence of female circumcision and the most severe type. The practice is antithetical to Western values and poses an ideological challenge to the construction of the normal body, its bodily processes and its existential being-in-the-world. From the global health perspectives, female circumcision is deemed to be a health hazard--especially during childbirth--though the scientific evidence is inconclusive from studies conducted in post-migration. Yet, Somali refugee women have higher childbearing disparities in host nations, including the U.S. They are also perceived as difficult patients and resistant to obstetrics interventions. Although their FGC status and "cultural" differences are often cited, there is a lack of adequate explanations as to why and how these factors shape patient-provider interactions and affect outcomes. The objectives of this dissertation study are to quantitatively and qualitatively explore these questions within and between Somali refugee women and their healthcare providers in Arizona. Two theoretical frameworks and methods--culture consensus and embodiment-- are applied to identify variations in childbearing knowledge and to explore how the cultural phenomenon of circumcision is subjectively and intersubjectively embodied in the context of childbearing. Culture consensus questionnaire (N=174) and ethnographic interviews (N=40) using phenomenology approach were conducted. Analyses suggest cross-cultural disagreement hinged on: faith in science versus God, pregnancy/childbirth interventions, language challenges, and control-resistance issues; intra-cultural disagreement underscores that Somalis are not culturally homogenous group. Preconceptions of female circumcision body as a cultural phenomenon has different and conflicting meanings that may adversely impact patient-provider interactions and outcomes. / Dissertation/Thesis / Ph.D. Anthropology 2014

This thesis employs a post-anarchist influenced lens and develops a collective capacity framework in order to explore how the media consumption and production practices of the Chinese Canadian, Latin American, and Somali Canadian communities in Ottawa, Canada, can strengthen these communities’ ability to facilitate the process by which immigrants become community members and form a sense of belonging in Ottawa. The thesis explores both how ethno-cultural media can help newcomers to form a sense of belonging and become part of a local ethno-cultural community, as well as how such media can help members of minority ethno-cultural communities become part of the broader local community and to form a sense of belonging in Ottawa, and Canada more broadly. Throughout, the thesis identifies and explores the differences that emerge between the three communities in order to gain better insight into the potential benefits of ethno-cultural media. In order to explore and to answer these questions, the thesis employs quantitative and qualitative methods. It relies on analysis of secondary literature, raw data from the OMMI 2012 Survey, raw content coding of local Chinese and Spanish language media carried out as part of the Ottawa Multicultural Media Initiative, and primary research consisting of content coding of a Somali Canadian television program. The main contribution of this thesis lies in offering a new lens through which to assess the integrative potential of ethno-cultural media. Approaching the question from a bottom-up, relationship-centred perspective has yielded different findings than those generally reported in Canadian ethno-cultural media research. Although there were significant differences in terms of media use and media production between the three communities, the findings revealed that all three used ethno-cultural media in ways that had the potential to help them in the process of settling down and taking root in a new city, and of helping them to form a sense of belonging.

Refugee children are at risk of experiencing social, emotional or behavioural needs (SEBN) due to the stressful events they have experienced. These events may have occurred whilst in their country of origin, or when travelling to and seeking asylum in a new country. There are a high number of refugee children in the local authority where the current research takes place. Educational Psychologists (EPs) in the authority have become aware of some of the needs of these pupils through individual case work. However there is an acknowledgement that more detailed information about their needs is still required. There is also a role for EPs in working with school staff to support refugee and asylum seeker children. The current research was carried out by a Trainee Educational Psychologist (TEP) in a primary school with a high number of refugee children (10%). An action research design was employed, using the RADIO model to structure collaborative working with school staff. The focus of the action research was to identify the SEBN of refugee children in the school and to develop school practice. A whole staff questionnaire was completed for each class (15 classes in total) to explore the needs of all refugee children and identify the provision they had received. The ‘Strengths and Difficulties Questionnaire’ (SDQ) (Goodman, 1997) was incorporated into this questionnaire to obtain scores for all 46 refugee children in the school. Descriptive statistics were used to analyse the data. In order to further explore this data, three focus groups were run, one with members of staff and two with groups of children in Key Stage 2. The focus group data was analysed using thematic analysis. The SDQ data revealed that just less than 50% of the refugee children scored in the abnormal range for total difficulties. The themes emerging from the thematic analysis highlighted a range of ‘pupils’ emotions and behaviours’ and ‘reasons for different emotions and behaviours’. Provision in school was discussed in relation to ‘newly arrived pupils’, ‘social, emotional and behavioural support in school’ and ‘links with parents’. Somali refugee pupils were also highlighted as a group who had particular SEBN.An action planning group undertook further development work in response to the issues highlighted during the data collection phase. The group devised an action plan to focus on areas of the school’s provision to improve upon. The TEP supported the action planning group to focus on further developing the induction procedure in school. The implications of this research are discussed at the individual child level, the whole school level and for the role of the EP. The TEP also reflects on the role of the EP in identifying the SEB needs of refugee children and in supporting a school to carry out action research.

In the past decade, the Somali Canadian community has experienced a heightened rate of youth violence. Since 2005 several dozen young Somali men have lost their lives. Most of the incidents occurred in Edmonton and Toronto, with sporadic incidents in Ottawa as well. The violence, mostly concentrated in northern Alberta, attracted sustained media attention which, in turn, led to public and private discussions within the Somali community. This study explores the determinants of youth involvement in violence and related criminal activities, as well as the impact of that violence on the families of its victims and perpetrators, and the larger Somali community. The study’s design consisted of in-depth interviews with Somali Canadians and non-Somali key informants, in the three cities where the majority of the Somali population resides, to elicit their explanations of the violence, and their perceptions of its impact. Results indicate that the proximal determinant of the violence was the young men’s participation in the drug trade in northern Alberta. Distally, determinants of the violence link three intersecting themes: poverty, racialization and gender. Poverty and racism marked the early lives of the male youth and their families in Ontario. The resettlement barriers experienced by first generation Somali refugees, the racism that this community and its youth encountered in public institutions such as schools, the criminal justice system and the media, and the anti-poor posture of neoliberalism, combined to create vulnerabilities to risky behaviour in male youth. My analysis suggests that young men entered the drug trade and/or participated in criminal activities in order to fill material needs and enhance their self-esteem. The inequities that underpin the determinants of violence require remedy at multiple levels. I propose an evidence-based population health framework for the prevention of youth violence, and identify interactive levels (individual, community, institutional, societal) at which to target prevention and intervention efforts.