Communicating Reproductive Coercion in the Context of Domestic and Family Violence: Perspectives of Service Providers Supporting Migrant and Refugee Women

The current study explored the language barriers to help-seeking in the context of reproductive coercion and abuse (RCA), domestic and family violence (DFV), and sexual violence (SV), drawing on observations by key informants supporting women from migrant and refugee communities. A lack of shared language has been identified as a key barrier to help seeking for migrant and refugee women experiencing DFV more broadly, though how language intersects with help seeking in the context of RCA is yet to be investigated. We conducted 6 focus groups with 38 lawyers, counsellors, and social workers supporting women experiencing DFV in Brisbane and Melbourne, Australia. Our findings address two main areas. First, consistent with past research in DFV, our participants identified language as a barrier for women when communicating about sexual and reproductive issues in the context of health and police encounters. More specifically, our findings suggest that the inability of health professionals and police to communicate with women who have low or no English proficiency not only negatively impacted victims/survivors’ ability to access support, but also facilitated the perpetration of RCA. We conclude that language can be a mechanism through which coercive control is enacted by perpetrators of RCA and health and policing systems may not be equipped to recognise and address this issue. We also suggest that greater conceptual clarity of RCA is needed within the DFV sector in order to tailor responses.

Mental health of clinic-attending Syrian refugee women in Jordan: associations between social ecological risks factors and mental health symptoms

Background The mental health of refugee women is often affected by multiple risk factors in their social ecology. Assessing these risk factors is foundational in determining potential areas for intervention. We used the social ecological model to examine risk factors associated with self-reported mental health symptoms among clinic-attending Syrian refugee women in Jordan. We hypothesize that individual (older age, unmarried, have more children under 18, difficulty reading/writing with ease), interpersonal (intimate partner violence [IPV]), community and societal level risk factors (greater number of postmigration stressors), will be associated with depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms. Methods We surveyed 507 women using a cross-sectional clinic-based systematic sampling approach between April and November 2018. We used multivariable regressions to examine associations between different risk factors in the social ecology on depression, anxiety, and PTSD. Additional multivariable regressions explored associations between specific postmigration stressors and mental health conditions. Results We found rates of depression among our sample to be 62.92%; anxiety 57.46%; and PTSD 66.21%. Our hypothesis was partially supported. At the individual level, age was directly associated with anxiety (aOR 1.04, 95% CI [1.02, 1.06]) and PTSD (aOR 1.03, 95% CI [1.01, 1.06]), while marriage decreased odds for depression (aOR 0.41, 95% CI [0.19, 0.92]) and PTSD (aOR 0.36, 95% CI [0.15, 0.87]). IPV was associated with depression (aOR 2.78, 95% CI [1.72, 4.47]); anxiety (aOR 3.30, 95% CI [2.06, 5.27]); and PTSD (aOR 5.49, 95% CI [3.09, 9.76]). Each additional community and societal risk factor (postmigration stressor) increased the odds for depression (aOR 1.32, 95% CI [1.22, 1.42]), anxiety (aOR 1.28, 95% CI [1.19, 1.39]), and PTSD (aOR 1.46, 95% CI [1.33, 1.60]). Conclusion Understanding social ecological risk factors associated with mental health conditions of Syrian refugee women is vital to addressing their mental health needs. IPV and postmigration stressors are consistently impactful with all mental health conditions. IPV resulted in the largest odds increase for all mental health conditions. Multilevel interventions are needed to address mental health risk factors at multiple levels of the social ecology.

From Hell to High Water: The Life of Rohingya Refugee Women in Bangladesh

Bangladesh is currently hosting nearly a million Rohingya refugees from Myanmar and more than half of the refugee population comprises women. In Myanmar, due to the government-imposed securitization and relatively conservative culture, Rohingya women were not able to enjoy their rights and freedom and were mainly confined to their homes. Upon arriving in Bangladesh, they are facing additional challenges. This article aims to find the underlying causes that alienated women from enjoying their rights and whether the life of the Rohingya women has improved or not in Bangladesh. This article shows that, due to the lack of a women-friendly environment inside camps, gender norms and malpractices, breakdown of family ties, and increased number of gender-based violence against women, they are more vulnerable than ever. This paper argued that humanitarian organization and the government should promote gender mainstreaming towards bringing refugee women into the community decision-making process along with raising awareness among the Rohingya community.

Family Planning Knowledge, Attitudes and Practices Among Rohingya Women Living in Refugee Camps in Bangladesh: A Cross-Sectional Study

Background: Considering more than 720,000 Rohingya into Bangladesh, unplanned pregnancy, and serious complications of pregnancy among refugees, this study aims to explore the knowledge, attitude, and practice (KAP) of family planning (FP) and associated factors among the Rohingya women living in the refugee camps in Cox’s Bazar, Bangladesh. Methods: Four hundred Rohingya women were investigated, and data were collected using a structured questionnaire, which included socio-demographic characteristics, awareness of contraceptive methods, knowledge, attitudes and practices on FP. Linear regression analysis was performed to identify the predictors of outcome variables. Results: Of the Rohingya refugee women, 60% were unaware that there is no physical harm in adopting a permanent method of birth control. Half of them lack proper knowledge of whether a girl was eligible for marriage before the age of 18. More than two-thirds think family planning methods should not be used without the husband’s permission. Besides, 40% were ashamed and afraid to discuss family planning matters with their husbands, considering it as a sin. Of them, 58% had the opinion that a couple should continue bearing children until a son is born. Linear regression analyses demonstrated that Racidong in Myanmar as the region of residence, being professional, number of children, physician/nurse being the source of FP knowledge, having FP interventions in the camp, participating in a FP program, visiting a health facility, and talking with a health care provider on FP were significantly associated with Rohingya women’s better KAP of FP. Conclusions: The study showed that Rohingya refugee women are a marginalized population in family planning and the comprehensive FP-KAP capability was low. Contraceptives among the Rohingyas are unpopular, mainly due to a lack of education and family planning awareness. In addition, family planning initiatives among Rohingya refugees were limited by some traditional cultural and religious beliefs. Therefore, strengthening FP interventions and increasing the accessibility to essential health services and education are indispensable in order to improve maternal health among refugees.

Sociocultural barriers to information and integration of women refugees

PurposeThis study focuses on specifically women refugees' experiences of accessing information and how sociocultural barriers impact these experiences aiming to broaden the LIS literature of women refugees' information problems from sociocultural aspects. The socioculturally formed roles of a woman can impact the information practices of women refugees or cause certain information problems during the integration process. Hence, the research questions that drive this study are: What kind of information problems might women refugees face in a new host country? What kind of sociocultural barriers influence their information problems? How do they react toward these information problems?Design/methodology/approachThe study is designed based on semi-structured in-depth interviews with eighteen refugee women living in Sweden. The study is a part of a larger study in which authors intend to explore the information practices and integration challenges of almost 20 or more refugee women living in Sweden.FindingsWomen refugees face information overload, difficulties in understanding new communication culture and lack of appropriate sources and networks in a new country. These information problems are influenced by sociocultural barriers such as the role of women, national culture of “collectivism”, small-world and lack of information literacy. Women react in certain ways such as, stressing, panicking, quitting the tasks, wasting time and making wrong decisions which negatively impact the integration process.Research limitations/implicationsThe research has its limitations as it is conducted with a small group of women refugees, belong to specific Middle Eastern culture and cannot be generalized. Another limitation is that the interviews are conducted in English language (with sufficient language skill). However, conducting interviews in their mother language would have been an advantage.Practical implicationsPractically, the study provides awareness for official and private organizations, volunteers and policymakers dealing with refugees. The stakeholders involved in the societal integration process of refugees, must consider that women refugees are more prone to information problems due to certain sociocultural influences (i.e. “being a woman” and national culture) and need a separate plan than the male refugees. For instance, by increasing and offering intercultural opportunities at workplaces or schools can encourage the wider social networking for women refugees. The programs aiming to reduce the sociocultural differences among women refugees and the Swedes are needed to be included in the integration policy.Social implicationsThe study intends to help the refugees society and the Swedish society overall by improving the integration plan.Originality/valueThe findings related to the information experiences of women refugees have potential implications for research where the value of information in the integration process is explored. The study meets the gap in previous literature by presenting the gender specific views on information problems from sociocultural aspects. The study also provides future directions to understand how women refugees deal with potential sociocultural barriers to information in a new country.

‘It is a disease which comes and kills directly’: What refugees know about COVID-19 and key influences of compliance with preventive measures

Background Refugees are at increased risk for COVID-19 infection in part due to their living conditions, which make it harder to adopt and adhere to widely accepted preventive measures. Little empirical evidence exists about what refugees know about COVID-19 and what they do to prevent infection. This study explored what refugee women and their health care workers understand about COVID-19 prevention, the extent of their compliance to public health recommendations, and what influences the adoption of these measures. Methods In October 2020, we conducted 25 in-depth interviews with facility and community health care staff (n = 10) and refugee women attending antenatal and postnatal care services (n = 15) in Eastleigh, Nairobi. Findings While researchers found a high level of awareness about COVID-19 and related prevention and control measures among refugee women, various barriers affected compliance with such measures, due in part to poverty and in part to rampant misconceptions informed by religious beliefs and political narratives about the virus. Conclusions These findings indicated that Kenya’s Ministry of Health needs to institute a concerted and continuous education program to bring refugee communities up to speed about COVID-19 and its prevention. In addition to disseminating information about the need to wear masks and repeatedly wash hands, supplies—masks, soap and access to water—need to be made available to poor refugee communities. Future research could explore which measures for disseminating factual information work best in refugee populations with different cultural norms and how best to target interventions to these groups.

Neonatal morbidity among African refugee women in Israel: a case–control study

ObjectivesReports on neonatal morbidity (NM) among refugees in developed countries remain inconsistent. We aimed to compare NM among infants of African refugees in Israel to the native population based on a large population sample.DesignA case–control study.SettingA tertiary hospital in Israel.ParticipantsData on hospital-based live births of refugee women and their newborns who were born in 2014 and 2017 were retrieved from medical records. Perinatal and neonatal data were compared between the refugee group and the native residents matched for gestational age and year of birth as well as within the refugee group.Primary outcomePrevalence of NM among African refugees in Israel.ResultsNewborns delivered by 357 refugee women (mean age 30.2 years) and 357 controls (mean age 32.2 years) were analysed. Both groups were similar for the newborns’ weight and gestational age. There were no significant differences in NM between the groups. A within-refugee comparison conducted between 2014 and 2017 yielded significant differences in birth weight (3051.4 vs 3373.6 gr, p<0.001, 95% CI (198.3 to 446.2), d=0.56), the number of twin deliveries (10 vs 4, p=0.002, Φ=0.173), the number of neonates evaluated as small for gestational age (15 vs 10, p=0.003, Φ=0.167) and the use of human milk (71% vs 93%, p<0.001, Φ=−0.298).ConclusionsWe conclude that NM among neonates born to refugee mothers was not higher than that of neonates born to native Israeli mothers. We suggest that successful implementation of health policies for refugees has improved their accessibility to mother–child health services.

Conquering the labour market: the socioeconomic enablement of refugee women in Austria

Refugee women from the Near and Middle East face specific challenges when entering the Austrian labour market. Particularly gender-based factors, including care and reproductive work, exert pressure on these women and constitute major hurdles for successful entry into employment in Austria. Based on nine qualitative interviews with refugee women who swiftly gained entry to the labour market as well as ten qualitative interviews with experts from public and private support organisations, we investigate refugee women’s social and cultural capital as well as the individual agencies that foster paths into the labour market. We introduce the concept of enablement as the process of gathering the preconditions for overcoming the challenges that arise on that path. Finally, we illuminate the ways in which the three dimensions of individual, relational and institutional enablement interrelate and shape individual agency with regard to labour market integration.

“COVID affected us all:” the birth and postnatal health experiences of resettled Syrian refugee women during COVID-19 in Canada

Background Prior to COVID-19, postnatal resettled refugee women in Canada reported barriers to healthcare and low levels of social support, contributing to maternal health morbidities. The COVID-19 pandemic appears to be further exacerbating health inequities for marginalized populations. The experiences of resettled refugee women are not fully known. Aim To understand Syrian refugee women’s experiences accessing postnatal healthcare services and supports during the COVID-19 pandemic. Methods Semi-structured, virtual interviews were conducted with eight resettled Syrian refugee women living in Nova Scotia (Canada) who were postnatal between March and August 2020. Data analysis was informed by constructivist grounded theory. Findings Three themes emerged: “the impacts of COVID-19 on postnatal healthcare;” “loss of informal support;” and “grief and anxiety.” Women experienced difficult healthcare interactions, including socially and physically isolated deliveries, challenges accessing in-person interpreters, and cancelled or unavailable in-home services (e.g., public health nurse and doula visits). Increased childcare responsibilities and limited informal supports due to pandemic restrictions left women feeling overwhelmed and exhausted. Stay-at-home orders resulted in some women reporting feelings of isolation and loss, as they were unable to share in person postnatal moments with friends and family, ultimately impacting their mental wellness. Conclusions COVID-19 and associated public health restrictions had significant impacts on postnatal Syrian refugee women. Data presented in this study demonstrated the ways in which the pandemic environment and related restrictions amplified pre-existing barriers to care and postnatal health inequalities for resettled refugee women—particularly a lack of postnatal informal supports and systemic barriers to care.