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Knowledge and utilization of sexual and reproductive healthcare services among Thai immigrant women in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Division of Social Medicine and Global Health, Department of Clinical Sciences Malmo, Lund University, Malmö, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell kvinno- & mödrahälsovård och migration/Essén)
Division of Social Medicine and Global Health, Department of Clinical Sciences Malmo, Lund University, Malmö, Sweden.
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2016 (English)In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 16, article id 25Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Migration from Thailand to Sweden has increased threefold over the last 10 years. Today Thailand is one of the most common countries of origin among immigrants in Sweden. Since the year 2000, new HIV cases are also more prevalent among Thai immigrants compared to other immigrant nationalities in Sweden. The purpose of this study was to investigate the association between knowledge and utilization of sexual and reproductive healthcare services, contraceptive knowledge and socio-demographic characteristics and social capital among Thai immigrant women in Sweden.

METHODS: This is a cross-sectional study using a postal questionnaire to all Thai women (18-64) in two Swedish regions, who immigrated to the country between 2006 and 2011. The questionnaire was answered by 804 women (response rate 62.3 %). Bivariate and multivariate logistic regression analyses were used.

RESULTS: The majority (52.1 %) of Thai women had poor knowledge of where they should turn when they need sexual and reproductive healthcare services. After controlling for potential confounders, living without a partner (OR = 2.02, CI: 1.16-3.54), having low trust in others (OR = 1.61, CI: 1.10-2.35), having predominantly bonding social capital (OR = 1.50, CI: 1.02-2.23) and belonging to the oldest age group (OR = 2.65, CI: 1.32-5.29) were identified as risk factors for having poor knowledge. The majority (56.7 %) had never been in contact with healthcare services to get advice on contraception, and about 75 % had never been HIV/STI tested in Sweden. Low utilization of healthcare was associated with poor knowledge about healthcare services (OR = 6.07, CI: 3.94-9.34) and living without a partner (OR = 2.53, CI: 1.30-4.90). Most Thai women had knowledge of how to prevent an unwanted pregnancy (91.6 %) and infection with HIV/STI (91.1 %).

CONCLUSIONS: The findings indicate that social capital factors such as high trust in others and predominantly bridging social capital promote access to knowledge about healthcare services. However, only one-fourth of the women had been HIV/STI tested, and due to the HIV prevalence among Thai immigrants in Sweden, policy makers and health professionals need to include Thai immigrants in planning health promotion efforts and healthcare interventions.

Place, publisher, year, edition, pages
2016. Vol. 16, article id 25
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-305856DOI: 10.1186/s12914-016-0100-4ISI: 000384947700001PubMedID: 27724904OAI: oai:DiVA.org:uu-305856DiVA, id: diva2:1039313
Funder
Public Health Agency of Sweden Available from: 2016-10-23 Created: 2016-10-23 Last updated: 2019-02-05Bibliographically approved
In thesis
1. Challenges and opportunities for sexual and reproductive healthcare services for immigrant women in Sweden
Open this publication in new window or tab >>Challenges and opportunities for sexual and reproductive healthcare services for immigrant women in Sweden
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis aims to obtain an understanding of immigrant women’s access to healthcare services in Sweden in relation to sexual and reproductive health and rights (SRHR). Data were obtained from three different quantitative cross-sectional studies using self-administrated questionnaires and one qualitative study based on in-depth interviews. The sample consists of immigrant women, predominantly refugees from Afghanistan, Iraq, Syria, and Somalia in Study I (n=288) and Thai immigrant women in Studies II–IV: Study II (n=804), Study III (n=19) and Study IV (n=266). The results indicate that social capital factors seem to play an important role in knowledge about sexual and reproductive health (SRH) services. About one-third of immigrant women reported lack of knowledge of where to go for contraceptive counselling. Lack of knowledge was associated with experiencing lack of emotional social support and not having children. An even higher proportion lacked knowledge of where to go for HIV testing, which was associated with not having participated in a health examination. In a sample of Thai immigrant women, lack of knowledge about SRH services was associated with living without a partner, having low trust in others, having predominantly bonding social relationships and belonging to the oldest age groups. In all studies, the majority had not been tested for HIV or participated in contraceptive counselling. Among the Thai women, despite expressing a need for SRH care, most participants had not sought this type of care. Women found it challenging to seek care in Sweden due to lack of knowledge about the healthcare system and language difficulties. The majority of Thai women reported a significant need for information related to SRH services. Women who had never been HIV tested in Thailand had increased odds of not being tested in Sweden.

Lack of knowledge of where to turn for contraceptive counselling and HIV testing among immigrant women is a missed opportunity, as all citizens in Sweden have free access to these services. Providing information on SRH services to all immigrants in their native language, regardless of immigration status, is an important step in achieving equal access to SRH care.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 86
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1540
Keywords
Immigrant, Migrant, Access, Healthcare, Equal, Social capital, Contraceptive counselling, HIV testing, HIV, Sexual and reproductive health and rights, Sweden.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine; Health Care Research
Identifiers
urn:nbn:se:uu:diva-368357 (URN)978-91-513-0573-8 (ISBN)
Public defence
2019-03-25, A1:111a, BMC, Husargatan, ingång A11, Uppsala, 13:15 (Swedish)
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Supervisors
Available from: 2019-03-01 Created: 2019-02-05 Last updated: 2019-03-18

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