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A missed opportunity? Lack of knowledge about sexual and reproductive health services among immigrant women in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2019 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, Vol. 19, p. 64-70Article in journal (Refereed) Published
Abstract [en]

Objective: Poor sexual and reproductive health (SRH) among immigrant women is often related to limited access,or suboptimal use of healthcare services. This study investigates the knowledge about and use of sexual andreproductive healthcare services among immigrant women in Sweden.Method: A cross-sectional study of 288 immigrant women. A structured questionnaire was distributed amongimmigrants speaking Arabic, Dari, Somali or English registered at Swedish language schools for immigrants.Data collection took place in 19 strategically selected schools in Sweden. Descriptive statistics, chi-square tests,and logistic regressions were used for the analysis.Results: About one-third of the immigrant women reported lack of knowledge of where to go for contraceptivecounselling. Experiencing lack of emotional social support and not having had children was associated with thislack of knowledge. An even higher proportion (56%) lacked knowledge of where to go to be HIV tested, and thiswas associated with not having participated in a health examination. Almost 25% stated that their culture keptthem back from using contraception.Conclusion: Lack of knowledge of where to turn for contraceptive counselling and HIV testing among immigrantwomen participating in Swedish language schools for immigrants could be considered as a missed opportunity,as all citizens in Sweden have free access to these services. New health policies and strategies should aim toincrease knowledge of SRH services among immigrants. Swedish language schools could play an important rolein increasing knowledge of SRH-related information as many new immigrants become students during their firstyears in Sweden.

Place, publisher, year, edition, pages
The Netherlands, 2019. Vol. 19, p. 64-70
Keywords [en]
Health services accessibility, Sexual and reproductive health, Contraceptive counselling, Immigrant, Social capital, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
URN: urn:nbn:se:uu:diva-376260DOI: 10.1016/j.srhc.2018.12.005OAI: oai:DiVA.org:uu-376260DiVA, id: diva2:1285242
Available from: 2019-02-03 Created: 2019-02-03 Last updated: 2019-02-12
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)
Opponent
Supervisors
Available from: 2019-03-01 Created: 2019-02-05 Last updated: 2019-03-18

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