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  • 1.
    Ahlberg, Beth Maina
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology. Skaraborg Institute for Research and Development, Skövde, Sweden.
    Hamed, Sarah
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Thapar-Björkert, Suruchi
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.
    Bradby, Hannah
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Invisibility of Racism in the Global Neoliberal Era: Implications for Researching Racism in Healthcare2019In: Frontiers in Sociology, ISSN 2297-7775, Vol. 4, article id 61Article, review/survey (Refereed)
    Abstract [en]

    This paper describes the difficulties of researching racism in healthcare contexts as part of the wider issue of neoliberal reforms in welfare states in the age of global migration. In trying to understand the contradiction of a phenomenon that is historical and strongly felt by individuals and yet widely denied by both institutions and individuals, we consider the current political and socioeconomic context of healthcare provision. Despite decades of legislation against racism, its presence persists in healthcare settings, but data on these experiences is rarely gathered in Europe. National systems of healthcare provision have been subject to neoliberal reforms, where among others, cheaper forms of labor are sought to reduce the cost of producing healthcare, while the availability of services is rationed to contain demand. The restriction both on provision of and access to welfare, including healthcare, is unpopular among national populations. However, the explanations for restricted access to healthcare are assumed to be located outside the national context with immigrants being blamed. Even as migrants are used as a source of cheap labor in healthcare and other welfare sectors, the arrival of immigrants has been held responsible for restricted access to healthcare and welfare in general. One implication of (im)migration being blamed for healthcare restrictions, while racism is held to be a problem of the past, is the silencing of experiences of racism, which has dire consequences for ethnic minority populations. The implications of racism as a form of inequality within healthcare and the circumstances of researching racism in healthcare and its implication for the sociology of health in Sweden are described.

  • 2.
    Ahlberg, Beth Maina
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
    Krantz, Ingela
    Lindmark, Gunilla
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
    Warsame, Marian
    A replay to Johnsdotter and Essén2005Other (Other scientific)
  • 3.
    Ahlberg, Beth Maina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Skaraborg Inst Res & Dev, Skovde, Sweden.
    Maina, Faith
    Department of Curriculum Studies and Teacher Education, Texas Tech University, USA.
    Kubai, Anne
    Khamasi, Wanjiku
    Dedan Kimathi University of Technology, Nyeri, Kenya.
    Ekman, Marianne
    Royal Institute of Technology, Stockholm, Sweden.
    Lundqvist-Persson, Cristina
    Skaraborg Institute for Research and Development, Skövde, Sweden;Lund Univ, Dept Psychol, Psychol, Lund, Sweden.
    ‘"A child, a tree": Challenges in building collaborative relations in a community research project in a Kenyan context2016In: Action Research, ISSN 1476-7503, E-ISSN 1741-2617, Vol. 14, no 3, p. 257-275Article in journal (Refereed)
    Abstract [en]

    This paper highlights the potential for basing participatory action research on priorities identified by communities. The case builds on a research project by the Social Science Medicine Africa Network (Soma-net) focusing on AIDS prevention among school youth in Kajiado in Kenya during 2003-2006. It became clear from that study just how complex it is to promote open communication on issues of sexuality considered critical for sexual health promotion. Towards the end of that study a spin-off in the form of a concept a child, a tree or tree planting evolved and the research thereafter continued as a partnership between the school community and the researchers. The focus then was on understanding how health promotion could be integrated into other aspects of community life. The concept and tree planting when implemented created a sense of ownership among the pupils largely because they were placed at the centre of the development activities. The story illuminates the nature of change developing in the course of the project, but also the challenges and complexity of creating and maintaining collaborative relations in the face of cultural and gender power dynamics and interventions imposed from outside the community.

  • 4.
    Ahlberg, Beth Maina
    et al.
    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).
    Njoroge, Kezia Muthoni
    School of Health, Community of Education Studies, Northumbria University, Newcastle upon Tyne, UK.
    'Not men enough to rule!': politicization of ethnicities and forcible circumcision of Luo men during the postelection violence in Kenya2013In: Ethnicity and Health, ISSN 1355-7858, E-ISSN 1465-3419, Vol. 18, no 5, p. 454-468Article in journal (Refereed)
    Abstract [en]

    Background

    As a contribution to ongoing research addressing sexual violence in war and conflict situations in the Democratic Republic of Congo, Kenya and Rwanda, this paper argues that the way sexual violence intersects with other markers of identity, including ethnicity and class, is not clearly articulated. Male circumcision has been popularized, as a public health strategy for prevention of HIV transmission, although evidence of its efficacy is disputable and insufficient attention has been given to the social and cultural implications of male circumcision.

    Methods

    This paper draws from media reporting and the material supporting the prosecutor at the International Criminal Court case against four Kenyans accused of crimes against humanity, to explore the postelection violence, especially forcible male circumcision.

    Results

    During the postelection violence in Kenya, women were, as in other conflict situations, raped. In addition, men largely from the Luo ethnic group were forcibly circumcised. Male circumcision among the Gikuyu people is a rite of passage, but when forced upon the Luo men, it was also associated with cases of castration and other forms of genital mutilation. The aim appears to have been to humiliate and terrorize not just the individual men, but their entire communities. The paper examines male circumcision and questions why a ritual that has marked a life-course transition for inculcating ethical analysis of the self and others, became a tool of violence against men from an ethnic group where male circumcision is not a cultural practice.

    Conclusion

    The paper then reviews the persistence and change in the ritual and more specifically, how male circumcision has become, not just a sexual health risk, but, contrary to the emerging health discourse and more significantly, a politicized ethnic tool and a status symbol among the Gikuyu elite. In the view of the way male circumcision was perpetrated in Kenya, we argue it should be considered as sexual violence, with far-reaching consequences for men's physical and mental health.

  • 5.
    Ahlberg, Beth Maina
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
    Pertet, Anne
    A map of the complexities that have emerged in HIV and AIDS research.2006In: Social Science and Medicine Africa (SOMA-Net) Charper 1: In: Re-thinking research and intervention approaches that aim at preventing HIV infection among the youth., 2006, p. 7-16Chapter in book (Other (popular scientific, debate etc.))
  • 6.
    Belita, Alice N.
    et al.
    Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
    Kulane, Asli
    Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
    Ahlberg, Beth Maina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Adolescence and Sexuality in the Context of HIV and AIDS: Views and Concerns of Pupils in a Rural Primary School in Kenya2011In: Child Health and Education, ISSN 1911-7558, Vol. 3, no 2, p. 122-136Article in journal (Refereed)
    Abstract [en]

    New HIV infections in Kenya have been mostly among young people 15–24 years of age. The Maasai adolescents are an important group to study asthe Maasai have a distinct culture, which in light of current political and socioeconomic changes could be a risk factor for HIV infection. The aim of this study was to explore the views and concerns of school youth on adolescence and sexuality in the context of HIV and AIDS.A qualitative method using self-generated questions was used. The school youth wrote questions on adolescence, sexuality and HIV and AIDS, or those questions they could not ask their parents or other adults for fear or shame. They reported being curious about sex, sexual urge and feelings that they have. They expressedconfusion about adolescence and their experiences as adolescents in terms of both physical and emotional changes. They are also subject to prohibitivesilence from adults to an extent that they express fear of reporting sexual abuse. Relationship between different sexes was reflected as one that needed to be sanctioned; hence the young people wanted to know how they should relate with each other. They had concerns about condom use that indicated they were exposed to the different discourses on condom use. They showed limited knowledge on HIV and AIDS and STIs and also expressed eagerness to know more about them. In conclusion, communication between parents and their children on issues of sexuality needs to be assessed. Interventions for young people that involve the communities should be encouraged.

  • 7.
    Bjerneld, Magdalena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Ahlberg, Beth Maina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Lindmark, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Socialisation of humanitarian aid workers: Interviews with recruitment officersManuscript (Other academic)
    Abstract [en]

    International organisations employ thousands of aid workers for humanitarian aid around the world. One of the problems identified in earlier research is the high turnover of personnel.

    This article is part of a broader research project investigating how humanitarian organisations attract, recruit and prepare expatriate health professionals for field work and how these professionals are utilized in order to identify possible improvements in the human resource management system. The current study describes how recruitment officers in selected large humanitarian organisations perceive humanitarian aid work, how they recruit, prepare, and support their staff in order to achieve high retention, and what concerns and recommendations they have for future work. For the analysis of the interviews content analysis was used.

    The recruitment officers identified the importance of flexibility and diplomacy in complex realities. They confirmed the findings of earlier studies that team work often is a source of frustrations and sometimes disappointment. Their main concern was lack of time to find the right person for the right job, often a person with broad expertise in public health. Another difficulty was to find persons who could take responsibility as leaders and trainers. In order to socialize the newcomers into the organisation short courses and debriefing sessions were used. Persons, who stay too long in the field of humanitarian action and sometimes become cynical to the difficult situation they work in was also discussed as being problematic. This finding contradicts the otherwise frequently discussed question about the high turnover of personnel in humanitarian action. This article argues for the use of socialization theory in order to find sustainable solution to identified problems.

  • 8.
    Bradby, Hannah
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Ahlberg, Beth Maina
    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).
    Holiday parasites and furry friends2014Report (Other (popular science, discussion, etc.))
  • 9.
    Bradby, Hannah
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Thapar-Björkert, Suruchi
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.
    Hamed, Sarah
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Ahlberg, Beth Maina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology. Skaraborg Institute, Skövde, Sweden.
    Undoing the unspeakable: researching racism in Swedish healthcare using a participatory process to build dialogue2019In: Health Research Policy and Systems, ISSN 1478-4505, E-ISSN 1478-4505, Vol. 17, article id 43Article in journal (Refereed)
    Abstract [en]

    Background:

    Racism is difficult to discuss in the context of Swedish healthcare for various cultural and administrative reasons. Herein, we interpret the fragmentary nature of the evidence of racialising processes and the difficulty of reporting racist discrimination in terms of structural violence.

    Methods:

    In response to the unspeakable nature of racism in Swedish healthcare, we propose a phased participatory process to build a common vocabulary and grammar through a consultative framework involving healthcare providers and service users as well as policy-makers. These stakeholders will be involved in an educational intervention to facilitate discussion around and avoidance of racism in service provision.

    Discussion:

    Both the participatory process and outcomes of the process, e.g. educational interventions, will contribute to the social and political conversation about racism in healthcare settings. Creating new ways of discussing sensitive topics allows ameliorative actions to be taken, benefitting healthcare providers and users. The urgency of the project is underlined.

  • 10.
    Chikovore, Jeremiah
    et al.
    HIV/AIDS, Sexually Transmitted Infections, and Tuberculosis Unit, Human Sciences Research Council, Durban, South Africa.
    Nystrom, Lennarth
    Division of Epidemiology and Public Health Sciences, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Lindmark, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Ahlberg, Beth Maina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    "How Can I Gain Skills if I Don't Practice?'' The Dynamics of Prohibitive Silence against Pre-Marital Pregnancy and Sex in Zimbabwe2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 1, p. e53058-Article in journal (Refereed)
    Abstract [en]

    Young people face sexual and reproductive health (SRH) problems including Human immunodeficiency virus (HIV) and Acquired immunodeficiency syndrome (AIDS). It is critical to continue documenting their situation including the contexts they live in. As part of a larger study that explored perspectives of men to SRH and more specifically abortion and contraceptive use, 546 pupils (51% female; age range 9-25 years) from a rural area in Zimbabwe were invited to write anonymously questions about growing up or other questions they could not ask adults for fear or shame. The pupils were included following descriptions by adults of the violence that is unleashed on unmarried young people who engaged in sex, used contraceptives, or simply suggested doing so. The questions by the young people pointed to living in a context of prohibitive silence; their sexuality was silenced and denied. As a consequence they had poor knowledge and their fears and internal conflicts around sexuality and pregnancy were not addressed. Current action suggests concerted effort at the policy level to deal with young people's SRH in Zimbabwe. It nevertheless remains necessary, as a way to provide support to these efforts, to continue examining what lessons can be drawn from the past, and how the past continues to reflect in and shape present dynamics and relations. There is also need to look more critically at life skill education, which has previously been described as having failed to address adequately the practical needs of young people. Life skill education in Zimbabwe has rarely been systematically evaluated. A fuller understanding is also needed of the different factors co-existing in contemporary African societies and how they have been and continue to be constituted within history, and the implications to the promotion of adolescent SRH.

  • 11.
    Darj, Elisabeth
    et al.
    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).
    Infanti, Jennifer J.
    Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
    Ahlberg, Beth Maina
    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).
    Okumu, Jecinta
    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).
    "The fairer the better?": Use of potentially toxic skin bleaching products2015In: African Health Sciences, ISSN 1680-6905, E-ISSN 1729-0503, Vol. 15, no 4, p. 1074-1080Article in journal (Refereed)
    Abstract [en]

    Background:

    Skin bleaching is a widespread phenomenon in spite of their potentially toxic health effects.

    Objectives:

    This study aimed to determine if such products are used in Sweden in particular by pregnant women, furthermore to explore immigrant women’s view skin bleaching.

    Methods:

    455 pregnant women completed a questionnaire, which were statistically analysed. Focus groups and individual interviews were conducted with immigrant women, content analysis was used to assess the data.

    Results:

    Skin bleaching products were used by 2.6% of pregnant women, significantlly more by women born in non-European countries. Motivating factors were associated with the concept of beauty together with social and economic advantages. The women had low awareness of the potential health risks of the products. Regulations on the trade of skin bleaching products have not effectively reduced the availability of the products in Sweden nor the popularity of skin bleaching.

    Conclusion:

    There is need for further research especially among pregnant women and possible effects on newborns. Products should be tested for toxicity. Public health information should be developed and health care providers educated and aware of this practice, due to their potential negative health implications.

  • 12.
    Eriksson, Elisabet
    et al.
    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).
    Lindmark, Gunilla
    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).
    Axemo, Pia
    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).
    Haddad, Beverley
    School of Religion and Theology, University of KwaZulu-Natal, South Africa .
    Ahlberg, Beth Maina
    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).
    Faith, Premarital Sex and Relationships: Are Church Messages in Accordance with the Perceived Realities of the Youth?: A Qualitative Study in KwaZulu–Natal, South Africa2013In: Journal of religion and health, ISSN 0022-4197, E-ISSN 1573-6571, Vol. 52, no 2, p. 454-466Article in journal (Refereed)
    Abstract [en]

    Since religious messages on life style have a strong impact in South Africa, it is important to assess how they relate to the situation for young people at risk of HIV infection. Nine focus group discussions were conducted with youth (n=62), aged 13–20 years, from the Roman Catholic Church, the Lutheran Church, and the Assemblies of God. Young people were ambivalent toward sexual contacts since these generally were expected to be part of a relationship even though the church condemns premarital sex. Girls perceived the moral norms to concern them more than the boys for whom sexual needs were more accepted. These moral barriers lead to lack of information about protection and may increase the risk of HIV. The realities young people facing should be a major concern for the faith communities.

  • 13.
    Hamed, Sarah
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Ahlberg, Beth Maina
    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).
    Trenholm, Jill E.
    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).
    Powerlessness, Normalization, and Resistance: A Foucauldian Discourse Analysis of Women’s Narratives On Obstetric Fistula in Eastern Sudan2017In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 27, no 12, p. 1828-1841Article in journal (Refereed)
    Abstract [en]

    Eastern Sudan has high prevalence of female circumcision and child marriage constituting a risk for developing obstetric fistula. Few studies have examined gender roles’ relation with obstetric fistula in Sudan. To explore the associated power-relations that may put women at increased risk for developing obstetric fistula, we conducted nine interviews with women living with obstetric fistula in Kassala in eastern Sudan. Using a Foucauldian discourse analysis, we identified three discourses: powerlessness, normalization, and covert resistance. Existing power-relations between the women and other societal members revealed their internalization of social norms as absolute truth, and influenced their status and decision-making power in regard to circumcision, early marriage, and other transformative decisions as well as women’s general behaviors. The women showed subtle resistance to these norms and the harassment they encountered because of their fistula. These findings suggest that a more in-depth contextual assessment could benefit future maternal health interventions.

  • 14.
    Kaime-Atterhög, Wanjiku
    et al.
    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).
    Persson, Lars-Åke
    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).
    Ahlberg, Beth Maina
    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).
    “With An Open Heart We Receive the Children”: Caregivers’ strategies for reaching and caring for street children in Kenya2017In: Journal of Social Work, ISSN 1468-0173, E-ISSN 1741-296X, Vol. 17, no 5, p. 579-598Article in journal (Refereed)
    Abstract [en]

    Summary:

    The aim of the study was to explore how caregivers reach out and care for street children and understand their strategies and implication for outreach to the children, removal from the streets, rehabilitation and reintegration into society..  Data was collected over a period of two years using a semi-structured topic guide from seventy caregivers in 35 organisations in Kenya, identified using the snowball sampling strategy. Information generated was discussed with street children to help modify the interview and observation guides. To record interactions between the children and their caregivers, direct observation, video recording and photography were used at the caregivers’ workplaces on the streets and at institutions of care.

    Findings:

    Two themes were developed from the data, namely, the dedicated caregiver confronting street realities; and making a difference despite the limitations. The way caregivers interacted with the children on the streets and in the institutions greatly influenced the children’s decision to leave the streets, to be initiated into residential care, and attend rehabilitation and reintegration programmes. Children were more positive to caregivers who took time to understand them and were soft in establishing rapport with them.

    Application:

    The results suggest that caregivers’ strategies are potential contributors to declining trends of the street children phenomenon as they influence the children’s decision to leave the streets and undergo rehabilitation at institutions of care. Thus, we recommend the development of educational efforts focusing on helping caregivers develop healthy relationships and positive interactions with the children.

  • 15.
    Kalengayi, Faustine K. Nkulu
    et al.
    Umea Univ, Dept Publ Hlth & Clin Med, Div Epidemiol & Global Hlth, SE-90187 Umea, Sweden..
    Hurtig, Anna-Karin
    Umea Univ, Dept Publ Hlth & Clin Med, Div Epidemiol & Global Hlth, SE-90187 Umea, Sweden..
    Nordstrand, Annika
    Publ Hlth Ctr Norbotten Cty Council, Lulea, Sweden..
    Ahlm, Clas
    Umea Univ, Dept Clin Microbiol, Div Infect Dis, SE-90187 Umea, Sweden..
    Ahlberg, Beth M.
    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). Skaraborg Inst Res & Dev, Skovde, Sweden..
    'It is a dilemma': perspectives of nurse practitioners on health screening of newly arrived migrants2015In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 8, article id 27903Article in journal (Refereed)
    Abstract [en]

    Background: Screening newly arrived migrants from countries with high burden of communicable diseases of public health significance is part of the Swedish national strategy against the spread of these diseases. However, little is known about its implementation. Objective: This study aimed at exploring caregivers' experiences in screening newly arrived migrants to generate knowledge that could inform policy and clinical practice. Design: Using an interpretive description framework, we conducted semistructured interviews between November and December 2011 in four Swedish counties, with 15 purposively selected nurses with experience in screening migrants. Data were analyzed using thematic analysis. Results: Participants described a range of challenges including discordant views between migrants and the nurses about medical screening, inconsistencies in rules and practices, and conflicting policies. Participants indicated that sociocultural differences resulted in divergent expectations with migrants viewing the participants as agents of migration authorities. They also expressed concern over being given a new assignment without training and being expected to share responsibilities with staff from other agencies without adequate coordination. Finally, they indicated that existing policies can be confusing and raise ethical issues. All these were compounded by language barriers, making their work environment extremely complex and stressful. Conclusions: These findings illuminate complex challenges that could limit access to, uptake, and delivery of health screening and undermine public health goals, and highlight the need for a multilevel approach. This entails avoiding the conflation of migration with health issues, harmonizing existing policies to make health care services more accessible and acceptable to migrants, and facilitating health professionals' work in promoting public health, improving interagency collaboration and the skills of all staff involved in understanding and effectively responding to migrants' needs, and improving migrants' health literacy through community outreach interventions.

  • 16.
    Kalengayi, Faustine Kyungu Nkulu
    et al.
    Umea Univ, Div Epidemiol & Global Hlth, Dept Publ Hlth & Clin Med, SE-90187 Umea, Sweden..
    Hurtig, Anna-Karin
    Umea Univ, Div Epidemiol & Global Hlth, Dept Publ Hlth & Clin Med, SE-90187 Umea, Sweden..
    Nordstrand, Annika
    Norrbotten Cty Council, Publ Hlth Ctr, SE-97189 Lulea, Sweden..
    Ahlm, Clas
    Umea Univ, Dept Clin Microbiol, Div Infect Dis, SE-90187 Umea, Sweden..
    Ahlberg, Beth Maina
    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). Skaraborg Inst Res & Dev, SE-54130 Skovde, Sweden..
    Perspectives and experiences of new migrants on health screening in Sweden2016In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 16, article id 14Article in journal (Refereed)
    Abstract [en]

    Background: In Sweden, migrants from countries considered to have a high burden of certain infectious diseases are offered health screening to prevent the spread of these diseases, but also identify their health needs. However, very little is known about their experiences and perceptions about the screening process. This study aimed at exploring these perceptions and experiences in order to inform policy and clinical practice. Method: Using an interpretive description framework, 26 new migrants were interviewed between April and June 2013 in four Swedish counties. Thematic analysis was used to analyze data. Results: The three themes developed include: new country, new practices; new requirements in the new country; and unmet needs and expectations. Participants described what it meant for them to come to a new country with a foreign language, new ways of communicating with caregivers/authorities and being offered health screening without clarification. Participants perceived health screening as a requirement from the authorities to be fulfilled by all newcomers but conceded that it benefits equally the host society and themselves. However, they also expressed concern over the involvement of the Migration Board staff and feared possible collaboration with health service to their detriment. They further stated that the screening program fell short of their expectations as it mainly focused on identifying infectious diseases and overlooked their actual health needs. Finally, they expressed frustration over delay in screening, poor living conditions in reception centers and the restrictive entitlement to care. Conclusions: Migrants are aware of their vulnerability and the need to undergo health screening though they view it as an official requirement. Thus, those who underwent the screening were more concerned about residency rather than the actual benefits of screening. The issues highlighted in this study may limit access to and uptake of the screening service, and compromise its effectiveness. To maximize the uptake: (1) linguistically and culturally adapted information is needed, (2) other screening approaches should be tried, (3) trained medical interpreters should be used, (4) a holistic and human right approach should be applied, (5) the involvement of migration staff should be reconsidered to avoid confusion and worries. Finally, to improve the effectiveness, (6) all migrants from targeted countries should be offered screening and efforts should be taken to improve the health literacy of migrants and the living conditions in reception centers.

  • 17.
    Kubai, Anne
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, The Hugo Valentin Centre. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Department of Theology, Church and Mission studies, Science of Mission.
    Ahlberg, Beth Maina
    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).
    Making and unmaking ethnicities in the Rwandan context: implication for gender-based violence, health, and wellbeing of women2013In: Ethnicity and Health, ISSN 1355-7858, E-ISSN 1465-3419, Vol. 18, no 5, p. 469-482Article in journal (Refereed)
    Abstract [en]

    Objectives

    To examine ethnicity and gender violence in Rwanda from cultural and historical perspectives and explore the encounters between cultural beliefs and practices and the new gender equality policy and programs and the implications of the particular encounters to the health of women.

    Design

    The study is a qualitative drawing from the growing range of interactive approaches and methods within an ethnographic framework of the research design. Twenty individual interviews, six focus group discussions and two 'community mobilization' dialogs were conducted.

    Results

    Violence has continued and there is a conflict between cultural tradition, the de-ethnicization, and gender equality policies. Some of the gender violence preventive programs are influenced by the ethos of the traditional norms, and therefore unwittingly perpetuate gender-based violence.

    Conclusions

    In spite of the progress that Rwanda has made in political empowerment of women, it still seems a long way before real gender equality is achieved. It seems that women's empowerment is not only just an opportunity for political participation but also this is important. It is also about the capacity to make effective choices and to translate them into desired actions and outcomes, unfettered by cultural sanctions. Universalised, top-down gender policy programs have not furnished all women with the necessary capacity to make decisions that affect their traditionally all important reproductive functions; to challenge the embedded gender imbalance; and to strive for a holistic wellbeing of their families, where they play a central role. Indeed, some of the policies could have negative implications to the health of women, in particular, with sexually transmitted infections, including HIV and AIDS.

  • 18.
    Mathole, Thubelihle
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
    Lindmark, Gunilla
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
    Ahlberg, Beth Maina
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
    Knowing but not knowing: providing maternity care in the contest of HIV/AIDS in rural Zimbabwe2006In: African Journal of AIDS Res, Vol. 5, no 2, p. 133-139Article in journal (Refereed)
  • 19.
    Njoroge, Kezia M.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Olsson, Pia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Pertet, Ann M.
    Ahlberg, Beth Maina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Voices unheard: Youth and sexuality in the wake of HIV prevention in Kenya2010In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 1, no 4, p. 143-148Article in journal (Refereed)
    Abstract [en]

    Objective

    The aim of the study was to explore the concerns of young people on sexuality in its social contexts in the era of HIV/AIDS in three districts in Kenya.

    Study design

    Young people in Kajiado, Kirinyaga and Meru Districts were requested to write questions on sexuality and related problems that later formed the basis for discussion in community dialogue meetings with adults. The social ecological conceptual model (SEM) was used to illuminate the contextual factors and actors influencing sexual behaviours among young people.

    Results

    The study suggests that young people and adults are concerned about honest and open communication on sexuality. Predominant concerns for the young people were love, sexual urge, desires or sexual wellness and condom use. Their questions suggest that young people are sexually active, yet have little knowledge on sexual matters. The results describe a prohibitive silence from adults, an issue reflected in the questions from the school youth.

    Conclusion

    This study suggests the need to move from seeing sexuality as a problem and focus on sexual wellness and the positive aspects of sexuality. The adult participants suggested that bringing men and women together for reflection and discussion in a participatory mode, transformative learning and change could be achieved. It is vital that the youth and adults have open communication as a foundation for youth to mature into adults. This can be achieved, if interventions including research address multiple contextual factors such as cultural norms, gender differences, as well as communication barriers.

  • 20.
    Njue, Carolyne
    et al.
    Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
    Voeten, Helene
    Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
    Ahlberg, Beth Maina
    Skarborg Institute for Research and Development, Skövde, Sweden.
    ‘Youth in a void’: sexuality, HIV/AIDSand communication in Kenyan publicschools2011In: Sex Education: Sexuality, Society and Learning, ISSN 1468-1811, E-ISSN 1472-0825, Vol. 11, no 4, p. 459-470Article in journal (Refereed)
  • 21.
    Nkulu Kalengayi, Faustine Kyungu
    et al.
    Dept of Public Health and Clinical Medicine, Division of Epidemiology and Global Health, Umeå University, Sweden.
    Hurtig, Anna-Karin
    Dept of Public Health and Clinical Medicine, Division of Epidemiology and Global Health, Umeå University, Sweden.
    Ahlm, Clas
    Dept of Clinical Microbiology, Division of Infectious Diseases, Umeå University, Sweden.
    Ahlberg, Beth Maina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    "It is a challenge to do it the right way": an interpretive description of caregivers' experiences in caring for migrant patients in Northern Sweden2012In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 12, no 1, p. 433-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Experiences from nations with population diversity show extensive evidence on the need for cultural and linguistic competence in health care. In Sweden, despite the increasing diversity, only few studies have focused on challenges in cross-cultural care. The aim of this study was to explore the perspectives and experiences of caregivers in caring for migrant patients in Northern Sweden in order to understand the challenges they face and generate knowledge that could inform clinical practice.

    METHODS:

    We used an interpretive description approach, combining semi-structured interviews with 10 caregivers purposively selected and participant observation of patient-provider interactions in caring encounters. The interviews were transcribed and analyzed using thematic analysis approach. Field notes were also used to orient data collection and confirm or challenge the analysis.

    RESULTS:

    We found complex and intertwined challenges as indicated in the three themes we present including: the sociocultural diversity, the language barrier and the challenges migrants face in navigating through the Swedish health care system. The caregivers described migrants as a heterogeneous group coming from different geographical areas but also having varied social, cultural and religious affiliations, migration history and status all which influenced the health care encounter, whether providing or receiving. Participants also described language as a major barrier to effective provision and use of health services. Meanwhile, they expressed concern over the use of interpreters in the triad communication and over the difficulties encountered by migrants in navigating through the Swedish health care system.

    CONCLUSIONS:

    The study illuminates complex challenges facing health care providers caring for migrant populations and highlights the need for multifaceted approaches to improve the delivery and receipt of care. The policy implications of these challenges are discussed in relation to the need to (a) adapt care to the individual needs, (b) translate key documents and messages in formats and languages accessible and acceptable to migrants, (c) train interpreters and enhance caregivers' contextual understanding of migrant groups and their needs, (d) and improve migrants' health literacy through strategies such as community based educational outreach.

  • 22.
    Nor, Barni
    et al.
    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).
    Ahlberg, Beth Maina
    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).
    Doherty, Tanya
    Zembe, Yanga
    Jackson, Debra
    Ekström, Eva-Charlotte
    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).
    Mother's perceptions and experiences of infant feeding within a community-based peer counselling intervention in South Africa2012In: Maternal and Child Nutrition, ISSN 1740-8695, E-ISSN 1740-8709, Vol. 8, no 4, p. 448-458Article in journal (Refereed)
    Abstract [en]

    Exclusive breastfeeding (EBF) has the potential to significantly reduce infant mortality, but is frequently not practiced in low-income settings where infants are vulnerable to malnutrition and infections including human immunodeficiency virus (HIV). This study explores mothers' experiences of infant feeding after receiving peer counselling promoting exclusive breast or formula feeding. This qualitative study was embedded in a cluster randomized peer counselling intervention trial in South Africa that aimed to evaluate the effect of peer counselling on EBF. Participants were selected from the three districts that were part of the trial reflecting different socio-economic conditions, rural–urban locations and HIV prevalence rates. Seventeen HIV-positive and -negative mothers allocated to intervention clusters were recruited. Despite perceived health and economic benefits of breastfeeding, several barriers to EBF remained, which contributed to a preference for mixed feeding. The understanding of the promotional message of ‘exclusive’ feeding was limited to ‘not mixing two milks’: breast or formula and did not address early introduction of foods and other liquids. Further, a crying infant or an infant who did not sleep at night were given as strong reasons for introducing semi-solid foods as early as 1 month. In addition, the need to adhere to the cultural practice of ‘cleansing’ and the knowledge that this practice is not compatible with EBF appeared to promote the decision to formula feed in HIV-positive mothers. Efforts to reduce barriers to EBF need to be intensified and further take into account the strong cultural beliefs that promote mixed feeding.

  • 23.
    Puthoopparambil, Soorej Jose
    et al.
    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). Uppsala university.
    Ahlberg, Beth Maina
    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).
    Bjerneld, Magdalena
    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).
    €œA prison with extra flavours : Experiences of immigrants in Swedish immigration detention centres2015In: International Journal of Migration, Health and Social Care, ISSN 1747-9894, E-ISSN 2042-8650, Vol. 11, no 2, p. 73-85Article in journal (Refereed)
  • 24.
    Puthoopparambil, Soorej Jose
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Ahlberg, Beth Maina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Bjerneld, Magdalena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Do higher standards of detention promote well-being?2013Other (Other (popular science, discussion, etc.))
  • 25.
    Puthoopparambil, Soorej Jose
    et al.
    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).
    Ahlberg, Beth Maina
    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).
    Bjerneld, Magdalena
    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).
    "It is a thin line to walk on": challenges of staff working at Swedish immigration detention centres2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, p. 25196-Article in journal (Refereed)
    Abstract [en]

    Detention of irregular migrants awaiting deportation is widely practiced in many countries and has been shown to have profound negative impact on health and well-being of detainees. Detention staff, an integral part of the detention environment, affect and are affected by detainees' health and well-being. The objective of the study was to explore experiences of staff working at Swedish immigration detention centres. Fifteen semi-structured interviews were conducted with staff in three Swedish detention centres and were analysed using thematic analysis. The results indicate that the main challenge for the staff was to manage the emotional dilemma entailed in working as migration officers and simultaneously fellow human beings whose task was to implement deportation decisions while being expected to provide humane service to detainees. They tried to manage their dilemma by balancing the two roles, but still found it challenging. Among the staff, there was a high perception of fear of physical threat from detainees that made detention a stressful environment. Limited interaction between the staff and detainees was a reason for this. There is thus a need to support detention staff to improve their interaction with detainees in order to decrease their fear, manage their emotional dilemma, and provide better service to detainees. It is important to address staff challenges in order to ensure better health and well-being for both staff and detainees.

  • 26.
    Trenholm, Jill E.
    et al.
    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).
    Olsson, Pia
    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).
    Ahlberg, Beth Maina
    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).
    Battles on women's bodies: War, rape and traumatisation in eastern Democratic Republic of Congo2011In: Global Public Health, ISSN 1744-1692, E-ISSN 1744-1706, Vol. 6, no 2, p. 139-152Article in journal (Refereed)
    Abstract [en]

    Rape has been used as a weapon in the conflict in eastern Democratic Republic of Congo (DRC) in unprecedented ways. Research into the phenomenon of war-rape is limited, particularly in this context. The aim of this study was to explore perceptions of local leaders in eastern DRC concerning rape and raped women in the war context. Local leaders were chosen for their ability to both reflect and influence their constituencies. Interviews were conducted with 10 local leaders and transcripts subjected to qualitative content analysis. The study suggests that mass raping and the methods of perpetration created a chaos effectively destroying communities and the entire society and that humanitarian aid was often inappropriate. Furthermore, an exclusive focus on raped women missed the extent of traumatisation entire communities suffered. More significantly, the lack of political will, corruption, greed and inappropriate aid creates a tangled web serving to intensify the war. This complexity has implications for humanitarian interventions including public health.

  • 27.
    Trenholm, Jill
    et al.
    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). Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Centre for Gender Research.
    Olsson, Pia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Blomqvist, Martha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Centre for Gender Research.
    Ahlberg, Beth Maina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Constructing Soldiers from Boys in Eastern Democratic Republic of Congo2013In: Men and Masculinities, ISSN 1097-184X, E-ISSN 1552-6828, Vol. 16, no 2, p. 203-227Article in journal (Refereed)
    Abstract [en]

    This study is part of an ethnography focusing on war rape in eastern Democratic Republic of Congo where child soldiers are both victims and perpetrators of violence. Twelve ex-child soldier boys, aged thirteen to eighteen years, from a reintegration facility were interviewed about their soldiering experiences and their perspectives on sexual violence. Transcripts were analyzed using thematic analysis. Conceptual frameworks of militarized masculine identity and gender-based violence guided the process. Results revealed the systematic and violent construction of children into soldiers, inculcating a "militarized masculinity"; a rigid set of stereotypical hypermasculinized behaviors promoting dominance by violating, sexually and otherwise, the subordinate "other." This was achieved through terrorizing/coercing, use of indigenous preparations, substance abuse, and forbidden reflection. This article presents a more contextualized complex view of the violent perpetrator whose behaviors are a manifestation of the modes and mechanisms in which society has constructed/reconstructed gender, ethnicity, and class, and the power dynamics therein.

  • 28.
    Trenholm, Jill
    et al.
    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).
    Olsson, Pia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Blomqvist, Martha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Centre for Gender Research.
    Ahlberg, Beth Maina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    The global, the ethnic and the gendered war: women and rape in eastern Democratic Republic of Congo2016In: Gender, Place and Culture: A Journal of Feminist Geography, ISSN 0966-369X, E-ISSN 1360-0524, Vol. 23, no 4, p. 484-502Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to illuminate the perspectives of women who experienced sexual violence perpetrated in the warscapes of eastern Democratic Republic of Congo. Civilians are targeted for rape, loot and pillage yielding deleterious effects on the social fabric and the sustenance the community provides. The article is based on 11 qualitative semistructured interviews and 4 written narratives from women of reproductive age, recruited from organizations providing support post-sexual violation. The study departs from a larger ethnographic project investigating the phenomenon of war-rape. Thematic analysis guided the analysis through the theoretical lenses of structural violence and intersectionality. The women expressed total insecurity and a multitude of losses from bodily integrity, health, loss of family, life course possibilities, livelihoods and a sense of place; a profound dispossession of identity and marginalization. Pregnancies resulting from rape reinforced stigma and burdened the survivor with raising a stigmatized child on the margins of society. Perpetrators of rape were mostly identified as Interhamwe (Rwandan Hutus rebels) who entered Congo after the Rwandan genocide in 1994. Their goal, according to the women, was to spread HIV and impregnate Congolese women, thereby destroying families, communities and society. The women survivors of war-rape described experiences of profound loss in this conflict which has global, ethnic and gendered dimensions. Congo's conflict thus requires critical reflection on how local wars and subsequent human suffering are situated in a matrix of globalization processes, enabled by transnational actors and embedded in structural violence.

  • 29.
    Trenholm, Jill
    et al.
    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). Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Centre for Gender Research.
    Olsson, Pia
    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).
    Blomqvist, Martha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Centre for Gender Research.
    Bitenga, Ali
    Panzi Hospital.
    Maina-Ahlberg, Beth
    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). Skaraborg Institute for Research and Development.
    Against all odds:: Women Survivors of Sexual Violence in the War in Eastern Democrtic Republic of CongoManuscript (preprint) (Other academic)
    Abstract [en]

    This study is part of an ethnographic focus on the phenomena of war rape in eastern Democratic Republic of Congo. Its purpose was to explore and illuminate how women survivors of sexual violence navigated and negotiated “survive-ing” in the stigmatized margins of an already impoverished existence. The paper departs from a previous study where women expressed multiple losses and profound dispossession of identity with subsequent marginalization often with a child born of rape in tow.

    The findings are based on eleven qualitative in-depth interviews with rural women of reproductive age recruited from a variety of organizations supporting women after sexual violation. Thematic analysis and Payne’s theoretical framework concerning sites of resilience guided the analysis. Results indicated how the women exhibited agency, proactive decisions and resilience in severely compromised environments embedded in a larger oppressive complexity. Their faith in God, limited health interventions that challenge cultural understandings around sexuality, indigenous healing, and strategic alliances, ie aid organizations or survival sex supported these women to manage their daily existence in the margins. These survival strategies are identified as sites of resilience and are vital contextual knowledge for planning effective interventions. The findings suggest that strengthening collaboration between existing networks such as the church, healthcare and indigenous healing practices would extend the reach of health services, offering more sustainable holistic care and in effect, better serve the needs of sexual violated individuals but as well the entire community, subjected to mass traumatization.

1 - 29 of 29
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