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  • 1.
    Abdulcadir, Jasmine
    et al.
    Outpatient Clinic for Women with FGM/C, Department of Obstetric and Gynecology, Geneva University Hospitals.
    Abdulcadir, Omar
    Referral Centre for Preventing and Curing Female Genital Mutilation, Department of Maternal and Child Health, Careggi University Hospital, Florence, Italy.
    Caillet, Martin
    Outpatient Clinic for Women with FGM/C, Department of Obstetric and Gynecology, Geneva University Hospitals.
    Catania, Lucrezia
    Referral Centre for Preventing and Curing Female Genital Mutilation, Department of Maternal and Child Health, Careggi University Hospital, Florence, Italy.
    Cuzin, Béatrice
    Division of Urology and Transplantation, Edouard Herriot Hospital, Lyon, France.
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Foldès, Pierre
    Institute of Reproductive Health, Saint Germain en Laye, Paris, France.
    Johnsdotter, Sara
    Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Johnson-Agbakwu, Crista
    Refugee Women's Health Clinic, Obstetrics & Gynecology, Maricopa Integrated Health System.
    Nour, Nawal
    Global Ob/Gyn and African Women's Health Center, Ambulatory Obstetrics, Office for Multicultural Careers, Division of Global Obstetrics and Gynecology, Brigham and Women's Hospital.
    Ouedraogo, Charlemagne
    University Hospital Yalgado Ouedraogo of Ouagadougou, Ouagadougou, Burkina Faso.
    Warren, Nicole
    Department of Community Public Health Nursing, John Hopkins School of Nursing, Baltimore, MD, USA.
    Wylomanski, Sophie
    Department of Gynecology and Obstetrics, Nantes University Hospital, Nantes, France.
    Clitoral Surgery After Female Genital Mutilation/Cutting2017In: Aesthetic surgery journal, ISSN 1090-820X, E-ISSN 1527-330X, Vol. 37, no 9, p. NP113-NP115Article in journal (Other academic)
  • 2.
    Allvin, Marie Klingberg
    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), International Maternal and Reproductive Health and Migration.
    Atuhairwe, S
    Cleeve, A
    Byamugisha, J K
    Larsson, Elin C.
    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), International Maternal and Reproductive Health and Migration.
    Makenzius, M
    Oguttu, M
    Gemzell-Danielsson, K
    Co-creation to scale up provision of simplified high-quality comprehensive abortion care in East Central and Southern Africa.2018In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 11, no 1, article id 1490106Article in journal (Refereed)
    Abstract [en]

    Universal access to comprehensive abortion care (CAC) is a reproductive right and is essential to reduce preventable maternal mortality and morbidity. In East Africa, abortion rates are consistently high, and the vast majority of all abortions are unsafe, significantly contributing to unnecessary mortality and morbidity. The current debate article reflects and summarises key action points required to continue to speed the implementation of and expand access to CAC in the East, Central, and Southern African (ECSA) health community. To ensure universal access to quality CAC, a regional platform could facilitate the sharing of best practices and successful examples from the region, which would help to visualise opportunities. Such a platform could also identify innovative ways to secure women's access to quality care within legally restrictive environments and would provide information and capacity building through the sharing of recent scientific evidence, guidelines, and training programmes aimed at increasing women's access to CAC at the lowest effective level in the healthcare system. This type of infrastructure for exchanging information and developing co-creation could be crucial to advancing the Sustainable Development Goals 2030 agenda.

  • 3.
    Arousell, J.
    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), International Maternal and Reproductive Health and Migration.
    Carlbom, A.
    Malmö Univ, Fac Hlth & Soc, Malmö, Sweden.
    Larsson, Elin
    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), International Maternal and Reproductive Health and Migration.
    Johnsdotter, S.
    Malmö Univ, Fac Hlth & Soc, Malmö, Sweden.
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Unintended consequences of gender equality promotion in Swedish contraceptive counselling2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Supplement: 1, p. 105-105Article in journal (Other academic)
  • 4.
    Arousell, Jonna
    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), International Maternal and Reproductive Health and Migration.
    Carlbom, A.
    Malmö Univ, Fac Hlth & Soc, Malmö, Sweden..
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Is multiculturalism bad for swedish abortion care?: Exploring the diversity of religious counselling in public healthcare institutions2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no 1, p. 122-122Article in journal (Other academic)
    Abstract [en]

    Background:

    Sweden has one of the most liberal abortion laws in the world, granting women extensive rights to make autonomous reproductive decisions. At the same time, Swedish policy-makers are keen to protect society’s religious diversity. This ambition is reflected in decisions to grant religious leaders the possibility to provide ‘spiritual care’ in public hospitals. Through interviews with religious representatives in public healthcare institutions, we asked: In what ways would they counsel a religious woman who is seeking their advice about abortion? And how does this advice correspond with Swedish policies on, and provision of, abortion care?

    Methods:

    Individual interviews were conducted with religious representatives of the Swedish Church, the Catholic Church, and the Buddhist and Muslim communities. Interviews took place in 2016 and 2017.

    Findings:

    We found that informants saw it as their obligation to provide religious people with abortion advice according to religious norms, giving them limited opportunities to harmonise the content of their counselling with Swedish healthcare laws or regulations. Most informants argued that it was their responsibility to inform women about the wrongdoing of terminating a pregnancy, and to provide suggestions about how women could mitigate the sin in order to gain God’s forgiveness.

    Conclusion:

    Informants appeared inclined to deliver religious recommendations on abortion that were more conservative than what is established in the Swedish Abortion Act.

    Main messages:

    • ‘Spiritual care’ in the question of abortion favours the delivery of religious norms at the possible expense of women’s right to non-judgmental abortion counselling.

    • ‘Spiritual care’ is now an integral part of Swedish healthcare institutions. A critical discussion is needed about the extent to which such services should be in compliance with Swedish laws and public health aims on abortion.

  • 5.
    Arousell, Jonna
    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), International Maternal and Reproductive Health and Migration.
    Carlbom, A.
    Malmö Univ, Fac Hlth & Soc, Malmö, Sweden..
    Johnsdotter, S.
    Malmö Univ, Fac Hlth & Soc, Malmö, Sweden..
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Are 'Low Socioeconomic Status' and 'Religiousness' barriers to minority women's contraceptive use in Sweden and Denmark?: A qualitative interrogation of a common argument in health research2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 121-121Article in journal (Other academic)
  • 6.
    Axemo, Pia
    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), International Maternal and Reproductive Health and Migration.
    Wijwardena, Kumudu
    Department of Community Medicine Health, University of Sri Jayewardenepura, Colombo.
    Fonseka, Ruvani
    Joint Doctoral Program in Public Health, University of California, San Diego/San Diego State University, United States of America.
    Cooray, Sharika
    United Nations Population Fund, Colombo, Sri Lanka.
    Darj, Elisabeth
    Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
    Training university teachers and students in Sri Lanka on Gender Based Violence: testing of a participatory training program2018In: MedEdPublisher, ISSN 2312–7996Article in journal (Refereed)
    Abstract [en]

    In all societies, violence is a social problem and violation of human rights. Changing attitudes and behaviors, which accept violence atindividual and societal levels are key components in prevention strategies.

    The aim of this study was to produce educational material on Gender Based Violence (GBV). A participatory study design including educators and university students was used to create four teaching modules. The teaching was evaluated by descriptive surveys before andafter the training and focus group discussions followed the training session. The questionnaire covered attitudes to gender, violence and laws. One hundred eleven teachers and 25 students representing different faculties and universities participated in separate workshops in three Sri Lankan universities. The students lacked knowledge of the meaning of GBV, consequences and existing laws. Women held more gender-equitable attitudes. Both women and men favoured equal participation of work and decision in the households. Male undergraduates showed less accepting attitudes toward rape or blaming women for rape Three categories emerged after the FGDs; Maketraining module compulsory and teacher led; Mind your own business; What can be done.

    The newly prepared and context specific material was well-received by educators and students and they provided valuable inputs, which improved the educational modules.

  • 7.
    Bergström, Anna
    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), International Child Health and Nutrition.
    Ugarte Guevara, William J.
    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), International Maternal and Reproductive Health and Migration.
    Eustachio Colombo, Patricia
    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), International Child Health and Nutrition.
    Knowledge about Sexual and Reproductive Health among School Enrolled Adolescents in Tololar, Nicaragua, A Cross-Sectional Study2018In: Journal of Public Health International, Vol. 1, no 2, p. 27-38Article in journal (Refereed)
    Abstract [en]

    Background: Nicaragua has the highest prevalence of teenage pregnancies in Latin America. Knowledge regarding sexual and reproductive health plays an integral part in sexual behavior. The objective was to assess school going adolescents' knowledge about sexual and reproductive health and possible factors affecting it in the semi-rural community of Tololar, Nicaragua.

    Methods: A cross-sectional study with a self-administered questionnaire on tablets was used for data collection. All 253 registered students at the school present at the time of fieldwork who gave written informed consent were deemed eligible for the study. A total of 225 participants in the ages of 11-19 years were included. Simple linear regression and multiple linear regression were performed analyzing the outcome knowledge. A p-value <0.05 was considered significant.

    Results: The general knowledge about sexual and reproductive health was moderate; however, knowledge gaps were found such as prevailing myths and poor knowledge regarding human immunodeficiency virus (hiv) transmission and contraceptive methods. Being female and single were significant negative determinants of knowledge (p-value < 0.01) and knowledge increased significantly with age (p-value < 0.05). School teachers, websites, social networks, and TV were the most frequently chosen sources of information on the topic.

    Conclusions: Increased education on sexual and reproductive health with new interventions particularly for young females is recommended. Using IT-based materials as a complement may be an effective way to reach out to adolescents.

  • 8.
    Berhane, Hanna Y
    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), International Child Health and Nutrition.
    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), International Child Health and Nutrition.
    Jirström, Magnus
    Berhane, Yemane
    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), International Child Health and Nutrition.
    Turner, Christopher
    Alsanius, Beatrix W
    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), International Maternal and Reproductive Health and Migration.
    Mixed blessings:: A qualitative exploration of mothers' experience of child care and feeding in the rapidly urbanizing city of Addis Ababa, Ethiopia2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 11, article id e0207685Article in journal (Refereed)
    Abstract [en]

    Many studies have drawn attention to the vital role mothers have in safeguarding the health and nutritional wellbeing of their children. However, little is known about mothers' experiences and the challenges they face in fulfilling this role in rapidly urbanizing cities in Africa. This study aims to explore child care and feeding practices of mothers with children under five years of age in Addis Ababa, Ethiopia. This qualitative study was conducted using a semi-structured interview guide. A total of thirty-six interviews were conducted with purposively selected participants. All interviews were audio recorded, transcribed verbatim and translated for analysis. We used a thematic analysis approach, which was guided by a resilience framework. The findings are presented as three major themes. 1) 'Mixed blessings-balancing motherhood's expectations'. While mothers identified positively with the social recognition and sense of fulfillment of being a 'good mother', they were ambivalent/torn about earning the necessary income from outside work and fulfilling their duties at home. 2) 'Instabilities due to rampant urban sprawl'. While women expressed a keen desire to balance work and motherhood, the disintegrating social capital, due to large in-migration, market fluctuations and abrupt/forced resettlements to new housing units had left mothers without support for childcare, stressed and exhausted. 3) 'Anchored by faith: a source of resilience to cope with adversities'. In the face of the multiple adversities, mothers cited their strong faith as their most reliable foundation for their resilience. In summary, the societal and environmental changes accompanying the rapid urbanization in low income settings makes combining child care and working outside the home very challenging for mothers. As a result they suffer from fatigue and feelings of isolation. Efforts to improve child feeding and care in urban low-income settings need to consider context appropriate strategies that support mothers with small children.

  • 9.
    Berhane, Hanna Y
    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), International Child Health and Nutrition. Addis Continental Inst Publ Hlth, Addis Ababa 267511000, Ethiopia.
    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), International Child Health and Nutrition.
    Jirström, Magnus
    Lund Univ, Dept Human Geog, S-22362 Lund, Sweden.
    Berhane, Yemane
    Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia.
    Turner, Christopher
    Lund Univ, Dept Human Geog, S-22362 Lund, Sweden;London Sch Hyg & Trop Med, London WC1E 7HT, England.
    Alsanius, Beatrix W
    Swedish Univ Agr Sci, Dept Biosyst & Technol, S-23053 Alnarp, Sweden.
    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), International Maternal and Reproductive Health and Migration.
    What Influences Urban Mothers' Decisions on What to Feed Their Children Aged Under Five-The Case of Addis Ababa, Ethiopia2018In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 10, no 9, article id 1142Article in journal (Refereed)
    Abstract [en]

    Mothers carry the prime responsibility for childcare and feeding in low-income countries. Understanding their experiences in providing food for their children is paramount to informing efforts to improve the nutritional status of children. Such information is lacking in Sub-Saharan Africa. To understand what influences urban mothers' food acquisition and their motivations for selecting food for their children, 36 in-depth interviews were carried out with mothers having children under five years of age. Interviews were conducted in the local language, audio-recorded, transcribed, and translated into English. Data were analyzed using thematic analysis which led to the identification of four major themes: mothers give-in to a child-driven diet; quick-fix versus the privilege of planning; keen awareness on food safety, nutrition, and diet diversity; and social, familial, and cultural influences. The findings indicate that child feeding practices are influenced by interlinked social and environmental factors. Hence, nutrition education campaigns should focus on targeting not only families but also their children. Attention should also be given to food safety regulations, as well as to the much-needed support of mothers who are struggling to ensure their children's survival in low-income countries.

  • 10.
    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), International Maternal and Reproductive Health and Migration.
    What has happened during the last two decades?: A follow up study of unaccompanied Somali girls in Sweden2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Supplement: 1, p. 101-101Article in journal (Other academic)
  • 11.
    Bjerneld, Magdalena
    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), International Maternal and Reproductive Health and Migration.
    Ismail, Nima
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Puthoopparambil, Soorej Jose
    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), International Maternal and Reproductive Health and Migration.
    Experiences and reflections of Somali unaccompanied girls on their first years in Sweden: a follow-up study after two decades2018In: International Journal of Migration, Health and Social Care, ISSN 1747-9894, E-ISSN 2042-8650, Vol. 14, no 3, p. 305-317Article in journal (Refereed)
    Abstract [en]

    Purpose:

    Unaccompanied asylum-seeking children (UASC) from Somalia are one of the largest groups of UASC in Europe and Sweden. The current study is a follow-up of a Swedish study conducted in 1999, where unaccompanied asylum-seeking girls (UASG) from Somalia were interviewed. In 2013, UASG from the 1999 study were interviewed again, as adults who have settled and found a new life in Sweden. The purpose of this paper is to explore how these women experienced their transition into the Swedish society.

    Design/methodology/approach:

    A qualitative research design using semi-structured interviews was adopted for this descriptive study. Thematic analysis was used to analyze the data.

    Findings:

    UASG need support from different groups of adults, ranging from the staff at the group homes to community members, including countrymen, to establish a good life in their new country. The UASG need understanding and knowledgeable staff that can support them through the initial period, when they do not have their parents close to them. All actors in the supporter network need more knowledge about the difficulties in war situations. Former UASC can assist newcomers as well as being informants to authorities in a new country. Both parties involved need to be open and willing to learn from each other.

    Research limitations/implications:

    UASG who consider themselves successful in being integrated into the Swedish society were interviewed and, therefore, the study mainly describes aspects that promote integration.

    Originality/value:

    There are limited follow-up studies on how UASG have experienced their life after almost two decades in the new country.

  • 12. Brolin Ribacke, Kim J
    et al.
    van Duinen, Alex J
    Nordenstedt, Helena
    Höijer, Jonas
    Molnes, Ragnhild
    Froseth, Torunn Wigum
    Koroma, A P
    Darj, Elisabeth
    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), International Maternal and Reproductive Health and Migration.
    Bolkan, Håkon Angel
    Ekström, AnnaMia
    The Impact of the West Africa Ebola Outbreak on Obstetric Health Care in Sierra Leone.2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 2, article id e0150080Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: As Sierra Leone celebrates the end of the Ebola Virus Disease (EVD) outbreak, we can begin to fully grasp its impact on already weak health systems. The EVD outbreak in West Africa forced many hospitals to close down or reduce their activity, either to prevent nosocomial transmission or because of staff shortages. The aim of this study is to assess the potential impact of EVD on nationwide access to obstetric care in Sierra Leone.

    METHODS AND FINDINGS: Community health officers collected weekly data between January 2014-May 2015 on in-hospital deliveries and caesarean sections (C-sections) from all open facilities (public, private for-profit and private non-profit sectors) offering emergency obstetrics in Sierra Leone. This was compared to official data of EVD cases per district. Logistic and Poisson regression analyses were used to compute risk and rate estimates. Nationwide, the number of in-hospital deliveries and C-sections decreased by over 20% during the EVD outbreak. The decline occurred early on in the EVD outbreak and was mainly attributable to the closing of private not-for-profit hospitals rather than government facilities. Due to difficulties in collecting data in the midst of an epidemic, limitations of this study include some missing data points.

    CONCLUSIONS: Both the number of in-hospital deliveries and C-sections substantially declined shortly after the onset of the EVD outbreak. Since access to emergency obstetric care, like C-sections, is associated with decreased maternal mortality, many women are likely to have died due to the reduced access to appropriate care during childbirth. Future research on indirect health effects of health system breakdown should ideally be nationwide and continue also into the recovery phase. It is also important to understand the mechanisms behind the deterioration so that important health services can be reestablished.

  • 13. Emtell Iwarsson, Karin
    et al.
    Larsson, Elin C.
    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), International Maternal and Reproductive Health and Migration.
    Gemzell-Danielsson, Kristina
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Klingberg-Allvin, Marie
    Contraceptive use among migrant, second-generation migrant and non-migrant women seeking abortion care: a descriptive cross-sectional study conducted in Sweden.2019In: BMJ sexual & reproductive health, ISSN 2515-2009, article id bmjsrh-2018-200171Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The objective of this study was to compare ever-in life contraception use, use of contraception at current conception, and planned use of contraception after an induced abortion, among three groups of women: migrants, second-generation migrants and non-migrant women, and to compare the types of contraception methods used and intended for future use among the three groups of women.

    METHODS: The cross-sectional study administered a questionnaire face-to-face to women aged 18 years and older who were seeking abortion care at one of six abortion clinics in Stockholm County from January to April 2015.

    RESULTS: The analysis included 637 women. Migrants and second-generation migrants were less likely to have used contraception historically, at the time of the current conception, and to plan to use contraception after their induced abortion compared with non-migrant women. Historically, non-migrants had used pills (89%) and withdrawal (24%) while migrants had used the copper intrauterine device (24%) to a higher extent compared to the other two groups of women. Both the migrants (65%) and second-generation migrants (61%) were more likely than the non-migrants (48%) to be planning to use long-acting reversible contraception.

    CONCLUSIONS: Lower proportions of contraception use were found in migrants and second-generation migrants than in non-migrants. In addition, there were significant differences in the types of contraception methods used historically and intended for future use.

  • 14.
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Johnsdotter, Sara
    Malmo Univ, Malmo, Sweden..
    Is research data used in education for health professionals on management of Female Genital Cutting?: results from Sweden2017In: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 14, no S2, article id 5Article in journal (Other academic)
  • 15.
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Puthoopparambil, Soorej Jose
    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), International Maternal and Reproductive Health and Migration.
    Mosselmans, Luce
    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), International Maternal and Reproductive Health and Migration.
    Salzmann, Talia
    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), International Maternal and Reproductive Health and Migration.
    Improving the health care of pregnant refugee and migrant women and newborn children: Technical guidance2018Report (Other academic)
    Abstract [en]

    While the amplitude and direction of variations in outcomes differ between host countries, migrant origin/status and the outcome examined, there is a marked trend for worse pregnancy-related indicators among refugees and migrants. Being a migrant can be considered a risk factor in itself for poorer maternal and newborn health outcomes and also be a proxy for other risk factors and potential explanations. This technical guidance identifies problems and entry points for interventions for maternal and newborn health in refugees and migrants in the WHO European Region. Policy considerations are outlined for four main areas affecting refugee and migrant maternal and newborn health: individual health status, accessibility of health care, quality of care, and health care policy and financing systems.

  • 16. Fagerli, Tove Anita
    et al.
    Mogren, Ingrid
    Andolfsson, Annsofie
    Edvardsson, Kristina
    Åhman, Annika
    Holmlund, Sofie
    Darj, Elisabeth
    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), International Maternal and Reproductive Health and Migration.
    Eggebø M, Torbjørn
    Midwives’ and obstetricians’ views on appropriate obstetric sonography in Norway2017In: Sexual & Reproductive Health Care, ISSN 1877-5756Article in journal (Refereed)
  • 17.
    Hamed, Sarah
    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, International Maternal and Child Health (IMCH), International Maternal and Reproductive Health and Migration. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    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), International Maternal and Reproductive Health and Migration.
    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.

  • 18. Hargreaves, Sally
    et al.
    Rustage, Kieran
    Nellums, Laura
    Powis, Jaynaide
    Milburn, James
    Severoni, Santino
    Dara, Masoud
    Puthoopparambil, Soorej Jose
    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), International Maternal and Reproductive Health and Migration.
    Friedland, Jon
    What constitutes an effective and efficient package of services for the prevention, diagnosis, treatment and care of tuberculosis among refugees and migrants in the WHO European Region? Themed issues on migration and health, VIII2018Book (Refereed)
  • 19.
    Johnsdotter, Sara
    et al.
    Malmo Univ, Malmo, Sweden..
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    FGM alerts and expert assessments from healthcare providers: legal case analysis2017In: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 14, no S2, article id 3Article in journal (Other academic)
  • 20.
    Johnsdotter, Sara
    et al.
    Malmo Univ, Malmo, Sweden..
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    The increasing demand for reconstructive clitoral surgery among circumcised women living in Europe: A nexus analysis2017In: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 14, no S2, article id 7Article in journal (Other academic)
  • 21.
    KC, Ashish
    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), International Child Health and Nutrition. Health Section, UNICEF, UN House, Lalitpur, Nepal.
    Bergström, Anna
    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), International Child Health and Nutrition. Institute for Global Health, University College London, London, UK.
    Chaulagain, Dipak
    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), International Child Health and Nutrition. Lifeline Nepal, Kathmandu, Nepal.
    Brunell, Olivia
    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), International Child Health and Nutrition.
    Ewald, Uwe
    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), International Child Health and Nutrition.
    Gurung, Abhishek
    Lifeline Nepal, Kathmandu, Nepal.
    Eriksson, Leif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Litorp, Helena
    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), International Maternal and Reproductive Health and Migration.
    Wrammert, Johan
    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), International Child Health and Nutrition.
    Grönqvist, Erik
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Economics.
    Edin, Per-Anders
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Economics.
    Le Grange, Claire
    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), International Child Health and Nutrition.
    Lamichhane, Bikash
    Department of Health Services, Ministry of Health, Nepal.
    Shrestha, Parashuram
    Department of Health Services, Ministry of Health, Nepal.
    Pokharel, Amrit
    Department of Health Services, Ministry of Health, Nepal.
    Pun, Asha
    Health Section, UNICEF, UN House, Lalitpur, Nepal.
    Singh, Chahana
    Health Section, UNICEF, UN House, Lalitpur, Nepal .
    Målqvist, Mats
    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), International Child Health and Nutrition.
    Scaling up quality improvement intervention for perinatal care in Nepal (NePeriQIP); study protocol of a cluster randomised trial2017In: BMJ global health, Vol. 2, no 3, article id e000497Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Nepal Perinatal Quality Improvement Project (NePeriQIP) intends to scale up a quality improvement (QI) intervention for perinatal care according to WHO/National guidelines in hospitals of Nepal using the existing health system structures. The intervention builds on previous research on the implementation of Helping Babies Breathe-quality improvement cycle in a tertiary healthcare setting in Nepal. The objective of this study is to evaluate the effect of this scaled-up intervention on perinatal health outcomes.

    METHODS/DESIGN: Cluster-randomised controlled trial using a stepped wedged design with 3 months delay between wedges will be conducted in 12 public hospitals with a total annual delivery rate of 60 000. Each wedge will consist of 3 hospitals. Impact will be evaluated on intrapartum-related mortality (primary outcome), overall neonatal mortality and morbidity and health worker's performance on neonatal care (secondary outcomes). A process evaluation and a cost-effectiveness analysis will be performed to understand the functionality of the intervention and to further guide health system investments will also be performed.

    DISCUSSION: In contexts where resources are limited, there is a need to find scalable and sustainable implementation strategies for improved care delivery. The proposed study will add to the scarce evidence base on how to scale up interventions within existing health systems. If successful, the NePeriQIP model can provide a replicable solution in similar settings where support and investment from the health system is poor, and national governments have made a global pledge to reduce perinatal mortality.

    TRIAL REGISTRATION NUMBER: ISRCTN30829654.

  • 22.
    Larsson, Elin
    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), International Maternal and Reproductive Health and Migration. Karolinska Inst, Stockholm, Sweden.
    Emtell-Iwarsson, K.
    Karolinska Inst, Stockholm, Sweden.
    Gemzell-Danielsson, K.
    Karolinska Inst, Stockholm, Sweden.
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Klingberg-Allvin, M.
    Dalarna Univ, Falun, Sweden.
    Contraceptive use among immigrant and non-immigrant women seeking abortion care in Stockholm County, Sweden2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Supplement: 1, p. 103-103Article in journal (Other academic)
  • 23. Liyew, Ewnetu Firdawek
    et al.
    Yalew, Alemayehu Worku
    Afework, Mesganaw Fantahun
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Maternal near-miss and the risk of adverse perinatal outcomes: a prospective cohort study in selected public hospitals of Addis Ababa, Ethiopia.2018In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 18, article id 345Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Presence of maternal near-miss conditions in women is strongly associated with the occurrence of adverse perinatal outcomes, but not well-understood in low-income countries. The study aimed to ascertain the effect of maternal near-miss on the risk of adverse perinatal outcomes in Ethiopia.

    METHODS: A prospective cohort study was conducted in five public hospitals of Addis Ababa, Ethiopia. Women admitted from May 1, 2015 to April 30, 2016 were recruited for the study. We followed a total of 828 women admitted for delivery or treatment of pregnancy-related complications along with their singleton newborn babies. Maternal near-miss was the primary exposure and was ascertained using the World Health Organization criteria. Women who delivered without complications were taken as the non-exposed groups. The main outcome was adverse perinatal outcomes. Data on maternal near-miss and perinatal outcomes were abstracted from medical records of the participants. Exposed and non-exposed women were interviewed by well-trained data collectors to obtain information about potential confounding factors. Logistic regressions were performed using Stata version 13.0 to determine the adjusted odds of adverse perinatal outcomes.

    RESULTS: A total of 207 women with maternal near-miss and 621 women with uncomplicated delivery were included in the study. After adjusting for potential confounders, women with maternal near-miss condition had more than five-fold increased odds of adverse perinatal outcomes compared to women who delivered without any complications (AOR = 5.69: 95% CI; 3.69-8.76). Other risk factors that were independently associated with adverse perinatal outcomes include: rural residence, history of prior stillbirth and primary educational level.

    CONCLUSIONS: Presence of maternal near-miss in women is an independent risk factor for adverse perinatal outcomes. Hence, interventions rendered at improvement in maternal health of Ethiopia can lead to an improvement in perinatal outcomes.

  • 24. McGarry, Orla
    et al.
    Hannigan, Ailish
    De Almeida, Maria Manuela
    Santino, Severoni
    Puthoopparambil, Soorej Jose
    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), International Maternal and Reproductive Health and Migration. The World Health Organization Regional Office for Europe.
    MacFarlane, Anne
    What strategies to address communication barriers for refugees and migrants in health care settings have been implemented and evaluated across the WHO European Region? Themed issues on migration and health, IX2018Book (Refereed)
  • 25.
    Mohammadi, Soheila
    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), International Maternal and Reproductive Health and Migration.
    Gargari, S. Saleh
    Shahid Beheshti Univ Med Sci, Infertil & Reprod Hlth Res Ctr, Tehran, Iran..
    Fallahian, M.
    Shahid Beheshti Univ Med Sci, Infertil & Reprod Hlth Res Ctr, Tehran, Iran..
    Ziaei, Shirin
    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), International Child Health and Nutrition.
    Källestål, Carina
    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), International Child Health and Nutrition.
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Afghan mothers with near-miss morbidity face disparity in obstetric care at university hospitals in Tehran, Iran2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 122-122Article in journal (Other academic)
  • 26.
    Mohammadi, Soheila
    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), International Maternal and Reproductive Health and Migration. Shahid Beheshti Univ Med Sci, Infertil & Reprod Hlth Res Ctr, Tehran, Iran..
    Gargari Saleh, Soraya
    Shahid Beheshti Univ Med Sci, Infertil & Reprod Hlth Res Ctr, Tehran, Iran..
    Fallahian, Masoumeh
    Shahid Beheshti Univ Med Sci, Infertil & Reprod Hlth Res Ctr, Tehran, Iran..
    Källestål, Carina
    Ziaei, Shirin
    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).
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Afghan Migrants Face more Suboptimal Care than Natives: a Maternal Near-Miss Audit Study at University Hospitals in Tehran, Iran2017In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 17, article id 64Article in journal (Refereed)
    Abstract [en]

    Background: Women from low-income settings have higher risk of maternal near miss (MNM) and suboptimal care than natives in high-income countries. Iran is the second largest host country for Afghan refugees in the world. Our aim was to investigate whether care quality for MNM differed between Iranians and Afghans and identify potential preventable attributes of MNM. Methods: An MNM audit study was conducted from 2012 to 2014 at three university hospitals in Tehran. Auditors evaluated the quality of care by reviewing the hospital records of 76 MNM cases (54 Iranians, 22 Afghans) and considering additional input from interviews with patients and professionals. Main outcomes were frequency of suboptimal care and the preventable attributes of MNM. Crude and adjusted odds ratios with confidence intervals for the independent predictors were examined. Results: Afghan MNM faced suboptimal care more frequently than Iranians after adjusting for educational level, family income, and insurance status. Above two-thirds (71%, 54/76) of MNM cases were potentially avoidable. Preventable factors were mostly provider-related (85%, 46/54), but patient-(31%, 17/54) and health system-related factors (26%, 14/54) were also important. Delayed recognition, misdiagnosis, inappropriate care plan, delays in care-seeking, and costly care services were the main potentially preventable attributes of MNM. Conclusions: Afghan mothers faced inequality in obstetric care. Suboptimal care was provided in a majority of preventable near-miss events. Improving obstetric practice and targeting migrants' specific needs during pregnancy may avert near-miss outcomes.

  • 27. Odland, Maria Lisa
    et al.
    Membe-Gadama, Gladys
    Kafulafula, Ursula
    Jacobsen, Geir Wenberg
    Odland, Jon Øyvind
    Darj, Elisabeth
    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), International Maternal and Reproductive Health and Migration.
    Effects of refresher training on the use of manual vacuum aspiration in the treatment of incomplete abortions: a quasi-experimental study in Malawi.2018In: BMJ global health, ISSN 2059-7908, Vol. 3, no 5, article id e000823Article in journal (Refereed)
    Abstract [en]

    Introduction: The maternal mortality ratio is decreasing globally, although it remains high in Malawi. Unsafe abortion is a major cause and treatment of complications after abortion is a big burden on the health system. Even though manual vacuum aspiration (MVA) is the recommended surgical treatment of incomplete abortions in the first trimester, many hospitals in Malawi continue to use sharp curettage. It is known to have more complications and is more expensive in the long run. The purpose of this study was to determine the effectiveness of a structured MVA training programme in the treatment of incomplete abortions in Malawi.

    Methods: A quasi-experimental before-and-after study design was employed in an MVA training programme for health personnel at three hospitals in Southern Malawi. A total of 53 health personnel at the Queen Elizabeth Central Hospital and the district hospitals of Chikwawa and Chiradzulu (intervention hospitals) were trained in the use of MVA. Kamuzu Central Hospital in Lilongwe and the Thyolo District Hospital served as control institutions. Medical files for all women treated for an incomplete abortion at the study hospitals were reviewed before and after the intervention. Information on demographic and obstetric data and the type of treatment was collected.

    Results: There was a significant increase in the use of MVA from 7.8% (95% CI 5.8 to 10.3) to 29.1% (95% CI 25.9 to 32.5) 1 year after the intervention. In comparison, we found a mere 3% increase in the control hospitals.

    Conclusions: By providing a refresher training programme to health personnel who treat women with incomplete abortions, it was possible to increase the use of MVA as recommended in the Malawi national guidelines.

  • 28. Odland, Maria Lisa
    et al.
    Membe-Gadama, Gladys
    Kafulafula, Ursula
    Jacobsen W, Geir
    Kumwenda, James
    Darj, Elisabeth
    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), International Maternal and Reproductive Health and Migration. Department of Public Health and Nursing, Norwegian University of Science and Technology,Trondheim, Norway; Department of Gynecology, St. Olav´s Hospital, NO-7030 Trondheim, Norway.
    The Use of Manual Vacuum Aspiration in the Treatment of Incomplete Abortions: A Descriptive Study from Three Public Hospitals in Malawi2018In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 2, article id 370Article in journal (Refereed)
    Abstract [en]

    Malawi has a high maternal mortality rate, of which unsafe abortion is a major cause. About 140,000 induced abortions are estimated every year, despite there being a restrictive abortion law in place. This leads to complications, such as incomplete abortions, which need to be treated to avoid further harm. Although manual vacuum aspiration (MVA) is a safe and cheap method of evacuating the uterus, the most commonly used method in Malawi is curettage. Medical treatment is used sparingly in the country, and the Ministry of Health has been trying to increase the use of MVA. The aim of this study was to investigate the treatment of incomplete abortions in three public hospitals in Southern Malawi during a three-year period. All medical files from the female/gynecological wards from 2013 to 2015 were reviewed. In total, information on obstetric history, demographics, and treatment were collected from 7270 women who had been treated for incomplete abortions. The overall use of MVA at the three hospitals during the study period was 11.4% (95% CI, 10.7–12.1). However, there was a major increase in MVA application at one District Hospital. Why there was only one successful hospital in this study is unclear, but may be due to more training and dedicated leadership at this particular hospital. Either way, the use of MVA in the treatment of incomplete abortions continues to be low in Malawi, despite recommendations from the World Health Organization (WHO) and the Malawi Ministry of Health.

  • 29.
    Odland, Maria Lisa
    et al.
    Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, Trondheim, Norway.
    Membe-Gadama, Gladys
    Queen Elizabeth Cent Hosp, Blantyre, Malawi.
    Kafulafula, Ursula
    Kamuzu Coll Nursing, Blantyre, Malawi.
    Odland, Jon Öyvind
    Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, Trondheim, Norway;Univ Malawi, Coll Med, Blantyre, Malawi;Univ Pretoria, Pretoria, South Africa.
    Darj, Elisabeth
    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), International Maternal and Reproductive Health and Migration. Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, Trondheim, Norway;St Olavs Hosp, Dept Obstet & Gynecol, Trondheim, Norway.
    "Confidence comes with frequent practice": health professionals' perceptions of using manual vacuum aspiration after a training program2019In: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 16, article id 20Article in journal (Refereed)
    Abstract [en]

    Background: Malawi has one of the highest maternal mortality rates in the world, with unsafe abortion as a major contributor. Curettage is most frequently used as the surgical method for treating incomplete abortions, even though it is costly for an impoverished health system and the less expensive and safe manual vacuum aspiration (MVA) method is recommended.

    Methods: The aim of this 2016-17 study is to explore health worker's perception of doing MVA 1 year after an educational intervention. Focus group discussions were recorded, transcribed verbatim, and analyzed using content analysis for interpreting the findings. A knowledge, attitude and practice survey was administered to health professionals to obtain background information before the MVA training program was introduced.

    Results: Prior to the training sessions, the participants demonstrated knowledge on abortion practices and had positive attitudes about participating in the service, but preferred curettage over MVA. The training was well received, and participants felt more confident in doing MVA after the intervention. However, focus group discussions revealed obstacles to perform MVA such as broken equipment and lack of support. Additionally, the training could have been more comprehensive. Still, the participants appreciated task-sharing and team work.

    Conclusion: Training sessions are considered useful in increasing the use of MVA. This study provides important insight on how to proceed in improving post-abortion care in a country where complications of unsafe abortion are common and the health system is low on resources.

  • 30.
    Ogbe, Emilomo
    et al.
    Univ Ghent, Int Ctr Reprod Hlth, Ghent, Belgium.
    Van Braeckel, Dirk
    Univ Ghent, Int Ctr Reprod Hlth, Ghent, Belgium.
    Temmerman, Marleen
    Univ Ghent, Ghent, Belgium;Aga Khan Univ, Nairobi, Kenya.
    Larsson, Elin C.
    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), International Maternal and Reproductive Health and Migration.
    Keygnaert, Ines
    Univ Ghent, Int Ctr Reprod Hlth, Ghent, Belgium.
    Aragon, Wilson De los Reyes
    RFSU Swedish Assoc Sexual Educ, Stockholm, Sweden.
    Cheng, Feng
    Tsinghua Univ, Sch Med, Beijing, Peoples R China;Tsinghua Univ, Res Ctr Publ Hlth, Beijing, Peoples R China.
    Lazdane, Gunta
    Riga Stradins Univ, Dept Obstet & Gynaecol, Riga, Latvia.
    Cooper, Diane
    Univ Western Cape, Sch Publ Hlth, Cape Town, South Africa.
    Shamu, Simukai
    Fdn Profess Dev, Pretoria, South Africa;Univ Witwatersrand, Sch Publ Hlth, Johannesburg, South Africa.
    Gichangi, Peter
    Univ Ghent, Ghent, Belgium;Univ Nairobi, Nairobi, Kenya;Int Ctr Reprod Hlth, Nairobi, Kenya.
    Dias, Sonia
    Univ Nova Lisboa, Ctr Invest Saude Publ, Escola Nacl Saude Publ, Lisbon, Portugal.
    Barrett, Hazel
    Coventry Univ, Ctr Trust Peace & Social Relat, Coventry, W Midlands, England.
    Nobels, Anne
    Univ Ghent, Int Ctr Reprod Hlth, Ghent, Belgium.
    Pei, Kaiyan
    Natl Res Inst Family Planning, Beijing, Peoples R China.
    Galle, Anna
    Univ Ghent, Int Ctr Reprod Hlth, Ghent, Belgium.
    Esho, Tammary
    Tech Univ Kenya, Dept Community & Publ Hlth, Nairobi, Kenya.
    Knight, Lucia
    Univ Western Cape, Sch Publ Hlth, Cape Town, South Africa.
    Tabana, Hanani
    Univ Western Cape, Sch Publ Hlth, Cape Town, South Africa.
    Degomme, Olivier
    Univ Ghent, Int Ctr Reprod Hlth, Ghent, Belgium.
    Opportunities for linking research to policy: lessons learned from implementation research in sexual and reproductive health within the ANSER network2018In: Health Research Policy and Systems, ISSN 1478-4505, E-ISSN 1478-4505, Vol. 16, article id 123Article in journal (Refereed)
    Abstract [en]

    Background: The uptake of findings from sexual and reproductive health and rights research into policy-making remains a complex and non-linear process. Different models of research utilisation and guidelines to maximise this in policy-making exist, however, challenges still remain for researchers to improve uptake of their research findings and for policy-makers to use research evidence in their work.

    Methods: A participatory workshop with researchers was organised in November 2017 by the Academic Network for Sexual and Reproductive Health and Rights Policy (ANSER) to address this gap. ANSER is a consortium of experienced researchers, some of whom have policy-making experience, working on sexual and reproductive health and rights issues across 16 countries and 5 continents. The experiential learning cycle was used to guide the workshop discussions based on case studies and to encourage participants to focus on key lessons learned. Workshop findings were thematically analysed using specific stages from Hanney et al.'s (Health Res Policy Syst 1:2, 2003) framework on the place of policy-making in the stages of assessment of research utilisation and outcomes.

    Results; The workshop identified key strategies for translating research into policy, including joint agenda-setting between researchers and policy-makers, as well as building trust and partnerships with different stakeholders. These were linked to stages within Hanney et al.'s framework as opportunities for engaging with policy-makers to ensure uptake of research findings.

    Conclusion: The engagement of stakeholders during the research development and implementation phases, especially at strategic moments, has a positive impact on uptake of research findings. The strategies and stages described in this paper can be applied to improve utilisation of research findings into policy development and implementation globally.

  • 31.
    Pun, Kunta Devi
    et al.
    Cent Norway Reg Hlth Author, Stjordal, Norway; Kathmandu Univ, Sch Med Sci, Dhulikhel, Kavre, Nepal;Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, Fac Med & Hlth Sci, Trondheim, Norway.
    Rishal, Poonam
    Cent Norway Reg Hlth Author, Stjordal, Norway; Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, Fac Med & Hlth Sci, Trondheim, Norway.
    Infanti, Jennifer Jean
    Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, Fac Med & Hlth Sci, Trondheim, Norway.
    Bjørngaard, Johan Håkon
    St Olavs Univ Hosp, Res Ctr Broset, Trondheim, Norway; Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, Fac Med & Hlth Sci, Trondheim, Norway.
    Koju, Rajendra
    Kathmandu Univ, Sch Med Sci, Dhulikhel, Kavre, Nepal.
    Schei, Berit
    St Olavs Univ Hosp, Dept Obstet & Gynecol, Trondheim, Norway; Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, Fac Med & Hlth Sci, Trondheim, Norway.
    Darj, Elisabeth
    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), International Maternal and Reproductive Health and Migration. Cent Norway Reg Hlth Author, Stjordal, Norway; St Olavs Univ Hosp, Dept Obstet & Gynecol, Trondheim, Norway; Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, Fac Med & Hlth Sci, Trondheim, Norway.
    Exposure to domestic violence influences pregnant women's preparedness for childbirth in Nepal: A cross-sectional study2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 7, article id e0200234Article in journal (Refereed)
    Abstract [en]

    Objective: This study aimed to evaluate if domestic violence affected women's ability to prepare for childbirth. Birth preparedness and complication readiness (BP/CR) includes saving money, arranging transportation, identifying a skilled birth attendant, a health facility, and a blood donor before childbirth. During data collection, Nepal experienced two earthquakes and therefore it was possible to examine associations between domestic violence, women's BP/CR and effects of the earthquakes.

    Methods: Women who were between 12 and 28 weeks of gestation participated in a descriptive crosssectional study at a hospital antenatal clinic in Nepal, where they completed a structured questionnaire on sociodemographic characteristics, obstetric history, experiences of domestic violence, and BP/CR. The 5-item Abuse Assessment Screen was used to assess prevalence of domestic violence, and a questionnaire on safe motherhood obtained from Jhpiego was used to assess BP/CR status. The participants self-completed the questionnaire on a tablet computer. Those who reported at least three out of five BP/CR activities were considered prepared for childbirth.

    Results: A total of 1011 women participated in the study: 433 pre-earthquakes and 578 post-earthquakes. With respect to BP/CR, 78% had identified a health facility for childbirth and 65% had saved money prior to childbirth. Less than 50% had identified a birth attendant to assist with the delivery, transportation to a health facility, or arranged for a potential blood donor. Prior to the earthquakes, 38% were unprepared; by contrast, almost 62% were not prepared after the earthquakes. A significant association was found between exposure to violence and not being prepared for childbirth (AOR = 2.3, 95% CI: 1.4-3.9). The women with increased odds of not being prepared for childbirth were illiterate (AOR = 9.9, 95% CI: 5.7-17), young (AOR = 3.4, 95% CI: 1.6-7.2), from the most oppressed social classes (AOR = 3.0, 95% CI: 1.2-7.6), were married to illiterate husbands (AOR = 2.5, 95% CI: 1.2-5.2), had attended fewer than four antenatal visits (AOR = 2.0, 95% CI: 1.4-2.6), had low incomes (AOR = 1.7, 95% CI: 1.1-2.9) or lived in rural settings (AOR = 1.5, 95% confidence interval CI: 1.2-2.1).

    Conclusion: The paper identifies vulnerable women who require extra care from the health system, and draws attention to the need for interventions to reduce the harmful effects of domestic violence on women's preparations for childbirth.

  • 32. Pusztai, Zsofia
    et al.
    Zivanov, Ivan
    Severoni, Santino
    Puthoopparambil, Soorej Jose
    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), International Maternal and Reproductive Health and Migration.
    Vuksanovic, Helena
    Stojkovic, Sanja Gajica
    Violeta, Egic
    Refugee and migrant health – improving access to health care for people in between2018In: PUBLIC HEALTH PANORAMA, Vol. 4, no 2Article in journal (Refereed)
  • 33.
    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), International Maternal and Reproductive Health and Migration. Univ Limerick, Grad Med Entry Sch, Limerick, Ireland.
    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), International Maternal and Reproductive Health and Migration.
    Källestål, Carina
    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), International Maternal and Reproductive Health and Migration.
    Quality of life among immigrants in Swedish immigration detention centres: a cross-sectional questionnaire study2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Supplement: 1, p. 64-64Article in journal (Other academic)
  • 34.
    Pérez, Wilton
    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).
    Contreras, Mariela
    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), International Child Health and Nutrition.
    Peña, Rodolfo
    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). Pan American Health Organization, Tegucigalpa, Honduras.
    Zelaya, Elmer
    Asociación para el Desarrollo Económico y Social de El Espino (APRODESE), Cinco Pinos, Nicaragua.
    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), International Child Health and Nutrition. Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK.
    Källestål, Carina
    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), International Maternal and Reproductive Health and Migration. Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK.
    Food insecurity and self-rated health in rural Nicaraguan women of reproductive age: a cross-sectional study2018In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 17, no 1, article id 146Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Access to food is a basic necessity, and food insecurity may impair the individual's well-being and health. Self-rated health measurements have frequently been used to assess population health. Little is known, however, as to whether food security is associated with self-rated health in low- and middle-income settings. This study aims at analyzing the association between food security and self-rated health among non-pregnant women of reproductive age in a rural Nicaraguan setting.

    METHODS: Data was taken from the 2014 update of a health and demographic surveillance system in the municipalities of Los Cuatro Santos in northwestern Nicaragua. Fieldworkers interviewed women about their self-rated health using a 5-point Likert scale. Food insecurity was assessed by the household food insecurity access (HFIAS) scale. A multilevel Poisson random-intercept model was used to calculate the prevalence ratio.

    RESULTS: The survey included 5866 women. In total, 89% were food insecure, and 48% had poor self-rated health. Food insecurity was associated with poor self-rated health, and remained so after adjustment for potential confounders and accounting for community dependency.

    CONCLUSION: In this Nicaraguan resource-limited setting, there was an association between food insecurity and poor self-rated health. Food insecurity is a facet of poverty and measures an important missing capability directly related to health.

  • 35.
    Rishal, Poonam
    et al.
    Norwegian Univ Sci & Technol NTNU, Fac Med & Hlth Sci, Dept Publ Hlth & Nursing, Postbox 8905, NO-7491 Trondheim, Norway;Teaching Hosp, Dept Community Med, Kathmandu Med Coll, Kathmandu, Nepal.
    Pun, Kunta Devi
    Norwegian Univ Sci & Technol NTNU, Fac Med & Hlth Sci, Dept Publ Hlth & Nursing, Postbox 8905, NO-7491 Trondheim, Norway;Kathmandu Univ, Sch Med Sci, Kathmandu, Nepal.
    Darj, Elisabeth
    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), International Maternal and Reproductive Health and Migration. Norwegian Univ Sci & Technol NTNU, Fac Med & Hlth Sci, Dept Publ Hlth & Nursing, Postbox 8905, NO-7491 Trondheim, Norway;St Olavs Hosp, Dept Obstet & Gynaecol, Trondheim, Norway.
    Joshi, Sunil Kumar
    Teaching Hosp, Dept Community Med, Kathmandu Med Coll, Kathmandu, Nepal.
    Bjorngaard, Johan Hakon
    Norwegian Univ Sci & Technol NTNU, Fac Med & Hlth Sci, Dept Publ Hlth & Nursing, Postbox 8905, NO-7491 Trondheim, Norway;St Olavs Univ Hosp, Forens Dept, Trondheim, Norway;St Olavs Univ Hosp, Res Ctr Broset, Trondheim, Norway.
    Swahnberg, Katarina
    Linnaeus Univ, Fac Hlth & Life Sci, Dept Hlth & Caring Sci, Vaxjo, Sweden.
    Schei, Berit
    Norwegian Univ Sci & Technol NTNU, Fac Med & Hlth Sci, Dept Publ Hlth & Nursing, Postbox 8905, NO-7491 Trondheim, Norway;St Olavs Hosp Trondheim Univ Hosp, Dept Obstet & Gynaecol, Trondheim, Norway.
    Lukasse, Mirjam
    Oslo & Akershus Univ Coll, Fac Hlth Sci, Kjeller, Norway;Univ Coll Southeast Norway, Dept Hlth & Social Sci, Horten, Norway.
    Prevalence and associated factors of domestic violence among pregnant women attending routine antenatal care in Nepal2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 8, p. 785-793Article in journal (Refereed)
    Abstract [en]

    Aims: The primary aim of this study was to assess the prevalence of domestic violence (DV) and its associated factors among pregnant women in Nepal. The secondary aims were to investigate disclosure of DV by women to health-care personnel and to assess whether health-care personnel had asked women about their experience of DV.

    Methods: This cross-sectional study included 2004 pregnant women between 12 and 28 weeks of gestation attending routine antenatal care at two hospitals in Nepal from August 2014 to November 2015. In this study, DV was defined as fear of a family member and/or an experience of physical, emotional or sexual violence. Associated risk factors were analysed using logistic regression analyses.

    Results: Twenty-one per cent of the women had experienced DV; 12.5% experienced fear only, 3.6% violence only and 4.9% experienced both violence and fear. Less than 2% per cent reported physical violence during pregnancy. This study found that just 17.7% had ever been asked by health-care personnel about DV, and of the women who had reported DV, only 9.5% had disclosed their experience to health-care personnel. Women of young age and low socio-economic status were more likely to have experienced DV. Women who reported having their own income and the autonomy to use it were at significantly lower risk of DV compared to women with no income.

    Conclusions: A substantial proportion of women reported having experienced DV. Victims had rarely disclosed their experience of DV to health-care personnel. This study underlines the importance of integrating systematic assessment of DV in antenatal care.

  • 36.
    Villadsen, S.
    et al.
    Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark.
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Azria, E.
    Descartes Univ, INSERM, Paris, France.
    McCourt, C.
    City Univ London, Ctr Maternal & Child Hlth, London, England.
    Schytt, E.
    Ctr Clin Res, Falun, Dalarna, Sweden.
    Salway, S.
    Univ Sheffield, Hlth Equ & Inclus Res Grp, Sheffield, S Yorkshire, England.
    Interventions for good practice in maternity care for immigrant women - insights from the ROAM collaboration. ROAM: Reproductive Outcomes among Migrants2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Supplement: 1, p. 16-16Article in journal (Other academic)
  • 37. Villarroel, Nazmy
    et al.
    Hannigan, Ailish
    Severoni, Santino
    Puthoopparambil, Soorej Jose
    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), International Maternal and Reproductive Health and Migration.
    MacFarlane, Anne
    Migrant health research in the Republic of Ireland: a scoping review2019In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, no 1Article in journal (Refereed)
    Abstract [en]

    Migration to European countries has increased in number and diversity in recent years. Factors such as access to healthcare, language barriers and legal status can impact the health outcomes of migrant groups. However, little is known about the evidence base on the health status of migrants in the Republic of Ireland. Our aim was to scope existing peer-reviewed research on the health of migrants in Ireland and identify any gaps in the evidence.

  • 38.
    Volgsten, Helena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Jansson, Caroline
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive biology.
    Darj, Elisabeth
    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), International Maternal and Reproductive Health and Migration. Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology and Department of Obstetrics and Gynecology, St Olav's Hospital, Trondheim, Norway.
    Stavreus-Evers, Anneli
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive biology.
    Women's experiences of miscarriage related to diagnosis, duration, and type of treatment.2018In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Women with miscarriage experience several negative emotional feelings such as grief, isolation, coping, and despair. However, less is known about how the type of treatment and diagnosis of miscarriage influence the emotional experience.

    MATERIAL AND METHODS: The present study was a randomized prospective longitudinal cohort study, in which women with spontaneous miscarriage (n = 35), and women with missed miscarriage (n = 67), were included to answer 3 validated questionnaires: Revised Impact of Miscarriage Scale, Perinatal Grief Scale, and Montgomery and Åsberg Depression Rating Scale, concerning experience of miscarriage, psychological well-being, and mental health 1 week and 4 months after finalized treatment.

    RESULTS: There was no difference between the 2 diagnosis groups in feelings as measured by Revised Impact of Miscarriage Scale, Montgomery and Åsberg Depression Rating Scale, and Perinatal Grief Scale 1 week after the miscarriage. However, the psychological well-being improved significantly 4 months after the miscarriage. Separated by treatment, women treated with misoprostol alone had more depressive symptoms than women treated with misoprostol and subsequent vacuum aspiration.

    CONCLUSIONS: It can be concluded that diagnosis of miscarriage had limited influence on the experiences of miscarriage, but shorter duration of treatment with misoprostol and subsequent vacuum aspiration resulted in fewer depressive symptoms.

  • 39.
    Volgsten, Helena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Jansson, Caroline
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive biology.
    Skoog Svanberg, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.
    Darj, Elisabeth
    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), International Maternal and Reproductive Health and Migration. Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Obstetrics and Gynecology, St Olav’s Hospital, Trondheim, Norway.
    Stavreus-Evers, Anneli
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive biology.
    Longitudinal study of emotional experiences, grief and depressive symptoms in women and men after miscarriage2018In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 64, p. 23-28Article in journal (Refereed)
    Abstract [en]

    Objective: Although miscarriage is common and affects up to 20 % of pregnant women, little is known about these couples’ short term and long term experiences after miscarriage.The aim of the present study was to study emotional experience, grief and depressive symptoms in women and men,one week and four months after miscarriage. Research design /setting:Women, (n=103), and their male partner (n=78), were recruited at the gynecological clinic after miscarriage. Control women were recruitedfrom the general population.Three validated questionnaires concerning psychological wellbeing and mental health, RIMS, PGS and MADRS-S were answered by the participants one week and four months after the miscarriage. Findings: It was shown that for women, the emotional experiences of miscarriage, grief and depressive symptoms were more pronounced than for their male partners. Grief and depressive symptoms were reduced with time, which was not the case for the emotional experiences of miscarriage. Previous children was favorable for emotional experience while previous miscarriage or infertility treatment made the emotional experience worse. Conclusion: Grief and depressive symptoms is reducedover time while emotional experiences such as isolation, loss of baby and a devastating event persist for longer time than four months. Lack of previous children, previous miscarriageand infertility diagnosis could increase negative emotional experiencesafter miscarriage, this was especially pronounced for grief reaction.The questionnaires could be used both clinically and in research to understand the emotional experiences after miscarriage.

  • 40.
    Wahlberg, Anna
    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), International Maternal and Reproductive Health and Migration.
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Johnsdotter, Sara
    Faculty of Health and Society, Malmö University.
    From sameness to difference: Swedish Somalis’ post-migration perceptions of the circumcision of girls and boysIn: Article in journal (Refereed)
  • 41.
    Åkerman, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Larsson, Elin
    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), International Maternal and Reproductive Health and Migration.
    Essén, Birgitta
    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), International Maternal and Reproductive Health and Migration.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Thai immigrant women's healthcare use and needs in relation to sexual and reproductive health: a cross-sectional study in Sweden2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Supplement: 1, p. 121-121Article in journal (Other academic)
1 - 41 of 41
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