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Introduction: Homelessness among women of reproductive age is a globalproblem. Several unique gender-based issues affect homeless women’s wellbeing, including reproductive health issues, their homelessness experiences,and a high rate of sexual violence. In this study, we aimed to describe women’sexperiences of street homelessness in their own terms and their suggestions toaddress their unmet needs.Methods: This photovoice study draws on photos, focus group discussions, andsemi-structured interviews. We conducted the study in collaboration with womenin their reproductive years experiencing homelessness (n = 9). A total of 80 photoswere taken, and 40 were chosen to be discussed in interviews and further focusgroup discussions. The participating women selected photographs, explained theirsignificance, and codified them based on how they related to their lives. Data fromthese discussions were then analysed using a reflexive thematic approach.Results: Four themes were developed from the data: (a) deprivation of basicneeds; (b) experiencing dependency, shame, and seclusion while dealingwith the burden of street life; (c) the vulnerability and neglect of children; and(d) being resilient to harsh conditions. In this study, women’s street life wascharacterised by numerous unfavourable aspects, including unmet needs,human rights violations, social exclusions, substance use, and child protectionissues. Participants provided suggestions for change and confirmed their beliefthat adequate housing represents one of the most urgent unmet basic needsof people experiencing homelessness. They also emphasised the critical needfor employment opportunities, non-discriminatory provision of social support,treatment programs for substance misuse, and legal and social protection.Conclusion: This study contributes to understanding how women experiencinghomelessness describe and articulate their living circumstances and whatthey perceive needs to be addressed. Based on participants’ proposal forchange, comprehensive services are needed to address women’s multifacetedissues. However, the mitigation strategies and long-term effects of women’shomelessness require further research.

Introduction: A South African social innovation based on peer support for mothers was contextualized in southern Sweden. The objective of the project was to support expectant women and mothers of young children in immigrant communities to access public services that would benefit maternal and child health. This study aimed to assess how the intervention was implemented, what the contextual barriers and facilitators were, and how the implementation was perceived by those who delivered and received it.

Methods: The study used mixed methods with a convergent parallel design and followed the Medical Research Council guidance on process evaluations of complex interventions. Semi-structured interviews (n = 19) were conducted with peer supporters, client mothers, and key stakeholders involved in the intervention. The qualitative data were analyzed using content analysis. Quantitative data on peer supporters' activities were collected during contacts with client mothers and were presented descriptively.

Results: The five peer supporters had 1,294 contacts with client mothers, of which 507 were first-time contacts. The reach was perceived as wide, and the dose of the intervention was tailored to individual needs. Barriers to implementation included community mistrust of social services, norms on gender roles and parenting, and funding challenges. The implementation was facilitated by the organization's reputation, network, experience, and third-sector affiliation. Peer supporters tended to prioritize linking clients to other services over the educational components of the intervention, sometimes doing more than what was originally planned. Implementation strategies used included building trust, using multiple outreach venues, using internal support structures, and providing practical assistance as an entry point to comprehensive psychosocial support. The personal connection between peer supporters and clients was highly valued, and the building of relationships enabled them to address sensitive topics. Peer supporters sometimes experienced a blurred line between professional and personal roles.

Conclusions: Peer supporters used a variety of strategies to navigate identified barriers and facilitators. Trust was central both as a contextual factor and a strategy for implementation. It is valuable to maintain a balance between flexibility and adherence to the function of peer supporters. Further research is needed to evaluate the effects of the intervention.

Background: Stroke prevalence is one of the most pressing issues in many sub-Saharan African countries. Stroke survivors often face disabilities, mental health problems, and experience stigma. Research on post-stroke experiences and interventions is limited, particularly in low and middle-income countries, including Ghana. This study aims to contribute to this gap by investigating experiences of everyday life following a stroke in urban Ghana.

Method: A qualitative in-depth study involving 14 interviews with stroke survivors who attended physiotherapy at Accra Physiotherapy and Sports Injury Clinic. Qualitative analysis was conducted to analyse the data.

Results: Data analysis generated four themes; [1] Mobility limitations; [2] Psychosocial burden [3] Employment Limitations [4] Financial burden.

Conclusion: Stroke survivors with disabilities perceive themselves as non-functional members of society, which limits their options for a normal life and undermines their well-being. A more in-depth understanding of these issues can contribute to strategies, interventions, and policies that address these problems.

Introduction: Globally, homelessness is a growing concern, and homeless women of reproductive age are particularly vulnerable to adverse physical, mental, and reproductive health conditions, including violence. Although Ethiopia has many homeless individuals, the topic has received little attention in the policy arena. Therefore, we aimed to understand the reason for the lack of attention, with particular emphasis on women of reproductive age.

Methods: This is a qualitative study; 34 participants from governmental and non-governmental organisations responsible for addressing homeless individuals' needs participated in in-depth interviews. A deductive analysis of the interview materials was applied using Shiffman and Smith's political prioritisation framework.

Results: Several factors contributed to the underrepresentation of homeless women's health and well-being needs in the policy context. Although many governmental and non-governmental organisations contributed to the homeless-focused programme, there was little collaboration and no unifying leadership. Moreover, there was insufficient advocacy and mobilisation to pressure national leaders. Concerning ideas, there was no consensus regarding the definition of and solution to homeless women's health and social protection issues. Regarding political contexts and issue characteristics, a lack of a well-established structure, a paucity of information on the number of homeless women and the severity of their health situations relative to other problems, and the lack of clear indicators prevented this issue from gaining political priority.

Conclusions: To prioritise the health and well-being of homeless women, the government should form a unifying collaboration and a governance structure that addresses the unmet needs of these women. It is imperative to divide responsibilities and explicitly include homeless people and services targeted for them in the national health and social protection implementation documents. Further, generating consensus on framing the problems and solutions and establishing indicators for assessing the situation is vital.

Background: Mental health conditions are among the health issues associated with homelessness, and providing mental healthcare to people experiencing homelessness is challenging. Despite the pressing issue of homelessness in Addis Ababa, Ethiopia, there is scant research on how service providers address women's mental health and psychosocial needs. Therefore, we explored service providers' and programme coordinators' perceptions and experiences regarding mental healthcare and psychosocial services delivery to women experiencing street homelessness in the city.

Methods: We conducted a descriptive qualitative study with selected healthcare and social support providers and programme coordinators. The study involved 34 participants from governmental and non-governmental organisations in Addis Ababa, Ethiopia. Data were analysed using an inductive thematic approach.

Results: Four themes were derived from the analysis. The first of these was "divergent intentions and actions". While service providers and programme coordinators showed empathy and compassion, they also objectified and blamed people for their own homelessness. They also expressed opposing views on mental health stigma and compassion for these people. The second theme addressed "problem-solution incompatibility", which focused on the daily challenges of women experiencing homelessness and the types of services participants prioritised. Service providers and programme coordinators proposed non-comprehensive support despite the situation's complexity. The participants did not emphasise the significance of gender-sensitive and trauma-informed care for women experiencing street homelessness in the third theme, "the lack of gendered and trauma-informed care despite an acknowledgement that women face unique challenges". The fourth theme, "mismatched resources," indicated structural and systemic barriers to providing services to homeless women.

Conclusions:Conflicting attitudes and practices exist at the individual, organisational, and systemic levels, making it challenging to provide mental healthcare and psychosocial services to women experiencing homelessness. An integrated, gender-sensitive, and trauma-informed approach is necessary to assist women experiencing homelessness.

Introduction and aim Social and health disparities persist in Sweden despite a high quality and universally accessible welfare system. One way of bridging social gaps is through social innovations targeting the most vulnerable groups. The South African Philani model, a social innovation for peer support aimed at pregnant women and mothers of young children, was adapted to the local context in southern Sweden. This study aimed to document and analyze the process of adapting the Philani model to the Swedish context. Methods Eight semi-structured interviews and three workshops were held with eleven stakeholders and peer supporters in the implementing organization and its steering committee. The data were analyzed using thematic analysis. Results The analysis resulted in five main themes and fifteen sub-themes representing different aspects of how the peer support model was contextualized. The main themes described rationalizations for focusing on social determinants rather than health behaviors, using indirect mechanisms and social ripple effects to achieve change, focusing on referring clients to established public and civil society services, responding to a heterogeneous sociocultural context by recruiting peer supporters with diverse competencies, and having a high degree of flexibility in how contact was made with clients and how their needs were met. Conclusion The South African Philani model was contextualized to support socially disadvantaged mothers and expectant mothers among migrant communities in Sweden. In the process, adaptations of the intervention's overall focus, working methods, and recruitment and outreach strategies were motivated by the existing range of services, the composition of the target group and the conditions of the delivering organization. This study highlights various considerations that arise when a social innovation developed in a low- or middle-income context is implemented in a high-income context.

Plain English Summary The main aim of this study was to explore doctors' experiences and perceptions of providing sexual and reproductive health care services at Catholic hospitals in a conflict affected area in Cameroon. In Cameroon, sexual, and reproductive health services are lacking, thereby contributing to a very high maternal mortality rate of about 456/100000 live births, far from the Sustainable Development Goal Agenda 2030. The Catholic Church remains one of the largest suppliers of health care services in Cameroon and receives huge funding from donors, but their role in providing sexual and reproductive health care is restricted by religious norms. This study therefore uses in-depth interviews with doctors from Catholic hospitals in the North-West region to explore their experiences in providing sexual and reproductive health services in a conflict region. Qualitative coding was done with NVivo, and data analysed using thematic analysis. The respondents described strict rules and a broad range of challenges to providing comprehensive sexual and reproductive health care services. Nonetheless, there is evidence of doctors overcoming obstacles to providing sexual and reproductive health (SRH) care despite the religious and political climate. However, while attempting to overcome challenges, participants describe numerous examples of poor SRH care and poor health outcomes. The study highlights the importance of understanding the intersect between religion and women's health, particularly in improving access to SRH for vulnerable populations in conflict affected areas. It further provides insight into doctors' motivations for practicing medicine, and how doctors cope and make efforts to provide care and minimize harm. Background Sexual and reproductive health (SRH) care services are essential to improving the lives of women and achieving the Sustainable Development Goals. In Cameroon, the Catholic Church is one the largest non-governmental suppliers of health care, but its role in providing SRH care is restricted by religious norms. Methods This study explored doctors' experiences and perceptions of providing SRH care at Catholic hospitals in a conflict-affected area in Cameroon by using 10 in-depth interviews with doctors from three Catholic hospitals in the North-West region. Qualitative coding was done with NVivo, and data were analysed using thematic analysis. Results Three themes and seven categories were identified. The respondents described strict rules and a broad range of challenges to providing comprehensive sexual and reproductive health care services. Nonetheless, there is evidence of doctors overcoming obstacles to providing SRH care despite the religious and political climate. However, whilst attempting to overcome challenges, participants described numerous examples of poor SRH care and health outcomes. Conclusion The study highlights the importance of understanding the intersect between religion and women's health, particularly in improving access to SRH for vulnerable populations in conflict-affected areas. It further provides insight into doctors' motivations in practicing medicine and how doctors cope and make efforts to provide care and minimize harm.

Over the past decade, donors have engaged faith-based organisations (FBOs) in health system reforms and health programmes in many sub-Saharan African countries, including Cameroon. Little knowledge is available concerning the types of FBOs that exist in the health sector in Cameroon. This article describes the complex landscape of Christian FBOs operating in Cameroon's health sector and provides an explanation for that diversity. It reflects on the implications of the use of the "FBO" acronym in Cameroon and argues that the FBO typology discussion is still relevant.

BACKGROUND: It is well established that migrants underutilise sexual and reproductive health (SRH) services for structural and socio-cultural reasons. Sex education at Swedish schools is compulsory and an important part of Swedish upbringing, yet little is known about how migrants perceive this. This study examined migrant parents' views on sex education that their children receive at Swedish schools.

METHODS: This is a qualitative study using 14 focus group discussions (74 = n) with Arabic speaking migrant parents attending Swedish integration courses. Qualitative data analysis was used following Saldana's coding method.

RESULTS: Migrants' perceptions about sex education provided at Swedish schools are influenced by their home countries, where most participants received no sex education at schools and very little sex education at home. Therefore, values about sex in home countries and Sweden are often contrasting. Consequently, migrant parents are concerned about sex education that their children receive at Swedish schools. There are varied interpretations of sex education, concern over the content and methods taught, and there are numerous assumptions about potential negative effects of sex education.

CONCLUSION: The study echoes findings on intergenerational challenges in migrant families surrounding the topic of gender and sex, often brought on by discussions about sex education at schools. Innovative approaches are needed to support migrant parents as part of Sweden's effort to strengthen effectiveness and inclusiveness of sex education.

Background; The resurgence of measles globally and the increasing number of unvaccinated clusters call for studies exploring factors that influence measles vaccination uptake. Armenia is a middle-income post-Soviet country with an officially high vaccination coverage. However, concerns about vaccine safety are common. The purpose of this study was to measure the prevalence of measles vaccination coverage in children under three years of age and to identify factors that are associated with measles vaccination in Armenia by using nationally representative data.

Methods: Cross-sectional analysis using self-report data from the most recent Armenian Demographic Health Survey (ADHS VII 2015/16) was conducted. Among 588 eligible women with a last-born child aged 12-35months, 63 women were excluded due to unknown status of measles vaccination, resulting in 525 women included in the final analyses. We used logistic regression models in order to identify factors associated with vaccination status in the final sample. Complex sample analyses were used to account for the study design.

Results: In the studied population 79.6% of the children were vaccinated against measles. After adjusting for potential confounders, regression models showed that the increasing age of the child (AOR 1.07, 95% CI: 1.03-1.12), secondary education of the mothers (AOR 3.38, 95% CI: 1.17-9.76) and attendance at postnatal check-up within two months after birth (AOR 2.71, 95% CI: 1.17-6.30) were significantly associated with the vaccination status of the child.

Conclusions: The measles vaccination coverage among the children was lower than the recommended percentage. The study confirmed the importance of maternal education and attending postnatal care visits. However, the study also showed that there might be potential risks for future measles outbreaks because of delayed vaccinations and a large group of children with an unknown vaccination status.