A scoping review on the nature and impact of gender based violence on women primary producers.

BACKGROUND: Women in low- and middle-income countries (LMICs) are primary producers of subsistence food and significant contributors to the agricultural economy. Gender Based Violence (GBV) adversely impacts their capacity to contribute and sustain their families and undermines social, economic, and human capital. Addressing GBV, therefore, is critical to creating safe and inclusive environments for women as primary producers to participate fully in rural communities. The aim of this scoping review is to explore the existing evidence on GBV in the context of women primary producers in LMICs to inform research gaps and priorities. METHODS: A scoping review was conducted using PubMed, Web of Science, Ebscohost and Google Scholar using keywords related to GBV and women producers in LMICs. Peer-reviewed journal articles published between January 2012 and June 2022 were included in the review. Duplicates were removed, titles and abstracts were screened, and characteristics and main results of included studies were recorded in a data charting form. A total of 579 records were identified, of which 49 studies were eligible for inclusion in this study. RESULTS: Five major themes were identified from our analysis: (1) extent and nature of GBV, (2) the impact of GBV on agricultural/primary production livelihood activities, (3) sociocultural beliefs, practices, and attitudes, (4) aggravating or protective factors, and (5) GBV interventions. Addressing GBV in agriculture requires inclusive research approaches and targeted interventions to empower women producers, promote gender equality, enhance agricultural productivity, and contribute to broader societal development. Despite attempts by researchers to delve into this issue, the pervasive under-reporting of GBV remains a challenge. The true extent and nature of GBV perpetrated against women is far from fully understood in this context. CONCLUSION: Despite the significant challenges posed by GBV to the health, economy and livelihoods of women primary producers in LMICs, there is a paucity in the current state of knowledge. To make meaningful progress, more research is required to understand the relationship between GBV and agricultural settings, and to gain nuanced insight into the nature and impact of GBV on women primary producers in different regions and contexts.

Too long to wait: South Asian migrants' experiences of accessing health care in Australia.

BACKGROUND: Migrants settling in a new country experience multiple complexities in navigating health care systems and adapting to a new way of life in the host country. In South Asia, migrating to another country for better life opportunities has been an ongoing trend and migration to Australia has significantly increased in recent years. Lower utilisation of health services and higher risks of chronic diseases among South Asian migrants poses a continuing challenge for the Australian health care system and little is known about why this demographic group does not access health services at the same rate. This study aimed to explore factors influencing access to health care by South Asian migrants in Australia. METHODS: Using a mixed-method design, we conducted 62 online survey and 14 in-depth interviews with participants from four South Asian countries: Nepal, India, Bhutan, and Sri Lanka. Participants were recruited using a purposive snowball sampling approach following a standard ethical approval process. Survey data were analysed descriptively in SPSS and interview data were recorded, transcribed, and analysed thematically. RESULTS: South Asian migrants experienced various complexities while accessing health services in Australia. The findings of this study highlighted a number of negative factors influencing their experiences of accessing health care: long waiting times for public health care, the expense of private health care, and communication problems due to socio-cultural differences. South Asian migrants also expressed their concern for a greater investment of resources into public health care to enable them to access quality and affordable care in these settings. CONCLUSIONS: Given limited evidence available to help understand factors leading to the lower utilisation of health care and higher risks of chronic diseases among South Asian migrants, this study plays an important role in highlighting social, cultural, financial, and institutional factors that are critical to designing appropriate health-care strategies. This study recommends incorporating a collaborative and culturally competent model of care to increase access to health care and thereby help reduce existing disparities in health outcomes among South Asian migrant populations.

Respectful Maternity Care in South Asia: What Does the Evidence Say? Experiences of Care and Neglect, Associated Vulnerabilities and Social Complexities.

Background: Respectful maternity care encompasses the right to continuity of care and dignified support for women during the reproductive period, enabling informed choice. However, the evidence is limited in the context of South Asia region where maternal, perinatal and newborn mortality is still a critical challenge to health systems. Evidence is required to better understand the context of respectful maternity care to inform directions for appropriate policy and practice. Objective: The objective of this scoping review was to explore facilitators and barriers of respectful maternity care practice in South Asia. Design: CINAHL, EMBASE, PubMed, Medline, SCOPUS and Cochrane databases were used to identify related studies. Data were systematically synthesized and analysed thematically. Findings: There was considerable heterogeneity in the 61 included studies from seven South Asian countries, with most of the research conducted in Nepal and India. While the experience of abuse and neglect was common, 10 critical themes emerged related to neglected choices and compromised quality of care (particularly where there were health inequities) in the context of institutional care experiences; and the imperative for improved investment in training and significant policy and legislative change to enforce equitable and respectful maternity care practice. Conclusions and Implications for Practice: Evidence about respectful maternity care in South Asia indicates that women accessing professional and facility-based services experienced high levels of disrespect, abuse and maltreatment. Women from vulnerable, socially disadvantaged and economically poor backgrounds were more likely to experience higher level abuse and receive poor quality of care. There is an urgent need for a well-resourced, sustained commitment to mandate and support the provision of respectful and equitable maternity care practice in South Asia.

First call, home: perception and practice around health among South Asian migrants in Melbourne, Australia.

The socio-cultural context of populations has a significant effect on health outcomes across every stage of life. In Australia, South Asian migrants have a comparatively higher incidence of chronic disease and less use of health services. Often overlooked are community views of health, cultural traits and belief systems. This study aimed to explore the factors that influence health perception and practice of South Asian migrants. The study used a mixed method approach with both a survey and interviews. A total of 62 participants between the age of 18 and 64 years were surveyed and 14 participants completed interviews. Data were analysed descriptively and thematically. South Asians share a common perception and practice around health and illness. This paper highlights two key findings. First, these groups take a broad view of health encompassing physical, mental, emotional, social and economic aspects of life. Second, these cultural groups do not seek medical help as their first choice, but have a high level of trust in family for providing health advice and share a belief in the effectiveness of home remedies for managing health conditions. Participants shared their expectation that the Australian health system should consider their socio-cultural construct to make services culturally safe and engaging to enhance service utilisation.

Childbirth traditions and cultural perceptions of safety in Nepal: critical spaces to ensure the survival of mothers and newborns in remote mountain villages.

OBJECTIVE: to uncover local beliefs regarding pregnancy and birth in remote mountainous villages of Nepal in order to understand the factors which impact on women's experiences of pregnancy and childbirth and the related interplay of tradition, spiritual beliefs, risk and safety which impact on those experiences. DESIGN: this study used a qualitative methodological approach with in-depth interviews framework within social constructionist and feminist critical theories. SETTING: the setting comprised two remote Nepalese mountain villages where women have high rates of illiteracy, poverty, disadvantage, maternal and newborn mortality, and low life expectancy. Interviews were conducted between February and June, 2010. PARTICIPANTS: twenty five pregnant/postnatal women, five husbands, five mothers-in-law, one father-in-law, five service providers and five community stakeholders from the local communities were involved. FINDINGS: Nepalese women, their families and most of their community strongly value their childbirth traditions and associated spiritual beliefs and they profoundly shape women's views of safety and risk during pregnancy and childbirth, influencing how birth and new motherhood fit into daily life. These intense culturally-based views of childbirth safety and risk conflict starkly with the medical view of childbirth safety and risk. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: if maternity services are to improve maternal and neonatal survival rates in Nepal, maternity care providers must genuinely partner with local women inclusive of their cultural beliefs, and provide locally based primary maternity care. Women will then be more likely to attend maternity care services, and benefit from feeling culturally safe and culturally respected within their spiritual traditions of birth supported by the reduction of risk provided by informed and reverent medicalised care.