ABSTRACT
OBJECTIVE: This study aimed to explore the health care professional (HCP) experiences of working with interpreters when consulting refugee and migrant women who are not proficient in English around sexual and reproductive health (SRH) issues, in order to identify service and policy implications. METHODS: Semi-structured interviews were conducted with 21 HCPs, including: nurses (8), general practitioners (GP) (5), health promotion officers (5), sexual therapists (2) and one midwife. Interviews were audio-recorded, professionally transcribed and thematically analysed using socio-ecological theory. RESULTS: Overall HCPs stated that language and cultural discordance were barriers to SRH communication with refugee and migrant women. The lack of women interpreters and concerns with the interpreters such as lack of health/SRH knowledge were the main considerations HCPs reported related to working with interpreters when consulting refugee and migrant women. CONCLUSION: Communication barriers in the provision of SRH services to refugee and migrant women may not be avoided despite the use of interpreters. Great attention needs to be paid to the availability of women interpreters and training of interpreters to work in SRH.
Subject(s)
Attitude of Health Personnel , Communication Barriers , Refugees , Reproductive Health Services , Sexual Health , Transients and Migrants , Translating , Adult , Aged , Culture , Female , Focus Groups , Health Personnel , Humans , Interprofessional Relations , Language , Middle Aged , Professional Competence , Qualitative Research , Referral and Consultation , Reproductive HealthABSTRACT
Past research suggests that factors related to health care professionals' (HCPs) knowledge, training and competency can contribute to the underutilisation of sexual and reproductive health (SRH) care by refugee and migrant women. The aim of this study was to examine the perceived preparedness of HCPs in relation to their knowledge, confidence and training needs when it comes to consulting refugee and migrant women seeking SRH care in Australia. A sequential mixed methods design, comprising an online survey with 79 HCPs (45.6% nurses, 30.3% general practitioners (GPs), 16.5% health promotion officers, and 7.6% allied health professionals) and semi-structured interviews with 21 HCPs, was utilised. HCPs recognised refugee and migrant women's SRH as a complex issue that requires unique skills for the delivery of optimal care. However, they reported a lack of training (59.4% of nurses, 50% of GPs, and 38.6% of health promotion officers) and knowledge (27.8% of nurses, 20.8% of GPs, and 30.8% of health promotion officers) in addressing refugee and migrant women's SRH. The majority of participants (88.9% of nurses, 75% of GPs, and 76% of health promotion officers) demonstrated willingness to engage with further training in refugee and migrant women's SRH. The implications of the findings are argued regarding the need to train HCPs in culturally sensitive care and include the SRH of refugee and migrant women in university and professional development curricula in meeting the needs of this growing and vulnerable group of women.
Subject(s)
Health Knowledge, Attitudes, Practice , Health Personnel , Refugees , Reproductive Health , Sexual Health , Transients and Migrants , Adult , Australia , Culturally Competent Care , Female , Health Promotion , Humans , Male , Middle Aged , Perception , Reproduction , Sexual Behavior , Women's HealthABSTRACT
This Q methodological study was conducted to examine the perspectives of health professionals in providing sexual and reproductive health (SRH) care to refugee and migrant women. Forty-seven health professionals rank-ordered 42 statements and commented on their rankings in subsequent open-ended questions. A bi-person factor analysis was performed and factors were extracted according to the centroid method with a varimax rotation. Seven factors each with a distinct and meaningful viewpoint were identified. These factors are: "Communication difficulties-hurdles to counselling", "Lack of access to culturally appropriate care", "Navigating SRH care", "Cultural constraints on effective communication", "Effects of the lack of cultural competency", "Impacts of low income and language barrier" and "SRH services are accessible, but not culturally relevant". A more culturally adaptive healthcare model that considers refugee and migrant women's linguistic, cultural and socio-economic backgrounds; and engages health professionals on an ongoing process of building cultural competency is central to improve SRH access to these women.
Subject(s)
Attitude of Health Personnel , Culturally Competent Care/organization & administration , Refugees , Reproductive Health Services/organization & administration , Transients and Migrants , Adult , Aged , Communication , Communication Barriers , Cultural Competency , Culturally Competent Care/standards , Female , Health Knowledge, Attitudes, Practice , Health Services Accessibility/organization & administration , Humans , Male , Middle Aged , Patient Navigation/organization & administration , Qualitative Research , Reproductive Health Services/standards , Socioeconomic FactorsABSTRACT
BACKGROUND: In Australia only 2.2% of published health research has focused on multi-cultural health despite the increase of culturally and linguistically diverse populations. Research on the perceptions and experiences of health care professionals (HCPs) in engaging with refugee and migrant women is also lacking. Given the integral role of HCPs in providing sexual and reproductive health (SRH) care for these populations, an understanding of the challenges they experience is required. Therefore, this study sought to examine the perspectives and practices of Australian HCPs with regard to the provision of SRH care for refugee and migrant women. METHODS: Employing qualitative methods, twenty-one semi-structured interviews were conducted with HCPs representing various professions, work experiences, cultural backgrounds, age and healthcare sectors. The interviews were analysed using thematic analysis and the socio-ecological model was utilised to interpret the data. RESULTS: The complexities of HCP's engagement with refugee and migrant women were identified in three major themes: Being a Migrant; Gender Roles and SRH Decision-making; and Women in the Healthcare System. HCPs discussed the impact of accessing SRH care in women's country of origin and the influence of re-settlement contexts on their SRH knowledge, engagement with care and care provision. Perception of gender roles was integral to SRH decision-making with the need to involve male partners having an impact on the provision of women-centred care. Barriers within the healthcare system included the lack of services to address sexual functioning and relationship issues, as well as lack of resources, time constraints, cost of services, and funding. CONCLUSION: Australian HCPs interviewed reported that migrant and refugee women do not have appropriate access to SRH care due to multifaceted challenges. These challenges are present across the entire socio-ecological arena, from individual to systemic levels. Multiple and multidimensional interventions are required to increase SRH utilisation and improve outcomes for refugee and migrant women.