Turkish-Dutch Muslim and Orthodox reformed parents in the Netherlands: religious identity negotiations in contexts of children's education

Religious parents can be thoroughly involved in tensions in educational contexts in western,secular countries. This study explores the understudied religious parents’ processes of religious identity negotiation in educational contexts in a western, secular country, the Netherlands. Compared to other western countries, the Netherlands is more strongly observed in shifting away from collective religious freedoms, towards a focus on individual rights. It therefore forms a particularly relevant arena to explore these tensions. Ten in-depth semi-structured interviews (N=16) were conducted. Participants are selected from two religious minority groups: Dutch-Turkish Muslim parents (N=6), attending Diyanet mosques, and Dutch Christian orthodox reformed parents (N=10), attending the Reformed Congregations in the Netherlands. The psychological and sociological perspective of identity theory and related theoretical aspects are used as an analytical framework in the abductive analysis of the interview data. The findings highlight an individualised nature of parents’ religious identities, relevant across situations and strongly interwoven with their parenting identities. This interwovenness seems expressed through an identity concern towards their children’s identities. The parents’ experiences of frictions in educational contexts appear to be surprisingly diverse, in this study analysed in theoretical terms of macro and micro contexts. The findings indicate that parents’ identity negotiations move beyond social recognition, instead prioritising a relationship with God and religious transmission to children. Importantly, this seems to result in an avoidance of religious identity expressions and interactions in educational contexts, and in an involvement with children’s religious identities at home instead. Thus, drawing on a limited number of interviews, this study deepens an understanding of religious parents’ religious thinking processes when confronted with tensions in educational contexts. The findings are relevant in debates in the field of religion and educational policy in western countries, and in debates concerning the Dutch approach to freedom of education in particular

Conflicting rights? Dutch-Turkish Muslim parents fostering a religiously coloured agency

This article is an in-depth exploration of the roles of Dutch-Turkish Muslim parents in facilitating their children’s freedom of thought, conscience and religion, and the rights of these parents to provide their children with religious direction. A limited number of four semi-structured, in-depth interviews was conducted, with a total of six Dutch-Turkish Muslim parents. The interview data were analysed by both inductive and deductive analysis, so-called abductive analysis. Instead of fostering child agency by promoting their children’s individual choice, the parents seek to promote a religiously coloured agency. The findings indicate five ways the parents integrate a religious direction while fostering the child’s agency

Science religion encounters toolkit 13: Research summaries from the project

An online survey was designed to explore beginning teachers’ confidence and competence in planning for and responding to science/religion encounters in the classroom. The online survey was designed in response to comments in focus groups with 75 student teachers. There were 949 responses to the online survey. 324 primary teachers and student teachers completed over 50% of the survey and it is responses from this group that are analysed below

Science religion encounters, epistemic trespass, neighbourliness and overlapping domains: theorisation and quantitative evidence of extent

This study advances a concept of science religion encounter (SRE), with preliminary theorisation and shares findings on the extent and nature of such encounters reported by secondary religious education and science teachers. SREs are interdisciplinary engagements in classrooms involving subject knowledge from more than one subject. The researchers hypothesised they may arise unexpectedly, when a pupil asks a question, or be teacher-planned and intended. This article further elaborates the concept of SRE with reference to the concepts of ‘epistemic trespassing’ (ET), epistemic neighbourliness, and overlapping domains, introducing these to the field of education. The study is contextualised in the school classroom with quantitative data gathered among beginning and experienced teachers measuring whether this ET in SRE topics enter the classroom via ‘spontaneity’ or via a ‘deliberateness’. This clarifies the different roles a teacher may play and offers considerations for teacher development when navigating an SRE in ways that potentially reduce lost learning

An evaluation of self-management outcomes among chronic care patients in community home-based care programmes in rural Malawi: A 12-month follow-up study.

"This paper investigates the impact of community home-based care (CHBC) on self-management outcomes for chronically ill patients in rural Malawi. A pre- and post-evaluation survey was administered among 140 chronically ill patients with HIV and non-communicable diseases, newly enrolled in four CHBC programmes. We translated, adapted and administered scales from the Stanford Chronic Disease Self-Management Programme to evaluate patient's self-management outcomes (health status and self-efficacy), at four time points over a 12-month period, between April 2016 and May 2017. The patient's drop-out rate was approximately 8%. Data analysis included descriptive statistics, tests of associations, correlations and pairwise comparison of outcome variables between time points, and multivariate regression analysis to explore factors associated with changes in self-efficacy following CHBC interventions. The results indicate a reduction in patient-reported pain, fatigue and illness intrusiveness, while improvements in general health status and quality of life were not statistically significant. At baseline, the self-efficacy mean was 5.91, which dropped to 5.1 after 12\xC2\xA0months. Factors associated with this change included marital status, education, employment and were condition-related; whereby self-efficacy for non-HIV and multimorbid patients was much lower. The odds for self-efficacy improvement were lower for patients with diagnosed conditions of longer duration. CHBC programme support, regularity of contact and proximal location to other services influenced self-efficacy. Programmes maintaining regular home visits had higher patient satisfaction levels. Our findings suggest that there were differential changes in self-management outcomes following CHBC interventions. While self-management support through CHBC programmes was evident, CHBC providers require continuous training, supervision and sustainable funding to strengthen their contribution. Furthermore, sociodemographic and condition-related factors should inform the design of future interventions to optimise outcomes. This study provides a systematic evaluation of self-management outcomes for a heterogeneous chronically ill patient population and highlights the potential and relevant contribution of CHBC programmes in improving chronic care within sub-Saharan Africa.

Patient–provider perspectives on self‐management support and patient empowerment in chronic care: A mixed‐methods study in a rural sub‐Saharan setting

Aim: To explore how provision of self‐management support to chronically‐ill patients in resource‐limited settings contributes to patient empowerment in chronic care. Design: Concurrent descriptive mixed methods research. Methods: A survey of 140 patients with chronic conditions administered at four time‐points in 12 months. We conducted 14 interviews and four focus‐group discus‐ sions with patients (N = 31); 13 healthcare provider interviews; and observations of four patient‐support group meetings. Data were collected between April 2016 ‐ May 2017 in rural Malawi. Qualitative data were analysed using a thematic approach and descriptive statistical analysis performed on survey data. Results: Healthcare professionals facilitated patient empowerment through health education, although literacy levels and environmental factors affected self‐manage‐ ment guidance. Information exchanged during patient–provider interactions varied and discussions centred around medical aspects and health promoting behaviour. Less than 40% of survey patients prepared questions prior to clinic consultations. Health education was often unstructured and delegated to non‐physician providers, mostly untrained in chronic care. Patients accessed psychosocial support from vol‐ unteer‐led community home‐based care programmes. HIV support‐groups regularly interacted with peers and practical skills exchanged in a supportive environment, reinforcing patient's self‐mangement competence and proactiveness in health care. Conclusion: For optimal self‐management, reforms at inter‐personal and organiza‐ tional level are needed including; mutual patient‐provider collaboration, diversifying access to self‐management support resources and restructuring patient support‐ groups to cater to diverse chronic conditions.Impact: Our study provides insights and framing of self‐management support and empowerment for patients in long‐term care in sub‐Saharan Africa. Lessons drawn could feed into designing and delivering responsive chronic care interventions

Context matters: a qualitative study of the practicalities and dilemmas of delivering integrated chronic care within primary and secondary care settings in a rural Malawian district

Background: With the increasing double burden of communicable and non-communicable diseases (NCDs) in subSaharan Africa, health systems require new approaches to organise and deliver services for patients requiring longterm care. There is increasing recognition of the need to integrate health services, with evidence supporting integration of HIV and NCD services through the reorganisation of health system inputs, across system levels. This study investigates current practices of delivering and implementing integrated care for chronically-ill patients in rural Malawi, focusing on the primary level. Methods: A qualitative study on chronic care in Phalombe district conducted between April 2016 and May 2017, with a sub-analysis performed on the data following a document analysis to understand the policy context and how integration is conceptualised in Malawi; structured observations in five of the 15 district health facilities, selected purposively to represent different levels of care (primary and secondary), and ownership (private and public). Fifteen interviews with healthcare providers and managers, purposively selected from the above facilities. Meetings with five non-governmental organisations to study their projects and support towards chronic care in Phalombe. Data were analysed using a thematic approach and managed in NVivo. Results: Our study found that, while policies supported integration of various disease-specific programmes at point of care, integration efforts on the ground were severely hampered by human and health resource challenges e.g. inadequate consultation rooms, erratic supplies especially for NCDs, and an overstretched health workforce. There were notable achievements, though most prominent at the secondary level e.g. the establishment of a combined NCD clinic, initiating NCD screening within HIV services, and initiatives for integrated information systems. Conclusion: In rural Malawi, major impediments to integrated care provision for chronically-ill patients include the frail state of primary healthcare services and sub-optimal NCD care at the lowest healthcare level. In pursuit of integrative strategies, opportunities lie in utilising and expanding community-based outreach strategies offering multi-disease screening and care with strong referral linkages; careful task delegation and role realignment among care teams supported with proper training and incentive mechanisms; and collaborative partnership between public and private sector actors to expand the resource-base and promoting cross-programme initiatives