Theorising community engagement in sexual and reproductive health promotion in South Africa

This research explored barriers and facilitators of community engagement in sexual and reproductive health promotion in communities in the Eastern Cape, South Africa. Findings revealed various contextual individual-level and societal-level factors interact to influence community engagement. A theoretical model of influences was developed to guide future public health practice

Inclusive Policy? An Intersectional Analysis of Policy Influencing Women's Reproductive Decision‐Making

Policy can be used and experienced as a tool for social inclusion or exclusion; it can empower or disenfranchise. Women’s reproductive decision‐making and health is impacted by policy, and women’s experiences of diverse and intersecting marginalised social locations can influence their experiences of policy. This research aimed to explore how intersectionality is considered within Victorian state government policies that influence and impact women’s reproductive decision-making. A systematic search of Victorian (Australia) government policy instruments was undertaken, identifying twenty policy instruments. Policies were analysed using an intersectional policy analysis framework using a two‐stage process involving deductive coding into the domains of the framework, followed by inductive thematic analysis within and across domains. Findings reveal inconsistencies within and across policies in how they consider intersecting social relations of power in the representation of problems, women's positionings, policy impacts, and policy solutions. These gaps could exclude and marginalise individuals and groups and contribute to systemic inequities in women’s reproductive decision-making and the outcomes of those decisions, particularly among already marginalised groups. The lack of women's voices in policy further excludes and marginalises those impacted by the policy and limits the representation of all women in policy. Policy development needs to meaningfully involve women with diverse and intersecting marginalised social locations, and critical reflexivity of all stakeholders, to ensure policies can better account for the experiences of, and impacts upon, women who are marginalised and effect change to promote social inclusion and equity in women’s reproductive decision‐making

Navigating the ethics of cross-cultural health promotion research

Health promotion researchers must consider the ethics of their research, and are usually required to abide by a set of ethical requirements stipulated by governing bodies (such as the Australian National Health and Medical Research Council) and human research ethics committees (HRECs). These requirements address both deontological (rule-based) and consequence-based issues. However, at times there can be a disconnect between the requirements of deontological issues and the cultural sensitivity required when research is set in cultural contexts and settings etic to the HREC. This poses a challenge for health promotion researchers who must negotiate between meeting both the requirements of the HREC and the needs of the community with whom the research is being conducted. Drawing on two case studies, this paper discusses examples from cross-cultural health promotion research in Australian and international settings where disconnect arose and negotiation was required to appropriately meet the needs of all parties. The examples relate to issues of participant recruitment and informed consent, participants under the Australian legal age of consent, participant withdrawal when this seemingly occurs in an ad hoc rather than a formal manner and reciprocity. Although these approaches are context specific, they highlight issues for consideration to advance more culturally appropriate practice in research ethics and suggest ways a stronger anthropological lens can be applied to research ethics to overcome these challenges

Influences on reproductive decision-making among forcibly displaced women resettling in high-income countries: a scoping review and thematic analysis

Abstract Background Forced displacement impacts the health, rights and safety of women, which is further compounded by gender inequality. In particular, this has consequences for forcibly displaced women’s reproductive health once resettled in a new country. To ensure the reproductive health and rights of forcibly displaced women during and after resettlement, there must be careful consideration of their reproductive decision-making taking into account the context and environment of the host country. Aim This scoping review aimed to explore the influences on reproductive decision-making among forcibly displaced women resettling in high-income countries. Method A scoping review was conducted following the PRISMA-ScR for reporting. EBSCO was used to search databases covering global health, health policy, psychology, sociology, and philosophy for articles published from 1 January 2012 to 27 April 2022. Data extracted from each article included author(s), year of publication, publication type, aims/objectives, study design, sampling method, data collection or eligibility criteria, study population (i.e., sample size and characteristics), migration status, country(ies) of origin, host country(ies), key findings and limitations. Two independent reviewers screened all articles against eligibility criteria using Covidence. Data charting and thematic analysis were performed independently by one reviewer. Findings Nineteen articles published between 2013 and 2022 mostly conducted in the United States (36.8%) and Australia (21.1%), with the majority reporting on qualitative findings (68.4%), and women from a wide array of countries and cultures (most commonly African countries) were included. Influences on women’s reproductive decision-making related to the contexts before displacement, during displacement, and after arrival, with influences on women’s reproductive decision-making identified specific to the context. The influences before displacement included conflict; religious beliefs; socio-cultural gendered expectations; and external control over reproductive autonomy. During displacement influences included paternalism and access to education. Influences after arrival included pressure, restriction, coercion; knowledge and misconceptions; patriarchal power dynamics; and seeking empowerment. An adapted socio-ecological model was developed to interpret the findings. Conclusion This review highlights the complexity and nuances within forcibly displaced women’s experiences which influence their reproductive decision-making. Further research may review the evidence base to provide guidance for healthcare professionals and health policies aimed at empowering women to make autonomous reproductive decisions; develop training for healthcare professionals to prevent pressure, restriction and coercion of women’s reproductive autonomy; and inform development of policy that takes an intersectional approach to women’s health rights and gender equality

Australian social work academics’ perceptions of their teaching roles within higher education

The marketisation of higher education (HE) has created a number of tensions and ideological dilemmas that may influence how academics see their roles and teaching practices. This paper explores how academics in the discipline of social work (who were also in leadership roles) perceive their roles and identities and manage the tensions and dilemmas that arise for them as teachers in the current HE environment. Unless the tensions and dilemmas are articulated, it is not possible to understand and manage their impact on academics. This may lead to the loss of quality learning experiences for students and lower workplace satisfaction. This paper addresses the research question: were there ideological dilemmas experienced by social work academics in the current environment and if so, what subject positions did they adopt in response to these? A discursive psychology approach was used to answer this question. Data showed a range of ideological dilemmas represented by each of the different subject positions adopted. The paper concludes with questions for readers to consider, generating ideas for transferring understanding of these ideological dilemmas into positive action within the workplace