Sexual and reproductive health communication among Sudanese and Eritrean women: an exploratory study from Brisbane, Australia

This exploratory study piloted in Brisbane, Australia, reports on findings from in-depth focus-group discussions conducted with Sudanese and Eritrean women in Brisbane. We investigated and documented their experiences and knowledge of sexual and reproductive health and contraception, and explored their views on sexuality and relationships education within the family environment of minority ethnic communities in Australia. Underpinned by a qualitative psychosocial framework, the study also involved key-informant interviews with health and multicultural not-for-profit sector professionals. Through the knowledge and experiences shared by the participants, the key themes of cultural insensitivity, exclusion and poor communication within the family were highlighted by participants as determining factors in the achievement of sexual and reproductive health and good quality sex and relationships education. Participants proposed recommendations for how minority ethnic communities in Australia can more effectively support and communicate within the family environment to increase their own and their children's knowledge and understanding

The Role of Stakeholders in HIA: A Landfill Site and Housing Development in Mundijong, Western Australia

The use of Health Impact Assessment (HIA) as a tool to identify and manage issues relating to health has not been widely adopted in Western Australia. Health Impact Assessment methodology was applied to two concurrent developments in the Shire of Serpentine Jarrahdale, Western Australia. Potential health impacts of the expansionof a sanitary landfill adjacent to a proposed housing development were identified following a literature review and stakeholder interviews. Recommendations to assess the risk to the community in the housing estate through quantitative analysis, and risk management strategies were provided to the Shire. The ability of an existing stakeholder group for the landfill, the South Cardup Landfill Stakeholder Consultative Group, to resolve concerns of the community relating to environmental and social issues were also evaluated. Recommendations to improve collaborative decision making were provided to the Stakeholder Group using the Framework for Democratic Science. The outcomes of the HIA informed the Shire of potential health impacts to assist decision making during the development application process and the design of a local District Structure Plan

Resettlement Experiences of Afghan Hazara Female Adolescents: A Case Study from Melbourne, Australia

Young people from refugee backgrounds face a number of challenges in adjusting to life in a new country. Recently, there have been more studies documenting some of these challenges and experiences, and offering recommendations for the health and education sector to appropriately respond to their needs. This study sought to investigate some of the experiences and challenges faced by female Afghan Hazara refugee adolescents as a precursor to program development occurring within a community health service in the outer southeastern suburbs of Melbourne, Australia. This paper reports on a cross-sectional participatory qualitative research study undertaken with young Afghan female adolescents aged 14–17 years of Hazara ethnicity. The results document some of the key contested gender and cultural challenges facing these young women, their aspirations for their lives in Australia, and how this research has informed community health practice

Resettlement Experiences of Afghan Hazara Female Adolescents: A Case Study from Melbourne, Australia

Young people from refugee backgrounds face a number of challenges in adjusting to life in a new country. Recently, there have been more studies documenting some of these challenges and experiences, and offering recommendations for the health and education sector to appropriately respond to their needs. This study sought to investigate some of the experiences and challenges faced by female Afghan Hazara refugee adolescents as a precursor to program development occurring within a community health service in the outer southeastern suburbs of Melbourne, Australia. This paper reports on a cross-sectional participatory qualitative research study undertaken with young Afghan female adolescents aged 14–17 years of Hazara ethnicity. The results document some of the key contested gender and cultural challenges facing these young women, their aspirations for their lives in Australia, and how this research has informed community health practice

Are universities responding to the needs of students from refugee backgrounds?

Although many Australian universities have been proactive in responding to students' diverse needs through orientation and support programs, very little is known about programs needed for the successful transition of students from refugee backgrounds into tertiary study. Facilitating the early engagement of students with their studies and campus life is linked to greater student satisfaction, improved retention rates and better educational outcomes. One of the challenges that academics face is the paucity of research on the learning styles and academic needs of African and Middle Eastern students from refugee backgrounds.This paper reports on a needs analysis undertaken with a group of students from refugee backgrounds in Victoria and Western Australia, using in-depth interviews and focus group discussions. Participants reported that current support systems and programs are inadequate or non-existent and that many feel disadvantaged compared to Australian-born and international students. The article concludes with recommendations on how universities can better respond to the needs of students from refugee backgrounds

Resettlement experiences and resilience in refugee youth in Perth, Western Australia

Background: In Australia, the two major pathways of refugee entry are the United Nations High Commissioner for Refugees resettlement programme and irregular maritime arrivals (IMAs) seeking asylum. The Australian Government’s policies towards IMAs since July 2013 are controversial, uncompromising and consistently harsh, with asylum seekers held in detention centres for prolonged periods. Refugees and asylum seekers have distinct and unique stressors that make resettlement difficult. Methods: This exploratory study examines resettlement experiences for refugee youth in Western Australia using the psychosocial conceptual framework and qualitative methods. Focus group discussions and key informant interviews were undertaken with verbatim transcripts analysed using thematic analysis to identify themes. Results: Themes documented that language and its impact, and experience with education, health, and social activities, support structures provided to youth and supporting future aspirations as critical to successful resettlement. This exploratory study contributes to developing a broader understanding of the resettlement experiences of refugee youth, drawing on their current and past experiences, cultural differences and mechanisms for coping. Conclusion: Fluency in English language, especially spoken, was a facilitator of successful resettlement. Our results align with previous studies documenting that support programs are vital for successful resettlement. Although faced with immense difficulties refugee youth are resilient, want to succeed and have aspirations for the future. Strategies and recommendations suggested by refugee youth themselves could be used for developing interventions to assist successful resettlement

Between a rock and a hard place: stigma and the desire to have children among people living with HIV in northern Uganda

Abstract Background: HIV-related stigma, among other factors, has been shown to have an impact on the desire to have children amongpeople living with HIV (PLHIV). Our objective was to explore the experiences of HIV-related stigma among PLHIV in post-conflictnorthern Uganda, a region of high HIV prevalence, high infant and child mortality and low contraception use, and to describehow stigma affected the desires of PLHIV to have children in the future.Methods: Semi-structured interviews were conducted with 26 PLHIV in Gulu district, northern Uganda. The interviews,conducted in Luo, the local language, were audio recorded, transcribed and then translated into English. Thematic data analysiswas undertaken using NVivo8 and was underpinned by the ‘‘Conceptual Model of HIV/AIDS Stigma’’.Results: HIV-related stigma continues to affect the quality of life of PLHIV in Gulu district, northern Uganda, and also influencesPLHIV’s desire to have children. PLHIV in northern Uganda continue to experience stigma in various forms, including internalstigma and verbal abuse from community members. While many PLHIV desire to have children and are strongly influenced byseveral factors including societal and cultural obligations, stigma and discrimination also affect this desire. Several dimensionsof stigma, such as types of stigma (received, internal and associated stigma), stigmatizing behaviours (abusing and desertion)and agents of stigmatization (families, communities and health systems), either directly, or indirectly, enhanced or reducedPLHIV’s desire to have more children.Conclusions: The social-cultural context within which PLHIV continue to desire to have children must be better understoodby all health professionals who hope to improve the quality of PLHIV’s lives. By delineating the stigma process, the paperproposes interventions for reducing stigmatization of PLHIV in northern Uganda in order to improve the quality of life and healthoutcomes for PLHIV and their children

Family planning among people living with HIV in post-conflict Northern Uganda: A mixed methods study

<p>Abstract</p> <p>Background</p> <p>Northern Uganda experienced severe civil conflict for over 20 years and is also a region of high HIV prevalence. This study examined knowledge of, access to, and factors associated with use of family planning services among people living with HIV (PLHIV) in this region.</p> <p>Methods</p> <p>Between February and May 2009, a total of 476 HIV clinic attendees from three health facilities in Gulu, Northern Uganda, were interviewed using a structured questionnaire. Semi-structured interviews were conducted with another 26 participants. Factors associated with use of family planning methods were examined using logistic regression methods, while qualitative data was analyzed within a social-ecological framework using thematic analysis.</p> <p>Results</p> <p>There was a high level of knowledge about family planning methods among the PLHIV surveyed (96%). However, there were a significantly higher proportion of males (52%) than females (25%) who reported using contraception. Factors significantly associated with the use of contraception were having ever gone to school [adjusted odds ratio (AOR) = 4.32, 95% confidence interval (CI): 1.33-14.07; p = .015], discussion of family planning with a health worker (AOR = 2.08, 95% CI: 1.01-4.27; p = .046), or with one's spouse (AOR = 5.13, 95% CI: 2.35-11.16; p = .000), not attending the Catholic-run clinic (AOR = 3.67, 95% CI: 1.79-7.54; p = .000), and spouses' non-desire for children (AOR = 2.19, 95% CI: 1.10-4.36; p = .025). Qualitative data revealed six major factors influencing contraception use among PLHIV in Gulu including personal and structural barriers to contraceptive use, perceptions of family planning, decision making, covert use of family planning methods and targeting of women for family planning services.</p> <p>Conclusions</p> <p>Multilevel, context-specific health interventions including an integration of family planning services into HIV clinics could help overcome some of the individual and structural barriers to accessing family planning services among PLHIV in Gulu. The integration also has the potential to reduce HIV incidence in this post-conflict region.</p