Intimate Partner Violence among Immigrant Woman: intersectional challenges in health services

In a world in progressive movement, with increasingly diverse societies, the number of women living in a multicultural and migration context is a recognized reality. Many immigrant women living in Portugal suffer intimate partner violence, however there are a lack of knowledge about these realities. This invisibility makes it difficult to understand their specific needs and difficulties. It is known that many cases of intimate partner violence remain unreported (FRA- European Union Agency for Fundamental Rights, 2014), which in the case of immigrant women may be more serious (WHO, 2014). Studies suggest that immigrant women face huge challenges related with the accessibility and use of the health services (Fonseca, Silva, McGarrigle & Esteves, 2007), namely victim support services. Considering this, this paper aims, through an intersectional lens, to create a conceptual and theoretical discussion about intimate partner violence among immigrant women as well as to explore the different barriers in the access and use of health support services.info:eu-repo/semantics/publishedVersio

CUIDADOS DE SAÚDE MATERNO-INFANTIS A IMIGRANTES NA REGIÃO DO GRANDE PORTO

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Cuidados de saúde materno-infantis à população imigrante residente em Portugal

Tese de doutoramento em Psicologia (área de especialização em Psicologia Social)Num mundo em progressiva movimentação, com sociedades cada vez mais diversificadas, o número de mulheres a viver a maternidade em contexto multicultural e migratório é, nos dias de hoje, uma realidade com uma expressão reconhecida, tanto a nível mundial como nacional. Todavia, o conhecimento em torno da qualidade e da eficácia do acesso dos/as imigrantes aos cuidados de saúde, especialmente no que respeita às mulheres imigrantes, é ainda escasso em Portugal (Fonseca, Silva, Esteves & McGarrigle, 2007). Os estudos sugerem que as mulheres migrantes se deparam com enormes desafios no que à questão da acessibilidade aos cuidados de saúde diz respeito. As dificuldades parecem intensificar-se durante a gravidez e a maternidade, períodos de maior vulnerabilidade à doença e ao risco, para elas e para as/os suas/seus descendentes. Face a este cenário, a presente dissertação tem por objetivo principal analisar e caracterizar os cuidados materno-infantis prestados à população imigrante residente em Portugal. Situada em pressupostos teóricos e epistemológicos críticos oferecidos pelo construcionismo social, a presente investigação, de natureza qualitativa, compreendeu a realização de dois estudos empíricos. O estudo 1, pretendeu caracterizar os discursos, perceções e vivências de trinta mulheres de nacionalidade cabo-verdiana, brasileira e ucraniana nos cuidados de saúde materno-infantis em Portugal. O estudo 2, pretendeu contribuir para um melhor conhecimento sobre o acesso e capacidade de resposta do Sistema Nacional de Saúde e suas/seus profissionais à procura de cuidados por mulheres imigrantes grávidas residentes em Portugal bem como pretendeu caracterizar os discursos de catorze profissionais de saúde sobre os cuidados específicos preconizados às mulheres imigrantes durante o período de gravidez, parto e puerpério. No estudo 1 através da análise temática efetuada foram identificados dois temasmovimentações na diáspora e cuidados de saúde materna: facilidades e constrangimentos, cuja análise em profundidade foi auxiliada pela análise crítica do discurso (Willig, 2003, 2008). Os resultados mostram, de um modo geral, que os padrões de procura de serviços de saúde para vigilância de gravidez são tardios. Para isso contribuem as experiências vivenciadas nos diversos contextos sociais (e.g., experiências discriminatórias) bem como os múltiplos e diferenciados obstáculos que encontram (e.g., culturais, informativos, económicos, comunicacionais, burocráticas, familiares) quando acedem ou tentam aceder aos serviços. Embora a maioria faça uma apreciação positiva dos cuidados recebidos, todas elas alertam para a insensibilidade demonstrada pelas/os profissionais face à diversidade cultural e a constante discriminação preconizada, que é diferenciada consoante as suas pertenças identitárias. Face às dificuldades sentidas e aos discursos com os quais vão contactando, estas mulheres vão alimentando uma noção de si como pessoas com menos direitos, o que as leva conformarem-se com as práticas ocidentais de cuidado e a silenciar-se face às práticas discriminatórias a que são sujeitas. Deste modo, os resultados apontam para que as estratégias individuais utilizadas não constituem qualquer tipo de ameaça ao grupo hegemónico, contribuindo para a manutenção do status quo (Lewin, 1948/1997) e da desigualdade. No estudo 2 através da análise temática efetuada foi identificado um grande temaconhecimento, constrangimentos e práticas face aos cuidados de saúde à população imigrante grávida, cuja reflexão foi também complexificada com o uso da análise crítica do discurso. Neste estudo, os resultados apontam para a existência de vários entraves ao acesso das imigrantes aos cuidados de saúde primários. O desconhecimento da legislação vigente por parte das/os profissionais, a falta de infraestruturas de gestão capazes de responder às diferentes necessidades, nomeadamente no que concerne à atribuição de um/a técnico para seguir a grávida durante um longo período, o tempo limitado das consultas, bem como as barreiras comunicacionais e linguísticas existentes parecem contribuir para este cenário. Por outro lado, os resultados mostram que os discursos das/os profissionais são discursos hegemónicos que levam a uma regulação de saberes das imigrantes em prol do conhecimento biomédico ocidental. Assim, as evidências desta investigação apontam para uma assimetria de poderes nas relações de cuidado materno-infantis, que se por um lado, têm como função proteger as mulheres garantindo-lhes um melhor bem-estar e prevenção de problemas futuros, por outro lado, limitam, constrangem e reprimem as ações destas mulheres, aumentando assim a vulnerabilidade a que estão sujeitas durante o período de gravidez e puerpério.In a world in progressive movement, with increasingly diverse societies, the number of women living their motherhood in a multicultural and migration context is a recognized reality both at global and national levels. However, there’s little knowledge about the quality and effectiveness of the access of immigrant to the national health care system especially regarding immigrant women living in Portugal (Fonseca, Silva, McGarrigle & Esteves, 2007). Studies suggest that migrant women face huge challenges related with the accessibility to health care matters. These difficulties seem to intensify during pregnancy and maternity periods because the vulnerability to diseases and risk to women and their descendants increases. Taking this into account, this paper aims to analyze and characterize the maternal and child healthcare provided to the immigrant population resident in Portugal. Based on theoretical and epistemological critical assumptions given by social constructionism, this qualitative research is divided into two empirical studies. The study 1, intended to characterize (look for the common features in) the speeches, perceptions and experiences of thirty Capeverdean, Brazilian and Ukrainian women about the maternal and child health care services in Portugal. Study 2, intended to contribute to a better understanding of the access and responsiveness of the national health care system and its professionals towards regnant immigrant women living in Portugal as well as to characterize the speeches of fourteen health professionals about the specific care procedures provided to immigrant women during pregnancy, childbirth and postpartum periods. In study 1, a thematic analysis was conducted and two themes could be identified- Movements in the Diaspora and Maternal health care: facilities and constraints - whose in-depth analysis was helped by the critical analysis of the discourse (Willig, 2003, 2008). The results show, that the search of healthcare services for monitoring pregnancies are generally delayed. Personal experiences in different social contexts (e.g., experiences of discrimination) as well as the multiple and different obstacles encountered (e.g., cultural, informational, economic, communication, bureaucratic, familiar) when accessing or attempting to access services seem to be an important contribution. Most of the women made a positive assessment of the care services received but they all warn about the professionals’ insensitivity to cultural diversity and constant discrimination actions performed, which seems to appear in different shapes and related with their identity characteristics. Given the difficulties experienced and the speeches with which they contact, these women nurture a sense of themselves as people with fewer rights and this seems to lead them to comply with Western practices of care and to silence themselves about the discriminatory practices experienced. The results indicate that the individual strategies used do not constitute any threat to the hegemonic group and contribute to the maintenance of the status quo (Lewin, 1948/1997) and inequalities. In study 2, the thematic/theme analysis conducted identified one central subject- Knowledge, constraints and practices in relation to health care in pregnant immigrant population. Once again, the reflection about this matter was performed in accordance with the critical discourse analysis. In this study, the results point out the existence of several barriers to the immigrants’ access of primary health care services. The professionals’ lack of knowledge about legislation, the lack of management infrastructure capable of responding to different needs, particularly in relation to providing a technician to follow each woman for a long period, the time constrainments in the medical consultations as well as the language and communication barriers appear to contribute to this scenario. Moreover, the results show that professionals’ discourses are hegemonic discourses and lead to a regulation of immigrants’ knowledge in favor of western biomedical understandings. Thus, the evidences in this research highlight the presence of power asymmetries in the relations established in the maternal and child care services. If, on the one hand, these relations have the duty to protect women ensuring them a better well-being and prevention of future problems, on the other hand, limit, constrain and restrain the actions of these women while increasing the vulnerability to which they are subjected during pregnancy and postpartum periods

Racism in football in Portugal: perceptions of multiple actors

The present paper aims to analyze and understand, from an intersectional point of view, the extent and the characteristics of racism in football in Portugal, based on the perspectives of football fans, coaches, amateur players, professional players, journalists, parents, and other elements directly or indirectly involved in the modality. Using an online questionnaire, this exploratory study involved 1681 participants, 456 self-identified as women, 1221 as men, and 4 as non-binary, aged between 13 and 61 years old (M = 33.02; DP = 12.64). The results show gender, skin color, ethnicity, sexual orientation/gender identity, and functional diversity are the main factors explaining discrimination in football, with differences between genders. Nearly 70% of women and 50% of men admitted the existence of racism in football in Portugal. In addition, associations between participants’ condition, age, perceptions, and experiences of racism were found, with amateur players and younger participants revealing a stronger position concerning the topic. This study can inform contemporary debates in critical research, particularly around football, discrimination, and cultural citizenship. Intersectional research across football studies is crucial to better understand the racialized aspects of football and develop better policies that can prevent and combat racism.info:eu-repo/semantics/publishedVersio

Immigration and health: women immigrants' (in)ability to access health care

A utilização dos serviços de saúde pelas populações imigrantes tem vindo a ser considerado um dos mais importantes indicadores da sua integração nas sociedades receptoras (Dias e col., 2009). No entanto, o conhecimento em torno da qualidade e da eficácia do acesso dos/as imigrantes aos cuidados de saúde, especialmente no que respeita às mulheres imigrantes, é ainda escasso em Portugal (Fonseca e col., 2005). Embora os estudos nacionais tenham vindo, nas últimas décadas, a procurar traçar os diferentes perfis sociais das mulheres imigrantes em Portugal, sobretudo no que concerne às suas relações familiares ou laborais (Wall e col., 2005), a investigação no domínio da saúde é ainda parca e exclusora de uma análise centrada no género ou interseccional. Neste texto apresenta-se uma reflexão sobre os determinantes que condicionam a (in)acessibilidade das mulheres imigrantes aos cuidados de saúde, enfatizando-se os fatores que poderão estar a agir no sentido contrário à sua integração neste setor.The use of health services by immigrant populations has been considered one of the most important indicators of the integration of these communities (Dias et al., 2009). However, knowledge about the quality and efficacy of this access to care, especially for immigrant women, is still scarce in Portugal (Fonseca et al., 2009). Although domestic studies have, in recent decades, sought to trace the different social profiles of immigrant women in Portugal, especially with regard to family or work relationships (Wall et al., 2005), research on health is still sparse. Gender-centered or intersectorial analysis has not yet been done. This paper presents a reflection on the determinants that influence immigrant women's (in)ability to access health care, emphasizing the factors that may be acting to block integration in this sector

Death Threats and Attempted Femicide in the Context of Domestic Violence in Portugal

Domestic violence is a serious problem in Portugal, affecting mainly women. The significant number of femicides in the context of intimate partner violence has been showing not only the severity of the crime, but also the necessity to reinforce strategies to prevent and combat it. Although several studies were developed in the last decades to portray domestic violence, research on the threat of death and attempted femicide is scarce. This study aims to characterize death threats and attempts of femicide, in the light of the professionals’ perspectives from the Portugal National Support Network for Victims of Domestic Violence, contributing to informing best practices of risk assessment. Seventy one professionals, 62 female (87.3%) and 9 male (12.7%), at an average age of 37.69 years, filled a questionnaire survey. Results suggest weaknesses in the application of current legislation and the adoption of effective measures in situations where victims experience death threats and attempted murders. Although there are criminal proceedings before these episodes, this does not seem to have effective consequences in terms of protection and security, whereby the development of strategies that safeguard victims from tragic endings such as femicide are necessaryinfo:eu-repo/semantics/publishedVersio

Violent intimate relationships of Brazilian women in Portugal

This study aims to understand the intimate experiences of immigrant Brazilian women living in Portugal, and also to characterize possible victimization experiences in their intimate relationships. The empirical base was constituted by 114 immigrant women, and the results show that the intimate experiences of these women are marked by violence episodes both in Portugal and in Brazil. The most frequent types of violence were psychological and verbal violence, with these practices occurring more than once in their intimate relationships. When experiencing violence episodes, these women do not seek help and do not file a formal complaint, which legitimizes and reinforces the victimization to which they are subjected. This study intends to contribute to the development of action strategies that lead to the real protection of immigrant victims and to challenge the greater risk that immigration can entail in the lives of immigrant women, especially for victims of intimate violence

MUROS DE DISCRIMINACIÓN Y EXCLUSIÓN EN LA CONSTRUCCIÓN DE IDENTIDADES: LA MIRADA DE LAS CIENCIAS SOCIALES

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Estudo Nacional sobre o Racismo no Futebol em Portugal: Perceções e vivências

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Inclusão/exclusão das mulheres imigrantes nos cuidados de saúde em Portugal: reflexão à luz do feminismo crítico

O processo migratório pode constituir um factor de risco para a saúde, podendo acarretar uma maior vulnerabilidade em relação a problemas de saúde em geral (Carballo et al. , 1998) e de saúde mental em particular, devido não só à dureza do processo migratório (Carta et al. , 2005), mas também à exposição quotidiana a formas de discriminação (in Pusseti, Ferreira, Lechner & Santinho, 2009). Se existe um elevado desconhecimento do acesso efectivo dos/as imigrantes aos cuidados de saúde (Fonseca, Silva, Esteves & McGarrigle, 2009) mais acentuado é no que se concerne à mulher imigrante. Esta apresentação pretende evidenciar e reflectir sobre a necessidade dos países de acolhimento desenvolverem políticas a nível dos serviços de saúde, à luz dos feminismos, tendo em conta o estatuto de mulher e imigrante. Trata-se uma reflexão teórica sobre o tema que está a ser trabalhado empiricamente no âmbito de um doutoramento em Psicologia Socia