An analysis of reflections on researcher positionality

Reflexivity is a central tenet of qualitative research. Engaging in self-reflexive praxis allows researchers to identify areas of tension in the research process that need to be further deconstructed. In this paper, we draw on our collective self-reflective experiences as qualitative health researchers whose scholarship is informed by critical and postcolonial feminist epistemologies to offer some guidance on how to approach the concept of insider versus outsider in the research process. Specifically, we analyze recurring methodological tensions related to positionality and outline how they were addressed. The lessons learned from our studies can be instructive to other qualitative researchers.http://nsuworks.nova.edu/tqrpm2022Agricultural Economics, Extension and Rural Developmen

An Emancipatory Approach to Cultural Competency: The Application of Critical Race, Postcolonial, and Intersectionality Theories

Nurses teach, work, and conduct research in an increasingly hostile sociopolitical climate where health inequities persist among marginalized communities. Current approaches to cultural competency do not adequately equip nurses to address these complex factors and risk perpetuating stereotypes and discrimination. A theory-driven emancipatory approach to cultural competency will instead lead to lasting change and uphold the core nursing value of commitment to social justice. This article explicates key tenets of critical race, postcolonial feminist, and intersectionality theories and then applies them, using an emancipatory approach to cultural competency that can reshape nursing education, research, and practice

A qualitative assessment of gender roles in child nutrition in Central Malawi

This study was part of a baseline study conducted in 2017 as part of the CARE Southern Africa Nutrition Initiative (SANI), a project undertaken with the financial support of the Government of Canada through Global Affairs Canada.BACKGROUND : Child malnutrition persists globally with men and women playing distinct roles to support children’s nutrition. Women frequently carry the bulk of the workload related to food, care, and health, all of which are critical factors in child nutrition. For this reason, development efforts have emphasised women ignoring the potential role of men in supporting children’s nutrition. This study sought to understand the different roles that Malawian men and women play in children’s nutrition. METHODS : This qualitative was conducted in rural Central Malawi as part of a baseline study in 2017 for the CARE Southern Africa Nutrition Initiative. Seventy-six participants were interviewed, including 19 men and 57 women, using focus group discussions and in-depth interviews. We sought to understand the gender distribution of men’s and women’s roles and how these roles influence child nutrition. RESULTS : We found that both men and women were involved in productive, reproductive, and community work. However, consistent with the literature, women carried a disproportionate workload in supporting child nutrition compared to men. Women’s heavier workloads often prevented them from being able to meet children’s food needs. Nevertheless, shifts in gender roles were observed in some of the sampled communities, with men taking up responsibilities that have been typically associated with women. These changes in gender roles, however, did not necessarily increase women’s power within the household. CONCLUSIONS : Traditional gender roles remain prevalent in the sampled communities. Women continue to be primarily responsible for the food, care, and health of the household. Women’s heavy workloads prevent them from providing optimal care and nutrition for children. While efforts to advance gender equality by encouraging men to participate in child care and other household responsibilities appear to have had marginal success, the extent to which these efforts have successfully encouraged men to share power remains unclear. Improving gender equality and child nutrition will require efforts to redistribute gendered work and encourage men to move towards shared power with women over household decision-making and control over income.CARE Malawi.http://www.biomedcentral.com/bmcpublichealtham2023Agricultural Economics, Extension and Rural Developmen

Promoting the health of refugee women: a scoping literature review incorporating the social ecological model

The health of refugee women after settlement in a new country, can be adversely or positively affected by individual, interpersonal, community, and organizational factors. While much of the previous literature highlights these factors individually, there is a lack of comprehensive synthesis regarding how the factors interact to influence the health of refugee women. We conducted a thematic analysis in our literature review to elucidate how providers can work with refugee women to prevent adverse health outcomes and intervene at multiple levels to improve their health outcomes after resettlement. We reviewed peer-reviewed literature from 2009 to 2019 from Google Scholar, JSTOR, Global Health, PubMed, CINAHL, Sociological Abstracts, and Social Service Abstracts, and also used citation chaining, to identify relevant information pertaining to refugee women’s health. The key terms used for our literature review were, health care, violence, social support, and mental health. In total, we included 52 articles, 3 books, and 8 other sources. We found that refugee women are vulnerable to violence during migration and typically have high rates of post-traumatic stress disorder. There were also concerns of secondary victimization by providers after resettlement. We also found that social support is an important factor for reducing isolation, and improving access to health care, as well as improving mental health outcomes. However, social support was often difficult to maintain, and was moderated by factors such as English language fluency. Health care was influenced by health literacy, cultural difference, communication concerns, and access issues. The findings suggest that at the individual and interpersonal levels there is a need to address language barriers, improve provider-patient communication, and provide appropriate medical and mental health screenings. At the organizational level, interorganizational communication and awareness are vital. At the community level, providers can work with community leaders, to educate, create dialogue and collaboration, to help facilitate understanding and bolster community social support. Improved communication and knowledge about the unique needs and concerns of refugee women through an integrated, multi-system approach is necessary to improve their health outcomes

The Mental Health Implications of Living in the Shadows: The Lived Experience and Coping Strategies of Undocumented African Migrant Women

In the United States, undocumented immigrants often encounter complex challenges that impact their emotional well-being. Existing literature has primarily focused on Latino immigrants. Thus, little is known about the mental health needs of undocumented African immigrant women. To address this gap, we examined the stressors, mental health concerns and coping strategies of undocumented African migrant women in the United States. This qualitative study used a postcolonial feminist framework approach. Twenty-four undocumented African migrant women were interviewed, and data were analyzed using thematic analysis. Findings showed that the women dealt with complex stressors created by the sociopolitical environment. These stressors contributed to feelings of depression and anxiety which they coped with using social support and religion. The results uncover the need for culturally relevant tools for screening and addressing the mental health needs of undocumented women and increased awareness amongst healthcare providers on how social context and policies adversely impact the mental health of marginalized groups. Lastly, at a structural level, the need for policy and social change that fosters an inclusive and safe environment for undocumented persons

A black dog enters the home : hunger and malnutrition in Malawi

Hunger and inadequate nutrition are ongoing concerns in rural Malawi and are exemplified in traditional proverbs. Traditional proverbs and common expressions offer insight into commonly held truths across societies throughout sub-Saharan Africa. Strong oral traditions allow community beliefs embodied in proverbs to be passed down from generation to generation. In our qualitative study, we conducted 8 individual and 12 focus group interviews with a total of 83 participants across two districts in rural central Malawi with the aim of soliciting context-specific details on men and women’s knowledge, attitudes and practices related to nutrition, gender equality and women’s empowerment. Each interview began by asking participants to share common proverbs related to nutrition. Our qualitative analysis, informed by an indigenous-based theoretical framework that recognises and centres African indigenous knowledge production, yielded six themes: ’a black dog enters the home’, ’don’t stay with your hands hanging’, ’a man is at the stomach’, ’showers have fallen’, ’we lack peace in our hearts’ and ’the hunger season’. Traditional proverbs can provide insight into the underlying causes of hunger and malnutrition. Physicians, nurses and other allied health professionals around the world have a role to play in addressing hunger and malnutrition, which have been exacerbated by climate change. We have an ethical duty to educate ourselves and others, and change our behaviours, to mitigate the root causes of climate change, which are contributing to food insecurity and resultant poor health outcomes in countries like Malawi.CARE’s Southern African Nutrition Initiative (SANI), a project undertaken with the financial support of the Government of Canada provided through Global Affairs Canada.Https://mh.bmj.comam2022Agricultural Economics, Extension and Rural Developmen

Local to global: Working together to meet the needs of vulnerable communities.

Since 2012, the University of Wisconsin-Milwaukee (UWM) faculty from nursing and physical therapy (PT) have been working together towards a common goal: to meet the healthcare needs of vulnerable populations in Malawi and Milwaukee. Sharing valuable knowledge and understanding one another's professions have allowed us to develop interprofessional education (IPE) learning experiences for students to help identify how quality of life could be improved or enhanced for children and their families across two different geographic spaces, one in rural Malawi and the other in urban Milwaukee. IPE learning modules were implemented in UWM's community health-focused short-term study abroad programmes to Malawi. IPE learning modules were also piloted at one of UWM's nurse-managed community health centres, located in a low-income, African American community in the inner city of Milwaukee, Wisconsin. Based on survey data collected from 10 participating IPE students in Milwaukee, from nursing, occupational therapy, PT, and speech and language pathology, a pilot study yielded a statistically significant change in a positive direction for increased understanding of three interprofessional collaborative practice core competencies: values and ethics, roles and responsibilities, and teams and teamwork. In this article, we discuss the processes used to develop, implement, and evaluate IPE experiences for UWM students, which may enable other professionals to envision the various projects they can embark upon from an interprofessional perspective

Advocating for HIV Prevention and Care

The number of older women living with HIV in Kenya is increasing. However, there are little empirical data available about their role in HIV prevention. The purpose of this study was to understand the nuanced role of older women in HIV prevention. We engaged 54 HIV-positive women in three narrative-eliciting interviews between 2009 and 2010 over a period of 6 months to understand their role in HIV prevention. In this article, we focus on a sample subset of 7 rural women 50 years and older living with HIV. From narrative analysis of 19 interviews from 7 women who were 50 years and older, four themes emerged: promoting HIV transmission risk reduction, promoting HIV testing, educating others about HIV, and protecting children from HIV infection. HIV-positive older women are engaged in helping mitigate HIV in their communities and should be central to meaningful HIV-related interventions especially in rural communitie