Experiences of primary healthcare workers in Australia towards women and girls living with female genital mutilation/cutting (FGM/C) : a qualitative study

Female genital mutilation/cutting (FGM/C) is a harmful cultural practice with significant health consequences for affected women and girls. Due to migration and human mobility, an increasing number of women with FGM/C are presenting to healthcare facilities of western countries (including Australia) where the practice is non-prevalent. Despite this increase in presentation, the experiences of primary healthcare providers in Australia engaging and caring for women/girls with FGM/C are yet to be explored. The aim of this research was to report on the Australian primary healthcare providers’ experiences of caring for women living with FGM/C. A qualitative interpretative phenomenological approach was utilised and convenience sampling was used to recruit 19 participants. Australian primary healthcare providers were engaged in face-to-face or telephone interviews, which were transcribed verbatim and thematically analysed. Three major themes emerged, which were: exploring knowledge of FGM/C and training needs, understanding participants’ experience of caring for women living with FGM/C, and mapping the best practice in working with women. The study shows that primary healthcare professionals had basic knowledge of FGM/C with little or no experience with the management, support, and care of affected women in Australia. This impacted their attitude and confidence to promote, protect, and restore the target population’s overall FGM/C-related health and wellbeing issues. Hence, this study highlights the importance of primary healthcare practitioners being skilled and well-equipped with information and knowledge to care for girls and women living with FGM/C in Australia

White and non-White Australian mental health care practitioners’ desirable responding, cultural competence, and racial/ethnic attitudes

Background: Racial, ethnic, religious, and cultural diversity in Australia is rapidly increasing. Although Indigenous Australians account for only approximately 3.5% of the country’s population, over 50% of Australians were born overseas or have at least one migrant parent. Migration accounts for over 60% of Australia’s population growth, with migration from Asia, Sub-Saharan African and the Americas increasing by 500% in the last decade. Little is known about Australian mental health care practitioners’ attitudes toward this diversity and their level of cultural competence. Aim: Given the relationship between practitioner cultural competence and the mental health outcomes of non-White clients, this study aimed to identify factors that influence non-White and White practitioners’ cultural competence. Methods: An online questionnaire was completed by 139 Australian mental health practitioners. The measures included: the Balanced Inventory of Desirable Responding (BIDR); the Multicultural Counselling Inventory (MCI); and the Color-blind Racial Attitudes Scale (CoBRAS). Descriptive statistics were used to summarise participants’ demographic characteristics. One-way ANOVA and Kruskal–Wallis tests were conducted to identify between-group differences (non-White compared to White practitioners) in cultural competence and racial and ethnic blindness. Correlation analyses were conducted to determine the association between participants’ gender or age and cultural competence. Hierarchical multiple regression analysis was conducted to predict cultural competence. Results: The study demonstrates that non-White mental health practitioners are more culturally aware and have better multicultural counselling relationships with non-White people than their White counterparts. Higher MCI total scores (measuring cultural competence) were associated with older age, greater attendance of cultural competence-related trainings and increased awareness of general and pervasive racial and/or ethnic discrimination. Practitioners with higher MCI total scores were also likely to think more highly of themselves (e.g., have higher self-deceptive positive enhancement scores on the BIDR) than those with lower MCI total scores. Conclusion: The findings highlight that the current one-size-fits-all and skills-development approach to cultural competence training ignores the significant role that practitioner diversity and differences play. The recommendations from this study can inform clinical educators and supervisors about the importance of continuing professional development relevant to practitioners’ age, racial/ethnic background and practitioner engagement with prior cultural competence training

From the world to Western : a community-engaged teaching strategy to enhance students’ learning of cultural issues relevant to healthcare

Using the transformational learning theory and action research method, this study captured the experiences of students from health-related disciplines in the cultural immersion program From the World to Western. A total of nine students participated in the pilot program with four host families from Culturally and Linguistically Diverse (CALD) backgrounds, and four cultural facilitators who connected the host families and students. The findings of this research showed that it was beneficial for students in health-related disciplines to engage in the cultural immersion program to further prepare them for culturally competent care in their future roles as healthcare professionals. In addition, the students indicated the need for the cultural immersion program to be part of the curriculum for future students to develop cultural skills, awareness and encounters with diverse populations

Exploring tertiary health science student willingness or resistance to cultural competency and safety pedagogy

There is an increasing body of literature that considers the relevance and experiences of cultural competency and safety training in health professional students. However, less is written about Australian tertiary learners’ experiences of engaging with cultural competency training. The aim of this study is to explore tertiary students’ willingness or resistance to cultural competency and safety pedagogy. Qualitative student feedback to a teaching unit was collected and triangulated with data from focus groups with tutors. Results were thematically analyzed. Willingness and resistance to cultural competency and safety teaching emerged as two key themes. Willingness to engage with the unit was largely due to student interest in the content, teaching environment and relevance of cultural competency to students’ future practice. Resistance was linked to the students feeling personally attacked, or culturally confronted, with tutors noting the topics around sexuality and white privilege being more resisted. Acknowledging reasons for student resistance and developing strategies to reduce resistance can facilitate more student engagement with cultural competency topics, ultimately leading to their future provision of culturally competent healthcare

Prevalence and predictors of cigarette smoking and alcohol use among secondary school students in Nigeria

BACKGROUND: Cigarette and alcohol use are the most common causes of noncommunicable diseases. Studies related to cigarette and alcohol use among Nigerian adolescents have shown increases in the habits and require urgent intervention. Nationally representative data is needed to develop effective national policies and interventions, but this is lacking. Hence, this study aimed to provide nationally representative empiric information about cigarette and alcohol use prevalence and predictors among Nigerian secondary school students. METHODS: This study included 2,530 Nigerian students in Nigeria from five of the six geopolitical zones in Nigeria. A self-administered questionnaire was used to obtain information about the participants’ sociodemographic and school-based characteristics, cigarette and alcohol use status, and harm perception of tobacco and alcohol use. Data were analysed with SPSS version 25 at p<0.05. RESULTS: Participants' mean age (±SD) was 16.34 (±2.0) years. The prevalences (95%CI) for ever-cigarette and current-cigarette smoking were 11.1% (95%CI:9.9-12.4) and 8.4% (95%CI:7.3-9.5), respectively. While 21.0% (95%CI:19.4-22.7) and 15.6% (14.2-17.1) were the prevalences for lifetime and current alcohol use, respectively. The predictors of current cigarette smoking were studying in northern-Nigeria (aOR:1.94;95%CI:1.10-3.44), attending private-schools (aOR:1.56;95%CI:1.03-2.38), boarding-student (aOR:1.75;95% CI:1.15-2.69), male-gender (aOR:3.03; 95%CI:1.80-5.10), current alcohol use (aOR:12.50;95%CI:8.70-18.18), having no (aOR:2.59;95%CI:1.58-4.26) or low tobacco harm perception (aOR:2.04;95%CI:1.18-3.53). The predictors of current alcohol use were male (aOR:1.32; 95%CI:1.01-1.72) and current cigarette smoking (aOR:12.5;95%CI:8.77-17.86). CONCLUSION: The prevalences of cigarette and alcohol use were high among Nigerian secondary school students, and both habits were strongly associated. Their predictors were school-related factors, sociocultural characteristics, and tobacco harm perception

Prevalence Distribution and Risk Factors for Schistosoma hematobium Infection among School Children in Blantyre, Malawi

Schistosoma hematobium infection is a parasitic infection endemic in Malawi. Schistosomiasis usually shows a focal distribution of infection and it is important to identify communities at high risk of infection and assess effectiveness of control programs. We conducted a survey in one district in Malawi to determine prevalence and factors associated with S. hematobium infection among primary school pupils. Using a questionnaire, information on history of passing bloody urine and known risk factors associated with infection was collected. Urine samples were collected and examined for S. hematobium eggs. One thousand one hundred and fifty (1,150) pupils were interviewed, and out of 1,139 pupils who submitted urine samples, 10.4% were infected. Our data showed that male gender, child's knowledge of an existing open water source (includes river, dam, springs, lake, etc.) in the area, history of urinary schistosomiasis in the past month, distance of less than 1 km from school to nearest open water source and age 8–10 years compared to those 14 years and older were independently associated with infection. These findings suggest that children attending schools in close proximity to open water sources are at increased risk of infection