Sexual and Reproductive Health Services and Help-seeking Behaviors: Experiences and Perspectives of Young 1.5-Generation Bangladeshi Women in Toronto.

Abstract

BackgroundThe "1.5 generation" refers to those who immigrated to a new country as children or adolescents. In the context of Canada, 1.5-generation Bangladeshis are underrepresented in the extant literature on sexual and reproductive health (SRH). Their cross-cultural positionality and ethnic background have implications for their SRH-related help-seeking behaviors and service utilization.PurposeThis paper explored the SRH related help-seeking behaviors and perspectives and experiences with accessing and utilizing SRH services among 1.5-generation Bangladeshi women in Toronto, Ontario.MethodsTen 1.5-generation Bangladeshi women, aged between 18 and 22, participated in this qualitative study. This study employed a narrative inquiry methodological approach and the Conceptual Framework of Access to Healthcare as a theoretical lens.ResultsKnowledge about routine SRH tests and utilization of these services were found to be low. Mothers, sisters, peers, the internet and mobile apps were identified as sources of informal help-seeking. The family doctor is the most significant source of formal help-seeking. The findings shed light on the demand- and supply-side dimensions of access to SRH care as well as the multiple barriers and facilitators to services. Individual-level social and cultural factors in SRH help- and care-seeking behaviors and attitudes were identified. Structural factors within the health system hindered effective service delivery.ConclusionThe findings highlight the need for SRH-focused educational and informational campaigns in residential neighborhoods concentrated by the Bangladeshi diaspora. Policymakers should address the structural barriers in the health system to improve the quality of SRH care. Further investigation is required to understand what culturally responsive SRH care entails for 1.5-generation patients from South Asian and Muslim backgrounds.