Impact of Displacement on Refugee Women's Sexual and Reproductive Health: A Participatory Study Using Photovoice.

IF 4.3 1区 医学 Q1 OBSTETRICS & GYNECOLOGY
Jamilah Sherally, Franceska Dnestrianschii, Zainab Alshamari, Ekram Beshir, Habibe Jafari, Masume Jafari, Kowthar Mohamed, Semira Mohammadyasin, Maria van den Muijsenbergh, Thomas van den Akker, Marielle Le Mat, Saskia Elise Duijs
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引用次数: 0

Abstract

Objective: To explore how displacement impacts the sexual and reproductive health (SRH) of refugee women.

Design: Participatory photovoice study integrating photography with qualitative inquiry.

Setting: Conducted online between February and May 2024.

Population: Six refugee women formerly residing in Moria Reception and Identification Centre or Mavrovouni Closed Controlled Access Centre on Lesbos, Greece, now seeking asylum across Europe and the United States.

Methods: During the participatory photovoice study, participants (N = 6) took photographs reflecting the impact of displacement on their SRH and mental health. Visual data were explored in three focus groups and five in-depth interviews. Participants grouped photographs into themes, with additional thematic coding by the academic researchers. An intersectional lens guided the analysis.

Results: Thirty-six photographs, many including nature symbolism, illustrated how displacement shaped SRH experiences, healthcare-seeking behaviour and access to care for gender-based violence, female genital mutilation/cutting, family planning and menstrual, maternal, and gynaecological health. Eight themes emerged: bodily autonomy, instability, living conditions, social support, celebrations, healthcare access, resilience, and finding purpose. While displacement exacerbated SRH needs and undermined bodily autonomy, the instability of the asylum process led to deprioritisation of healthcare-seeking. Illness was only experienced until a sense of safety was established. Access to healthcare was compromised by language barriers, undignified treatment, and financial constraints. Despite challenges, narratives highlighted resilience, community, and personal growth.

Conclusions: Trauma-informed, culturally sensitive healthcare is essential for SRH equity among refugee women. Refugee-led visual research offers a transformative tool for knowledge production and advocacy.

流离失所对难民妇女性健康和生殖健康的影响:一项使用Photovoice的参与性研究。
目的:探讨流离失所如何影响难民妇女的性健康和生殖健康(SRH)。设计:将摄影与质性探究相结合的参与式照片声音研究。设置:2024年2月至5月在线进行。人口:六名难民妇女以前居住在希腊莱斯博斯岛的莫里亚接待和身份查验中心或马夫罗沃尼封闭控制通道中心,现在在欧洲和美国各地寻求庇护。方法:在参与式照片语音研究中,参与者(N = 6)拍摄了反映流离失所对其SRH和心理健康影响的照片。视觉数据通过三个焦点小组和五个深度访谈进行了探讨。参与者将照片按主题分组,并由学术研究人员进行额外的主题编码。交叉透镜指导了分析。结果:36张照片,其中许多包括自然象征,说明流离失所如何影响性健康和生殖健康经历、寻求医疗保健行为和获得基于性别的暴力、切割女性生殖器官、计划生育和月经、孕产妇和妇科健康方面的护理。出现了八个主题:身体自主、不稳定、生活条件、社会支持、庆祝、医疗保健、恢复力和寻找目标。流离失所加剧了性健康和生殖健康的需求,损害了人身自主权,而庇护程序的不稳定导致寻求医疗保健的机会被剥夺。直到有了安全感,人们才会经历疾病。由于语言障碍、不体面的治疗和财政限制,人们无法获得医疗保健服务。尽管面临挑战,但叙事强调了韧性、社区和个人成长。结论:了解创伤情况、对文化敏感的保健对难民妇女的性健康和健康平等至关重要。难民主导的视觉研究为知识生产和宣传提供了一种变革性工具。
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来源期刊
CiteScore
10.90
自引率
5.20%
发文量
345
审稿时长
3-6 weeks
期刊介绍: BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.
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