Migration and equity in sexual and reproductive health

What is the project about?

The overall goal for the project is to contribute to improved care for migrants from the Middle East and Somalia by increasing the knowledge of how value conflicts and cultural change are to be managed in the health care sector.

International comparisons show that Swedes' values are liberal, individualistic and pro equality to a greater extent than other populations. This means that their values in sexual and reproductive health and rights (SRHR) can be quite different from the dominant values of other countries. These values are also evident in the Swedish laws, such as the right to deny sex between spouses.

Swedish values are also evident in Swedish institutions, e.g. youth clinics where minors can receive sexual counseling and contraception without parental consent. Sweden is a multicultural country where many residents come from the Middle East region and Somalia, areas where commonly held values can stand in sharp contrast to those on which Swedish society, public health efforts and care are based. From previous research, we know that migrant women from these areas have poorer delivery outcomes, lower contraceptive use and more abortions than Swedish women.

According to current policy documents, staff in reproductive healthcare are encouraged to incorporate gender equality perspectives, while at the same time providing culturally sensitive care. It has proved challenging for healthcare professionals to provide care in meetings with individuals with values that differ from those on which Swedish society is based. In the healthcare provider and patient appointment sensitive topics such as reproduction, sex and cohabitation can lead to tensions, misunderstandings and ultimately a deterioration in appropriate care. Research on how healthcare systems handle these challenges is scarce. One explanation for this may be that research questions include difficult topics to study in an academic discipline alone, and require knowledge from both medical and social science research, which we hope the proposed research environment will remedy.

Research questions

• How and when do gender-related values change among newly arrived Middle East migrants?
• How could sexual and reproductive health (SRH) care be tailored, involving all relevant stakeholders, to best address value conflicts in clinical encounters with migrants?
• Can a participatory community based intervention involving the Swedish Somali diaspora change attitudes towards FGC among practicing families in Somalia?
  

To answer these questions, the research program uses both quantitative and qualitative methods. The data will be collected via surveys and focus group discussions between healthcare providers and migrants from the Middle East and Somalia.

Participants

• Uppsala University
• Institute for Future Studies
• Malmö University
• Karolinska Institutet
• Dalarna University

The project is interdisciplinary and conducted in collaboration between researches in Reproductive Health, Anthropology, Social Work and Norm Research. Both senior and junior researchers are included in the research environment, some with unique expertise based on their background in the Middle East and Somalia.

The research will be co-produced with health care providers and migrants from the Middle East and Somalia.