Department of Health Service Research, Norwegian Institute of Public Health, Oslo, Norway.
Department of Family Counselling, Oslo Municipality, Oslo, Norway.
PLoS One. 2020 Mar 10;15(3):e0229916. doi: 10.1371/journal.pone.0229916. eCollection 2020.
The European Action Plan for Sexual and Reproductive Health emphasizes the importance of improving access to contraceptive services for disadvantaged groups. However, a prior study showed that the prevalence of abortion is two times higher among refugees compared to non-immigrants in Norway. Similarly, a recent study reported that 50% of Somali women in Oslo had unintended childbirth on one occasion or more. These findings are supported by several studies in Europe that showed immigrant and refugee women have higher rates of unintended pregnancy and abortion than Non-immigrant women, and more than half of immigrants, who seek abortion are not using any form of contraception, raising concerns about their access to utilization of modern contraception. However, none of these studies have explored reasons underlying immigrant women's underutilization of modern contraception. The present study aimed to explore the barriers and facilitators to contraceptive usage among Somali immigrant women in Oslo area.
A qualitative study using unstructured in-depth interviews with twenty one Somali women of reproductive age, >18 years, was conducted in Oslo from May-August 2018. The participants were recruited using purposive sampling method. Interviews began with a general question and were followed with some probing questions, and were continued until data saturation was reached. Data were analyzed using thematic analysis.
Although the majority of the participants were educated, aware of the importance of contraceptive methods and interested in child spacing, systemic and socio-cultural barriers were found to be hindering their access to contraception. Several barriers were identified, including: language problems, lack of adequate information, religious beliefs, gender roles and social pressure.
Eliminating the barriers which prevent women from receiving their desired form of contraception will have important public health implications, including lengthening inter-pregnancy intervals, and fewer unplanned pregnancies and abortions. These findings can support policy makers, civil society organizations and health providers to develop cultural sensitive programmes and educational interventions, which help Somali immigrant women overcome the identified barriers to contraception.
《欧洲性与生殖健康行动计划》强调了为弱势群体改善避孕服务获取途径的重要性。然而，先前的一项研究表明，在挪威，与非移民相比，难民的堕胎率高出两倍。同样，最近的一项研究报告称，奥斯陆 50%的索马里妇女曾有过一次或多次意外怀孕。这些发现得到了欧洲的几项研究的支持，这些研究表明，移民和难民妇女的意外怀孕和堕胎率高于非移民妇女，超过一半寻求堕胎的移民没有使用任何形式的避孕措施，这让人对他们获取现代避孕措施的途径感到担忧。然而，这些研究都没有探讨移民妇女对现代避孕措施利用率低的原因。本研究旨在探讨在奥斯陆地区的索马里移民妇女中，使用避孕措施的障碍和促进因素。
2018 年 5 月至 8 月，在奥斯陆使用非结构化深入访谈对 21 名 18 岁以上的生殖年龄索马里移民妇女进行了一项定性研究。采用目的抽样法招募参与者。访谈从一个一般性问题开始，然后进行一些深入的提问，并继续进行，直到达到数据饱和。使用主题分析对数据进行分析。
尽管大多数参与者都受过教育，了解避孕方法的重要性，并且对控制生育间隔感兴趣，但发现一些系统和社会文化障碍阻碍了她们获得避孕措施。确定了几个障碍，包括：语言问题、缺乏足够的信息、宗教信仰、性别角色和社会压力。
消除阻止妇女获得所需避孕方式的障碍，将对公共卫生产生重要影响，包括延长生育间隔、减少意外怀孕和堕胎。这些发现可以为政策制定者、民间社会组织和卫生提供者提供支持，制定具有文化敏感性的方案和教育干预措施，帮助索马里移民妇女克服避孕障碍。
