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应对挑战:采用关键信息人访谈法对埃塞俄比亚厄立特里亚难民妇女的性与生殖健康障碍进行社会生态分析

Navigating challenges: a socioecological analysis of sexual and reproductive health barriers among Eritrean refugee women in Ethiopia, using a key informant approach.

作者信息

Zepro Nejimu Biza, Medhanyie Araya Abrha, Probst-Hensch Nicole, Chernet Afona, Tschopp Rea, Abongomera Charles, Paris Daniel H, Merten Sonja

机构信息

Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland

University of Basel, Basel, Switzerland.

出版信息

BMJ Open. 2024 Apr 23;14(4):e080654. doi: 10.1136/bmjopen-2023-080654.

Abstract

OBJECTIVES

The study aimed to explore the experiences and perceptions of healthcare providers (HCPs) regarding the sexual and reproductive health (SRH) challenges of Eritrean refugee women in Ethiopia.

DESIGN

A qualitative exploratory design with the key informant approach.

SETTING AND PARTICIPANTS

The study was conducted in the Afar regional state, North East, Ethiopia. The study participants were HCP responsible for providing SRH care for refugee women.

RESULTS

Eritrean refugee women have worse health outcomes than the host population. The SRH needs were found to be hindered at multiple layers of socioecological model (SEM). High turnover and shortage of HCP, restrictive laws, language issues, cultural inconsistencies and gender inequalities were among the main barriers reported. Complex multistructural factors are needed to improve SRH needs of Eritrean refugee women.

CONCLUSIONS

A complex set of issues spanning individual needs, social norms, community resources, healthcare limitations and structural mismatches create significant barriers to fulfilling the SRH needs of Eritrean refugee women in Ethiopia. Factors like limited awareness, cultural taboos, lack of safe spaces, inadequate healthcare facilities and restrictive policies all contribute to the severe limitations on SRH services available in refugee settings. The overlap in findings underscores the importance of developing multilevel interventions that are culturally sensitive to the needs of refugee women across all SEM levels. A bilateral collaboration between Refugees and Returnees Service (RRS) structures and the Asayta district healthcare system is critically important.

摘要

目标

本研究旨在探索医疗服务提供者(HCPs)对埃塞俄比亚厄立特里亚难民妇女的性与生殖健康(SRH)挑战的经历和看法。

设计

采用关键信息提供者方法的定性探索性设计。

背景与参与者

研究在埃塞俄比亚东北部的阿法尔州进行。研究参与者是负责为难民妇女提供性与生殖健康护理的医疗服务提供者。

结果

厄立特里亚难民妇女的健康状况比当地居民更差。研究发现,性与生殖健康需求在社会生态模型(SEM)的多个层面受到阻碍。报告的主要障碍包括医疗服务提供者的高流动率和短缺、限制性法律、语言问题、文化差异和性别不平等。需要复杂的多结构因素来改善厄立特里亚难民妇女的性与生殖健康需求。

结论

一系列复杂的问题,包括个人需求、社会规范、社区资源、医疗保健限制和结构不匹配,为满足埃塞俄比亚厄立特里亚难民妇女的性与生殖健康需求造成了重大障碍。意识有限、文化禁忌、缺乏安全空间、医疗设施不足和政策限制等因素都导致了难民环境中性与生殖健康服务的严重受限。研究结果中的重叠强调了制定对社会生态模型所有层面难民妇女需求具有文化敏感性的多层次干预措施的重要性。难民和回返者服务(RRS)机构与阿萨伊塔地区医疗系统之间的双边合作至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6d7/11043775/1d5ec92f254b/bmjopen-2023-080654f01.jpg

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