Providing sexual and reproductive health services to migrants in Southern Sweden: a qualitative exploration of healthcare providers’ experiences
Abstract Background While a large body of research has focused on the challenges experienced by healthcare staff when providing sexual and reproductive health services, little attention has been paid to the ways healthcare providers navigate these challenges. This study examined healthcare providers...
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-022-08967-3 |
| _version_ | 1797977526986866688 |
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| author | Nada Amroussia |
| author_facet | Nada Amroussia |
| author_sort | Nada Amroussia |
| collection | DOAJ |
| description | Abstract Background While a large body of research has focused on the challenges experienced by healthcare staff when providing sexual and reproductive health services, little attention has been paid to the ways healthcare providers navigate these challenges. This study examined healthcare providers’ accounts of encounters when providing sexual and reproductive health (SRH) services to migrants in Southern Sweden. It sought to examine challenges and dilemmas experienced by healthcare providers, strategies used to navigate these challenges and dilemmas, and assumptions underlying participants’ accounts. Methods The data collection was conducted between September 2020 and March 2021. Qualitative thematic analysis was used to analyze thirty-one interviews with healthcare providers working in youth clinics and women healthcare clinics. The analysis was guided by a conceptual framework combining person-centered care approach, Foucault’s concepts on power/knowledge, and theories to navigate diversity in healthcare setting: cultural competency and cultural humility. Results Three themes were identified in the analysis: 1) Between person centeredness and cultural considerations; 2) Knowledge positions and patient involvement; and 3) beyond the dyadic interaction healthcare provider-patient. Some participants understood person-centered care as individualized care where the influence of culture on the encounter should be de-emphasized, whereas others tended to highlight this influence. Many participants viewed the influence of culture as primarily driven by migrants’ cultural backgrounds, and as a source of challenges and dilemmas. Participants’ strategies to navigate these perceived challenges and dilemmas included practicing cultural humility and seeking cultural competency. Knowledge positions also emerged as an important aspect of participants’ accounts of encounters with migrants. Many participants experienced that migrant patients were lacking knowledge about the body and sexuality. This disadvantaged knowledge position affected migrant involvement in care. Additionally, the study shows how participants placed their experiences in a broader organizational and social context. Participants highlighted several organizational challenges to encountering migrants and discussed dilemmas stemming from the interplay between migrants’ structural and individual disadvantages. Conclusions The study findings illuminate the complex links between person-centered care and two important dimensions of the encounters with migrants: culture and knowledge positions. They also shed the light on the organizational and structural challenges surrounding these encounters. These findings suggest that multilevel strategies are needed to improve the quality of encounters when providing SRH services to migrants. These strategies could include ensuring universal access to SRH services to migrants, adjusting the encounter duration when interpretation is needed, and providing necessary resources to healthcare providers to build their structural competency. |
| first_indexed | 2024-04-11T05:08:22Z |
| format | Article |
| id | doaj.art-3621e10a044749a88d5364ca172531ac |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-11T05:08:22Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-3621e10a044749a88d5364ca172531ac2022-12-25T12:09:24ZengBMCBMC Health Services Research1472-69632022-12-0122111510.1186/s12913-022-08967-3Providing sexual and reproductive health services to migrants in Southern Sweden: a qualitative exploration of healthcare providers’ experiencesNada Amroussia0Centre for Sexology and Sexuality Studies (CSS), Faculty of Health and Society (HS), Malmö UniversityAbstract Background While a large body of research has focused on the challenges experienced by healthcare staff when providing sexual and reproductive health services, little attention has been paid to the ways healthcare providers navigate these challenges. This study examined healthcare providers’ accounts of encounters when providing sexual and reproductive health (SRH) services to migrants in Southern Sweden. It sought to examine challenges and dilemmas experienced by healthcare providers, strategies used to navigate these challenges and dilemmas, and assumptions underlying participants’ accounts. Methods The data collection was conducted between September 2020 and March 2021. Qualitative thematic analysis was used to analyze thirty-one interviews with healthcare providers working in youth clinics and women healthcare clinics. The analysis was guided by a conceptual framework combining person-centered care approach, Foucault’s concepts on power/knowledge, and theories to navigate diversity in healthcare setting: cultural competency and cultural humility. Results Three themes were identified in the analysis: 1) Between person centeredness and cultural considerations; 2) Knowledge positions and patient involvement; and 3) beyond the dyadic interaction healthcare provider-patient. Some participants understood person-centered care as individualized care where the influence of culture on the encounter should be de-emphasized, whereas others tended to highlight this influence. Many participants viewed the influence of culture as primarily driven by migrants’ cultural backgrounds, and as a source of challenges and dilemmas. Participants’ strategies to navigate these perceived challenges and dilemmas included practicing cultural humility and seeking cultural competency. Knowledge positions also emerged as an important aspect of participants’ accounts of encounters with migrants. Many participants experienced that migrant patients were lacking knowledge about the body and sexuality. This disadvantaged knowledge position affected migrant involvement in care. Additionally, the study shows how participants placed their experiences in a broader organizational and social context. Participants highlighted several organizational challenges to encountering migrants and discussed dilemmas stemming from the interplay between migrants’ structural and individual disadvantages. Conclusions The study findings illuminate the complex links between person-centered care and two important dimensions of the encounters with migrants: culture and knowledge positions. They also shed the light on the organizational and structural challenges surrounding these encounters. These findings suggest that multilevel strategies are needed to improve the quality of encounters when providing SRH services to migrants. These strategies could include ensuring universal access to SRH services to migrants, adjusting the encounter duration when interpretation is needed, and providing necessary resources to healthcare providers to build their structural competency.https://doi.org/10.1186/s12913-022-08967-3Sexual and reproductive health and rightsMigrantsHealthcare encounterQualitative thematic analysisPerson-centered careDiversity |
| spellingShingle | Nada Amroussia Providing sexual and reproductive health services to migrants in Southern Sweden: a qualitative exploration of healthcare providers’ experiences BMC Health Services Research Sexual and reproductive health and rights Migrants Healthcare encounter Qualitative thematic analysis Person-centered care Diversity |
| title | Providing sexual and reproductive health services to migrants in Southern Sweden: a qualitative exploration of healthcare providers’ experiences |
| title_full | Providing sexual and reproductive health services to migrants in Southern Sweden: a qualitative exploration of healthcare providers’ experiences |
| title_fullStr | Providing sexual and reproductive health services to migrants in Southern Sweden: a qualitative exploration of healthcare providers’ experiences |
| title_full_unstemmed | Providing sexual and reproductive health services to migrants in Southern Sweden: a qualitative exploration of healthcare providers’ experiences |
| title_short | Providing sexual and reproductive health services to migrants in Southern Sweden: a qualitative exploration of healthcare providers’ experiences |
| title_sort | providing sexual and reproductive health services to migrants in southern sweden a qualitative exploration of healthcare providers experiences |
| topic | Sexual and reproductive health and rights Migrants Healthcare encounter Qualitative thematic analysis Person-centered care Diversity |
| url | https://doi.org/10.1186/s12913-022-08967-3 |
| work_keys_str_mv | AT nadaamroussia providingsexualandreproductivehealthservicestomigrantsinsouthernswedenaqualitativeexplorationofhealthcareprovidersexperiences |