1
|
Nyikavaranda P, Pantelic M, Jones CJ, Paudyal P, Tunks A, Llewellyn CD. Barriers and facilitators to seeking and accessing mental health support in primary care and the community among female migrants in Europe: a "feminisms" systematic review. Int J Equity Health 2023; 22:196. [PMID: 37752502 PMCID: PMC10523615 DOI: 10.1186/s12939-023-01990-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/14/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Recent years have seen record levels of migration to Europe. Female migrants are at heightened risk of developing mental health disorders, yet they face barriers to accessing mental health services in their host countries. This systematic review aims to summarise the barriers and facilitators to accessing mental health support for female migrants in Europe. METHODS The review follows PRISMA guidelines, and the protocol was pre-published on PROSPERO. Six electronic databases were searched: CINAHL, Global Health Database, Medline, PsycARTICLES, PsycINFO and Web of Science. Thematic analysis was undertaken on the identified studies. A feminist quality appraisal tool was applied. RESULTS Eight qualitative, six quantitative and five mixed methods studies were identified. Barriers included a lack of information, stigma, religious and cultural practices and beliefs, and a lack of consideration of gender-specific needs within the health system. Gender-sensitive services, supportive general practitioners and religious leaders facilitated access. CONCLUSIONS The design of mental health research, services, policies, and commissioning of support for migrants must consider female migrant needs. Mental health support services must be culturally aware and gender sensitive. REGISTRATION The review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO, registration number CRD42021235571.
Collapse
Affiliation(s)
- Patrick Nyikavaranda
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK.
| | - Marija Pantelic
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, Surrey, UK
| | - Priyamvada Paudyal
- Institute for Global Health and Wellbeing School of Medicine, Keele University, Keele, Staffordshire, ST5 5GB, UK
| | - Alice Tunks
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
| | - Carrie D Llewellyn
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
| |
Collapse
|
2
|
Udenigwe O, Okonofua FE, Ntoimo LFC, Yaya S. Seeking maternal health care in rural Nigeria: through the lens of negofeminism. Reprod Health 2023; 20:103. [PMID: 37461037 DOI: 10.1186/s12978-023-01647-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Feminist scholarship is acutely aware that health is not dependent on behavioural choices alone but on interlocking social determinants that affect people's capacity to lead healthy lives. Women are situated within social structures that impact their health. but there is limited engagement with interpretive tools such as feminist theories that centre the realities of African women, particularly in the context of maternal health. It is imperative that women's control over their reproductive health and autonomy in seeking care, particularly skilled maternal healthcare are understood within this context. This study seeks to examine pregnant women's socio-cultural realities in a Nigerian context and in congruence with articulations of African feminism. Feminist scholarship acknowledges that women are situated within social structures that impact their health. Therefore, this paper seeks to examine pregnant women's socio-cultural realities in a Nigerian context and in congruence with articulations of African feminism. METHOD This is a cross-sectional qualitative study of a total of 64 participants: 39 women and 25 men in Ewato and Okpekpe communities, two Local Government Areas of Edo State in southern Nigeria. The study presents findings from eight sex-and-age desegregated focus group discussions. This study reports on emergent data related to women's decision-making in accessing skilled maternal care. Data were transcribed and translated to English. Using the NVivo 1.6 software, data were coded and analyzed using a conventional approach to content analysis. RESULTS Findings describe ways in which women negotiate authority by ascribing the role of decision-maker to their men spouses while maintaining influence over their pregnancy healthcare decisions and actions. Negofeminism's concepts of alliance, community and connectedness were highlighted through men's constructive involvement in maternal health. Furthermore, women were shown to maneuver patriarchal norms to gain control of their healthcare decisions. CONCLUSION This study offers a different narrative from the dominant view of non-Western women, specifically African women, as oppressed passive victims who are ineffectual in taking charge of their health. From the perspective of negofeminism, women navigate patriarchal environments to yield the best possible maternal health outcomes. The current study can be useful in informing policy and programming that acknowledges women's social embeddedness.
Collapse
Affiliation(s)
- Ogochukwu Udenigwe
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada.
| | - Friday E Okonofua
- Women's Health and Action Research Centre, KM 11 Lagos-Benin Expressway, Igue-Iyeha, Benin City, Edo State, Nigeria
- Centre for Excellence in Reproductive Health Innovation, Benin City, Nigeria
| | - Lorretta F C Ntoimo
- Federal University Oye-Ekiti, Km 3 Oye-Are Road, P. M. B. 373, Oye-Ekiti, Ekiti State, Nigeria
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, UK
| |
Collapse
|
3
|
Lefrançois M, Sultan-Taïeb H, Webb J, Gervais MJ, Messing K, Blanchette-Luong V, Riel J, Saint-Charles J, Faust R, Vaillancourt C, Fillion M, Laberge M. How to carry out participatory research that takes account of sex and gender issues: a scoping review of guidelines targeting health inequities. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:404-421. [PMID: 36752980 PMCID: PMC10283498 DOI: 10.17269/s41997-023-00742-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/05/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Conducting participatory research (PR) aimed at improving health implies considering inequitable power relations, including those related to sex/gender (S/G). This necessitates specific skills and methods and may be challenging especially since guidelines are scarce. Our objective was to perform a scoping review to provide a typology of existing guidelines for researchers on how to take account of S/G in the context of PR in public health, with a focus on occupational and environmental health. METHODS All steps of the research were conducted with the collaboration of an advisory committee, following PR principles. Nineteen documents were retained from 513 references identified in nine scientific databases and grey literature between 2000 and 2020. Data on recommendations were extracted and coded qualitatively. Cluster analysis based on similarities in recommendations proposed in the documents identified four types: (1) empowerment-centered; (2) concrete action-centered; (3) macrosystem-centered; and (4) stakeholder-centered. SYNTHESIS Many sources gave pointers on how to include S/G during data collection and analysis or during the dissemination of findings, but there was a dearth of suggestions for building partnerships with stakeholders and producing sustainable S/G sociopolitical transformations. Occupational health PR showed less similarities with other public health subfields including environmental health PR. Power relationships with workplace stakeholders generated specific obstacles related to S/G integration that require further attention. Intersectionality and reflexive practices emerged as overarching themes. CONCLUSION This review provides helpful guidelines to researchers at different stages of planning PR, ranging from familiarizing themselves with S/G approaches to anticipating difficulties in their ongoing S/G-transformative PR.
Collapse
Affiliation(s)
- Mélanie Lefrançois
- School of Management (ESG-UQAM), Université du Québec à Montréal (UQAM), Montreal, QC, Canada.
| | - Hélène Sultan-Taïeb
- School of Management (ESG-UQAM), Université du Québec à Montréal (UQAM), Montreal, QC, Canada
| | - Jena Webb
- CoPEH-Canada (Canadian Community of Practice in Ecosystem Approaches to Health), Université du Québec à Montréal (UQAM), Montreal, QC, Canada
| | - Mathieu-Joël Gervais
- Faculty of Social Sciences, Université du Québec à Montréal (UQAM), Montreal, QC, Canada
| | - Karen Messing
- Faculty of Sciences, Université du Québec à Montréal (UQAM), Montreal, QC, Canada
| | | | - Jessica Riel
- School of Management (ESG-UQAM), Université du Québec à Montréal (UQAM), Montreal, QC, Canada
| | - Johanne Saint-Charles
- Faculty of Communication, Université du Québec à Montréal (UQAM), Montreal, QC, Canada
| | - Rachel Faust
- School of Management (ESG-UQAM), Université du Québec à Montréal (UQAM), Montreal, QC, Canada
| | - Cathy Vaillancourt
- Centre Armand-Frappier Santé Biotechnologie, Institut national de recherche scientifique (INRS), Laval, QC, Canada
| | - Myriam Fillion
- Department of Science and Technology, Université TÉLUQ, Montreal, QC, Canada
| | - Marie Laberge
- School of Rehabilitation, Université de Montreal, Ste-Justine UHC Research Centre, Montreal, QC, Canada
| |
Collapse
|
4
|
Is There a Sampling Bias in Research on Work-Related Technostress? A Systematic Review of Occupational Exposure to Technostress and the Role of Socioeconomic Position. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042071. [PMID: 33672604 PMCID: PMC7924034 DOI: 10.3390/ijerph18042071] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/06/2021] [Accepted: 02/12/2021] [Indexed: 11/17/2022]
Abstract
Technostress is a widespread model used to study negative effects of using information communication technologies at work. The aim of this review is to assess the role of socioeconomic position (SEP) in research on work-related technostress. We conducted systematic searches in multidisciplinary databases (PubMed, PubMed Central, Web of Science, Scopus, PsycInfo, PsycArticles) in June 2020 and independently screened 321 articles against eligibility criteria (working population, technostress exposure, health or work outcome, quantitative design). Of the 21 studies included in the narrative synthesis, three studies did not collect data on SEP, while 18 studies operationalised SEP as education (eight), job position (five), SEP itself (two) or both education as well as job position (three). Findings regarding differences by SEP are inconclusive, with evidence of high SEP reporting more frequent exposure to overall technostress. In a subsample of 11 studies reporting data on educational attainment, we compared the percentage of university graduates to World Bank national statistics and found that workers with high SEP are overrepresented in nine of 11 studies. The resulting socioeconomic sampling bias limits the scope of the technostress model to high SEP occupations. The lack of findings regarding differences by SEP in technostress can partly be attributed to limitations in study designs. Studies should aim to reduce the heterogeneity of technostress and SEP measures to improve external validity and generalisability across socioeconomic groups. Future research on technostress would benefit from developing context-sensitive SEP measures and quality appraisal tools that identify socioeconomic sampling biases by comparing data to national statistics.
Collapse
|
5
|
Morgan T, Bharmal A, Duschinsky R, Barclay S. Experiences of oldest-old caregivers whose partner is approaching end-of-life: A mixed-method systematic review and narrative synthesis. PLoS One 2020; 15:e0232401. [PMID: 32516312 PMCID: PMC7282625 DOI: 10.1371/journal.pone.0232401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 04/15/2020] [Indexed: 01/11/2023] Open
Abstract
Population ageing has rapidly increased the number of people requiring end-of-life care across the globe. Governments have responded by promoting end-of-life in the community. Partly as a consequence, older spouses are frequently providing for their partner's end-of-life care at home, despite potentially facing their own health issues. While there is an emerging literature on young-old caregivers, less is known about spouse carers over 75 who are likely to face specific challenges associated with their advanced age and relationship status. The aim of this review, therefore, is to identify and synthesise the literature concerning the experiences of caregiver's aged 75 and over whose partner is approaching end-of-life. We conducted a mixed-method systematic review and narrative synthesis of the empirical literature published between 1985 and May 2019, identified from six databases: Medline, PsychINFO, Cumulative Index to Nursing and Allied Health Literature, Embase, Sociological Abstracts and Social Service Abstracts. Hand searching and reference checking were also conducted. Gough's Weight of Evidence and Morgan's Feminist Quality Appraisal tool used to determine the quality of papers. From the initial 7819 titles, 10 qualitative studies and 9 quantitative studies were included. We identified three themes: 1) "Embodied impact of care" whereby caring was found to negatively impact carers physical and psychological health, with adverse effects continuing into bereavement; 2) "Caregiving spouse's conceptualisation of their role" in which caregiver's navigated their self and marriage identities in relation to their partner's condition and expectations about gender and place; 3) "Learning to care" which involved learning new skills and ways of coping to remain able to provide care. We identified a recent up-surge in published papers about very old spousal caregivers, which now comprise a small, medium-quality evidence base. This review outlines a range of potential lines of inquiry for future research including further clarification of the impact of caregiving on the likelihood of mortality, the incidence of men and women providing end-of-life care amongst this age group, and the role of anticipatory grief in shaping their perceptions of their relationship and their own longevity.
Collapse
Affiliation(s)
- Tessa Morgan
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England, United Kingdom
| | - Aamena Bharmal
- Cambridge University Hospital NHS Foundation Trust, Cambridge, England, United Kingdom
| | - Robbie Duschinsky
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England, United Kingdom
| | - Stephen Barclay
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England, United Kingdom
| |
Collapse
|
6
|
Missing in Action: Sex and Gender in Substance Use Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072352. [PMID: 32244297 PMCID: PMC7177376 DOI: 10.3390/ijerph17072352] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 01/12/2023]
Abstract
Substance use and misuse is a significant global health issue that requires a sex- and gender-based analysis. Substance use patterns and trends are gendered: that is, women and men, girls and boys, and gender-diverse people often exhibit different rates of use of substances, reasons for use, modes of administration, and effects of use. Sex-specific effects and responses to substances are also important, with various substances affecting females and males differentially. Nevertheless, much research and practice in responding to substance use and misuse remains gender blind, ignoring the impacts of sex and gender on this important health issue. This special issue identifies how various aspects of sex and gender matter in substance use, illustrates the application of sex- and gender-based analyses to a range of substances, populations and settings, and assists in progressing sex and gender science in relation to substance use.
Collapse
|
7
|
Brabete AC, Greaves L, Hemsing N, Stinson J. Sex- and Gender-Based Analysis in Cannabis Treatment Outcomes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030872. [PMID: 32019247 PMCID: PMC7037030 DOI: 10.3390/ijerph17030872] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 01/28/2023]
Abstract
There is evidence that sex- and gender-related factors are involved in cannabis patterns of use, health effects and biological mechanisms. Women and men report different cannabis use disorder (CUD) symptoms, with women reporting worse withdrawal symptoms than men. The objective of this systematic review was to examine the effectiveness of cannabis pharmacological interventions for women and men and the uptake of sex- and gender-based analysis in the included studies. Two reviewers performed the full-paper screening, and data was extracted by one researcher. The search yielded 6098 unique records—of which, 68 were full-paper screened. Four articles met the eligibility criteria for inclusion. From the randomized clinical studies of pharmacological interventions, few studies report sex-disaggregated outcomes for women and men. Despite emergent evidence showing the influence of sex and gender factors in cannabis research, sex-disaggregated outcomes in pharmacological interventions is lacking. Sex- and gender-based analysis is incipient in the included articles. Future research should explore more comprehensive inclusion of sex- and gender-related aspects in pharmacological treatments for CUD.
Collapse
Affiliation(s)
- Andreea C. Brabete
- Centre of Excellence for Women´s Health, E311-4500 Oak Street, Vancouver, BC V6H 3N1, Canada; (L.G.); (N.H.); (J.S.)
- Correspondence: ; Tel.: +1-514-621-8601
| | - Lorraine Greaves
- Centre of Excellence for Women´s Health, E311-4500 Oak Street, Vancouver, BC V6H 3N1, Canada; (L.G.); (N.H.); (J.S.)
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Natalie Hemsing
- Centre of Excellence for Women´s Health, E311-4500 Oak Street, Vancouver, BC V6H 3N1, Canada; (L.G.); (N.H.); (J.S.)
| | - Julie Stinson
- Centre of Excellence for Women´s Health, E311-4500 Oak Street, Vancouver, BC V6H 3N1, Canada; (L.G.); (N.H.); (J.S.)
| |
Collapse
|
8
|
A critical review of human milk sharing using an intersectional feminist framework: Implications for practice. Midwifery 2018; 66:141-147. [PMID: 30172991 DOI: 10.1016/j.midw.2018.08.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 07/27/2018] [Accepted: 08/15/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Driven by a growing body of research demonstrating the health benefits of human milk over substitute feeding preparations, the demand for human milk donations in North America is rapidly increasing. In the context of an increasingly institutionalized and commercialized human milk market, informal peer-to-peer milk sharing networks are commonplace. Race, class, gender and sexual orientation are intersecting aspects of identity and power that influence participation in breastfeeding and the domain of milk exchange. Using an intersectional feminist framework, we critically review studies of participation in milk sharing to examine the identities and socio-political circumstances of milk sharing participants. DESIGN, SETTING AND PARTICIPANTS We use an intersectional feminist framework to conduct a critical review of the evidence pertaining to human milk sharing participants in North America. The search strategy included relevant databases (Pubmed, CINAHL) and hand-searches of key journals. We include research studies with participants in the United States and Canada and where participants milk shared as recipients or donors. FINDINGS Of those studies that examine socio-political identities such as race and class, participants are largely white and high-income. Many studies did not examine socio-political identities, and none examine sexual orientation. Themes we identify in this review include: (1) Socio-political identities; (2) Milk sharing supports parental health; (3) Socio-political influences; (4) Resistance against institutionalization. IMPLICATIONS FOR PRACTICE Maternity care providers can advocate for improved access to breastfeeding support and pasteurized human donor milk to address inequities. Maternity care providers can bring consciousness of intersecting socio-political identities to discussions with families about milk-sharing.
Collapse
|