Examining Sexual Health Organizational Networks in Urban African American Communities Using Social Network Theory

PURPOSE

Collaboration among organizations offering sexual health and youth development services has the potential to provide youth with effective sexual health support. However, formally structured efforts (eg, coalition formation) may be impractical or unsuitable for low-income communities where resources are often already limited. Social network theories provide an alternative approach for building collaborative organizational networks.

APPROACH

Research aims to evaluate the barriers and facilitators to collaboration in sexual health organizational networks.

SETTING

Organizations in low income, urban, communities in Chicago and San Francisco that serve African American adolescents.

PARTICIPANTS

Providers (n = 22) from organizations that offer sexual health services and youth development services.

METHODS

Focus groups (n = 4) were conducted and analyzed utilizing a combination of coding strategies.

RESULTS

Barriers to collaboration included resource limitations and competition, differences in organizational roles and deliverables, and prejudice and stigma. Identifying common ground among organizations was found to be a facilitator to collaboration. Social network concepts in conjunction with study findings lead to the development of a practice model that hypothesizes a pathway for organizations to improve collaboration without formally structured efforts.

CONCLUSION

Our findings offer ways to encourage collaboration among organizations that support youth sexual health in low-income, urban, African American communities without relying on formal structures. Such collaborations may be critical for improving the provision of comprehensive sexual health support.

Young female migrants and job placement brokers in Addis Ababa, Ethiopia

Introduction

Rates of urbanization in Ethiopia are high and adolescent girls and young women are predominant among those who move from rural to urban areas. Young women frequently undertake rural-urban migration on their own or with a friend, and with little planning for their initial settlement in the city. They frequently rely on job placement brokers to place them into jobs upon arrival, with positions such as domestic work normally including accommodation.

Methods

This is a qualitative study undertaken at the two largest bus stages in Addis Ababa, which are points of arrival for a large number of migrants from rural areas. Three categories of respondents were interviewed in-depth: migrant young women who had arrived within the last few days, job placement brokers who are located in and around the bus station, and market women/vendors at the bus stations who interact with both migrants and brokers.

Results

Migrant girls' point of arrival was an inflection point of risk, especially among girls who were on their own, not accompanied or met at the bus terminal and lacking in plans or preparation of accommodation. Such girls were targeted by thieves at the bus station and by unscrupulous brokers, some of whom forced girls into sexual relations before placing them into paid work. In contrast, market women and some well-meaning brokers took steps to protect girls such as providing temporary accommodation.

Conclusion

This research underscores the need for intensified support to rural-urban migrants to ensure safety and security at the time of arrival at their destination. This includes promotion of pre-migration education and planning; safety assets including sufficient money, cell phones and alternative contacts in the city; and arrangement for immediate, safe and secure accommodation. As a result of the study, a pilot program has been developed, using local resources to extend support for newly arriving migrant girls and young women.

Connecting knowledge: First-year health care students' learning in early interprofessional tutorials

Collaboration across professional boundaries is an essential aspect of health care, and interprofessional education (IPE) is a common way to help increase students' collaborative abilities. Research on how and when IPE should be arranged in a curriculum remains, however, inconclusive. How students actually develop interprofessional competencies have been difficult to demonstrate and is still an under-researched area. Studying IPE in context is therefore important to understand its full complexity. This paper examines how students work with scenarios from professional health care contexts when learning together in interprofessional problem-based learning tutorials during the first year of undergraduate education. The data are video-recorded tutorials of students from medicine, nursing, occupational therapy, speech and language pathology, and physiotherapy programmes. The analysis focuses on students' discussing their readings of the literature. Drawing on "Communities of Practice," findings show that students discuss and connect professional knowledge, with "brokers" (the tutors) and "boundary objects" (scenarios) supporting the emergence of students' professional knowledge. The scenarios, as boundary objects, also enabled the students to turn into brokers themselves. The paper contributes to research on interprofessional learning and offers support for implementing IPE in the early stages of undergraduate education.

Growing families in a shrinking world: legal and ethical challenges in cross-border surrogacy

Crossing national borders to have children is a rapidly growing phenomenon, fuelled by restrictions on access and technologies in some countries and for some patients, by high costs in others, and all generating a burgeoning multibillion dollar international industry. Cross-border gestational surrogacy is one form of family building that challenges legal, policy and ethical norms between countries and puts both intended parents and gestational surrogates at risk, and can leave the offspring of these arrangements vulnerable in a variety of ways, including parent-child, immigration and citizenship status. The widely varying political, religious and legal views amongst countries make line drawing and rule making challenging. This article reviews recent court decisions about and explores the legal dimensions of cross-border surrogacy.