| 1. |
- Ahlberg, Beth Maina, 1949-, et al.
(författare)
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"A child, a tree" : Challenges in building collaborative relations in a community research project in a Kenyan context
- 2016
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Ingår i: Action Research. - : Sage Publications. - 1476-7503 .- 1741-2617. ; 14:3, s. 257-275
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Tidskriftsartikel (refereegranskat)abstract
- This paper highlights the potential for basing participatory action research on priorities identified by communities. The case builds on a research project by the Social Science Medicine Africa Network (Soma-net) focusing on AIDS prevention among school youth in Kajiado in Kenya during 2003-2006. It became clear from that study just how complex it is to promote open communication on issues of sexuality considered critical for sexual health promotion. Towards the end of that study a spin-off in the form of a concept a child, a tree or tree planting evolved and the research thereafter continued as a partnership between the school community and the researchers. The focus then was on understanding how health promotion could be integrated into other aspects of community life. The concept and tree planting when implemented created a sense of ownership among the pupils largely because they were placed at the centre of the development activities. The story illuminates the nature of change developing in the course of the project, but also the challenges and complexity of creating and maintaining collaborative relations in the face of cultural and gender power dynamics and interventions imposed from outside the community.
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| 2. |
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| 3. |
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| 4. |
- Ahlberg, Beth Maina, 1949-, et al.
(författare)
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Ethnic, racial and regional inequalities in access to COVID-19 vaccine, testing and hospitalization : Implications for eradication of the pandemic
- 2022
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Ingår i: Frontiers in Sociology. - : Frontiers Media S.A.. - 2297-7775. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic has made visible inequalities as exemplified by unequal access to COVID-19 vaccine across and within countries; inequalities that are also apparent in rates of testing, disease, hospitalization and death from COVID-19 along class, ethnic and racial lines. For a global pandemic such as the COVID-19 to be effectively addressed, there is a need to reflect on the entrenched and structural inequalities within and between countries. While many countries in the global north have acquired more vaccines than they may need, in the global south many have very limited access. While countries in the global north had largely vaccinated their populations by 2022, those in the global south may not even complete vaccinating 70% of their population to enable them reach the so-called herd immunity by 2024. Even in the global north where vaccines are available, ethnic, racialized and poor working classes are disproportionately affected in terms of disproportionately low rates of infection and death. This paper explores the socio-economic and political structural factors that have created and maintain these disparities. In particular we sketch the role of neoliberal developments in deregulating and financializing the system, vaccine hoarding, patent protection and how this contributes to maintaining and widening disparities in access to COVID-19 vaccine and medication.
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| 5. |
- Ahlberg, Beth Maina, 1949-, et al.
(författare)
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Invisibility of Racism in the Global Neoliberal Era : Implications for Researching Racism in Healthcare
- 2019
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Ingår i: Frontiers in Sociology. - : Frontiers Media SA. - 2297-7775. ; 4
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Forskningsöversikt (refereegranskat)abstract
- This paper describes the difficulties of researching racism in healthcare contexts as part of the wider issue of neoliberal reforms in welfare states in the age of global migration. In trying to understand the contradiction of a phenomenon that is historical and strongly felt by individuals and yet widely denied by both institutions and individuals, we consider the current political and socioeconomic context of healthcare provision. Despite decades of legislation against racism, its presence persists in healthcare settings, but data on these experiences is rarely gathered in Europe. National systems of healthcare provision have been subject to neoliberal reforms, where among others, cheaper forms of labor are sought to reduce the cost of producing healthcare, while the availability of services is rationed to contain demand. The restriction both on provision of and access to welfare, including healthcare, is unpopular among national populations. However, the explanations for restricted access to healthcare are assumed to be located outside the national context with immigrants being blamed. Even as migrants are used as a source of cheap labor in healthcare and other welfare sectors, the arrival of immigrants has been held responsible for restricted access to healthcare and welfare in general. One implication of (im)migration being blamed for healthcare restrictions, while racism is held to be a problem of the past, is the silencing of experiences of racism, which has dire consequences for ethnic minority populations. The implications of racism as a form of inequality within healthcare and the circumstances of researching racism in healthcare and its implication for the sociology of health in Sweden are described.
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| 6. |
- Ahlberg, Beth Maina, et al.
(författare)
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'It's only a tradition' : making sense of eradication interventions and the persistence of female 'circumcision' within a Swedish context
- 2004
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Ingår i: Critical Social Policy. - London : Sage Publications. - 0261-0183 .- 1461-703X. ; 24:1, s. 50-78
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Tidskriftsartikel (refereegranskat)abstract
- This paper questions why female circumcision (FC) persists despite eradication interventions and the migration of people to non-practising countries and discusses the reasoning of Somali immigrants on female circumcision. It is based on interviews with diverse groups and individuals in the Somali community, mostly refugees in Sweden. Paradoxes implying denial and avoidance emerged. Female circumcision was described, as just 'a tradition' that has little to do with Islam. The fear of bringing up an uncircumcised daughter in the liberal sexual morality of Sweden was mentioned as a dilemma. Circumcised women said the health care they received during pregnancy and childbirth was poor while the law failed to take account of the experiences of the Somali people. We conclude that rather than eradication, interventions seem to have silenced and stigmatized the practice due to their failure to take account of its meanings, organization and contexts, including the diasporic dynamics within which immigrants negotiate identities.
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| 7. |
- Ahlberg, Beth Maina, 1949-, et al.
(författare)
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“Just Throw It Behind You and Just Keep Going” : Emotional Labor when Ethnic Minority Healthcare Staff Encounter Racism in Healthcare
- 2022
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Ingår i: Frontiers in Sociology. - Switzerland : Frontiers Media S.A.. - 2297-7775. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Encountering racism is burdensome and meeting it in a healthcare setting is no exception. This paper is part of alarger study that focusedonunderstandingandaddressingracismin healthcare in Sweden. In the paper, we draw on interviews with 12 ethnic minority healthcare staff who described how they managed emotional labor in their encounters with racism at their workplace. Data were analyzed using thematic analysis. The analysis revealed that experienced emotional labor arises from two main reasons. The first is the concern and fear that ethnic minority healthcare staff have of adverse consequences for their employment should they be seen engaged in discussing racism. The second concerns the ethical dilemmas when taking care of racist patients since healthcare staff are bound by a duty of providing equal care for all patients as expressed in healthcare institutional regulations. Strategies to manage emotional labor described by the staff include working harder to prove their competence and faking, blocking or hiding their emotions when they encounter racism. The emotional labor implied by these strategies could be intense or traumatizing as indicated by some staff members, and can therefore have negative effects on health. Given that discussions around racism are silenced, it is paramount to create space where racism can be safely discussed and to develop a safe healthcare environment for the benefit of staff and patients.
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| 8. |
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| 9. |
- Ahlberg, Beth Maina, 1949-, et al.
(författare)
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'Not men enough to rule!' : politicization of ethnicities and forcible circumcision of Luo men during the postelection violence in Kenya
- 2013
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Ingår i: Ethnicity and Health. - : Informa UK Limited. - 1355-7858 .- 1465-3419. ; 18:5, s. 454-468
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAs a contribution to ongoing research addressing sexual violence in war and conflict situations in the Democratic Republic of Congo, Kenya and Rwanda, this paper argues that the way sexual violence intersects with other markers of identity, including ethnicity and class, is not clearly articulated. Male circumcision has been popularized, as a public health strategy for prevention of HIV transmission, although evidence of its efficacy is disputable and insufficient attention has been given to the social and cultural implications of male circumcision.MethodsThis paper draws from media reporting and the material supporting the prosecutor at the International Criminal Court case against four Kenyans accused of crimes against humanity, to explore the postelection violence, especially forcible male circumcision.ResultsDuring the postelection violence in Kenya, women were, as in other conflict situations, raped. In addition, men largely from the Luo ethnic group were forcibly circumcised. Male circumcision among the Gikuyu people is a rite of passage, but when forced upon the Luo men, it was also associated with cases of castration and other forms of genital mutilation. The aim appears to have been to humiliate and terrorize not just the individual men, but their entire communities. The paper examines male circumcision and questions why a ritual that has marked a life-course transition for inculcating ethical analysis of the self and others, became a tool of violence against men from an ethnic group where male circumcision is not a cultural practice.ConclusionThe paper then reviews the persistence and change in the ritual and more specifically, how male circumcision has become, not just a sexual health risk, but, contrary to the emerging health discourse and more significantly, a politicized ethnic tool and a status symbol among the Gikuyu elite. In the view of the way male circumcision was perpetrated in Kenya, we argue it should be considered as sexual violence, with far-reaching consequences for men's physical and mental health.
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| 10. |
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| 11. |
- Belita, Alice N., et al.
(författare)
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Adolescence and Sexuality in the Context of HIV and AIDS : Views and Concerns of Pupils in a Rural Primary School in Kenya
- 2011
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Ingår i: Child Health and Education. - 1911-7558. ; 3:2, s. 122-136
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Tidskriftsartikel (refereegranskat)abstract
- New HIV infections in Kenya have been mostly among young people 15–24 years of age. The Maasai adolescents are an important group to study asthe Maasai have a distinct culture, which in light of current political and socioeconomic changes could be a risk factor for HIV infection. The aim of this study was to explore the views and concerns of school youth on adolescence and sexuality in the context of HIV and AIDS.A qualitative method using self-generated questions was used. The school youth wrote questions on adolescence, sexuality and HIV and AIDS, or those questions they could not ask their parents or other adults for fear or shame. They reported being curious about sex, sexual urge and feelings that they have. They expressedconfusion about adolescence and their experiences as adolescents in terms of both physical and emotional changes. They are also subject to prohibitivesilence from adults to an extent that they express fear of reporting sexual abuse. Relationship between different sexes was reflected as one that needed to be sanctioned; hence the young people wanted to know how they should relate with each other. They had concerns about condom use that indicated they were exposed to the different discourses on condom use. They showed limited knowledge on HIV and AIDS and STIs and also expressed eagerness to know more about them. In conclusion, communication between parents and their children on issues of sexuality needs to be assessed. Interventions for young people that involve the communities should be encouraged.
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| 12. |
- Bjerneld, Magdalena
(författare)
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Images, Motives, and Challenges for Western Health Workers in Humanitarian Aid
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis presents how humanitarian aid workers were attracted, motivated, recruited, and prepared for fieldwork, and how they reported their work experience directly from the field and when they returned home. Data were derived from interviews with experienced aid workers, focus group discussions with presumptive aid workers, analysis of letters from aid workers in the field on MSFs homepages in Europe, and from interviews with recruitment officers at some of the main humanitarian organisations. Health professionals were attracted by the positive images of humanitarian action. They wished to work in teams with like-minded people, and to make a difference in the world. However, this image was not supported by the recruitment officers, or experienced aid workers, who described a complex reality in humanitarian action. The experienced aid workers instead had realised they learned more than they contributed. The recruitment system for relief workers would benefit from a more holistic approach, where personalities of the aid workers are more in focus. More time must be spent with the applicants, both recruited and returning aid workers, in order to improve the system. A socialisation approach could help identify the right personnel and to motivate current personnel to continue.
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| 13. |
- Bjerneld, Magdalena, 1950-, et al.
(författare)
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Socialisation of humanitarian aid workers : Interviews with recruitment officers
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- International organisations employ thousands of aid workers for humanitarian aid around the world. One of the problems identified in earlier research is the high turnover of personnel.This article is part of a broader research project investigating how humanitarian organisations attract, recruit and prepare expatriate health professionals for field work and how these professionals are utilized in order to identify possible improvements in the human resource management system. The current study describes how recruitment officers in selected large humanitarian organisations perceive humanitarian aid work, how they recruit, prepare, and support their staff in order to achieve high retention, and what concerns and recommendations they have for future work. For the analysis of the interviews content analysis was used.The recruitment officers identified the importance of flexibility and diplomacy in complex realities. They confirmed the findings of earlier studies that team work often is a source of frustrations and sometimes disappointment. Their main concern was lack of time to find the right person for the right job, often a person with broad expertise in public health. Another difficulty was to find persons who could take responsibility as leaders and trainers. In order to socialize the newcomers into the organisation short courses and debriefing sessions were used. Persons, who stay too long in the field of humanitarian action and sometimes become cynical to the difficult situation they work in was also discussed as being problematic. This finding contradicts the otherwise frequently discussed question about the high turnover of personnel in humanitarian action. This article argues for the use of socialization theory in order to find sustainable solution to identified problems.
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| 14. |
- Bradby, Hannah, 1966-, et al.
(författare)
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Att förstå och åtgärda diskriminering inom hälso-och sjukvården
- 2017
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bevis på ojämlikheter i hälsostatus mellan svenskfödda och människor med utländsk bakgrund finns i Sverige men är osystematiskt och utspritt. Dock föreligger det rapporter över minoritetsgruppers erfarenheter avseende dålig kommunikation, icke-överensstämmande hälso- och sjukvård och respektlös hållning. Dessutom anger vårdpersonal sin osäkerhet och oro inför mötet med språkliga och/eller kulturella minoriteter samt religiösa personer i Sverige. Denna kombination bidrar potentiellt till vad som ibland kallas kulturellt osäker vård. I takt med att Sverige har lyckats med att reducera klass ojämlikheterna gällande förväntad livslängd i slutet av 1900-talet och sitt intagande av en ledande roll i det internationella flyktingarbetet, har Sverige framstått som en banbrytande "moralisk superkraft". Tillsammans med den Svenska expentionalismen har det varit således svårt att diskutera och undersöka diskriminering inom hälso-sjukvården. I avsaknaden av en diskussion om politiken och praxis för diskriminering mot minoriteter inom vården, kan kombinationen av missnöjet från patienternas och vårdpersonalens sida vara potentiellt explosivt. För att möjliggöra en meningsfull förändring i möten mellan patienter med utländsk bakgrund och vårdpersonal är det väsentligt att påbörja en meningsfull dialog om rasism. Vi vill kunna möjliggör för en konstruktiv och givande diskussion kring rasism inom hälso-och sjukvården på ett icke dömande sätt som bygger på en konsultativ och kollaborativt process. Detta för att göra det möjligt att dela, ta itu med och bygga på en rad erfarenheter från olika parter inom vården. Syftet med rundabordsdiskussionen är att erbjuda en omfattande diskussion från olika parter inom vården varför deltagarna ska representerar olika discipliner och roller som vårdpersonal, patienter, politiker.
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| 15. |
- Bradby, Hannah, 1966-, et al.
(författare)
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Designing an education intervention for understanding racism in healthcare in Sweden : development and implementation of anti-racist strategies through shared knowledge production and evaluation
- 2023
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 51:4, s. 531-534
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Tidskriftsartikel (refereegranskat)abstract
- An educational intervention, based on qualitative evidence of racism in healthcare, is described. Using vignettes from a previous project, interviews were conducted to gather qualitative evidence of racism in healthcare settings from a wide range of healthcare staff in Sweden. From this interview material, case studies were devised that were subsequently presented to trainee healthcare professionals, in a seminar discussion. After the seminar, trainees responded to reflective questions. The order of work, as well as the materials used, are described. This intervention was successful in facilitating discussion about racism in an educational context, despite the difficult nature of these conversations for some participants.
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| 16. |
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| 17. |
- Bradby, Hannah, 1966-, et al.
(författare)
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Undoing the unspeakable : researching racism in Swedish healthcare using a participatory process to build dialogue
- 2019
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Ingår i: Health Research Policy and Systems. - : Springer Science and Business Media LLC. - 1478-4505. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background:Racism is difficult to discuss in the context of Swedish healthcare for various cultural and administrative reasons. Herein, we interpret the fragmentary nature of the evidence of racialising processes and the difficulty of reporting racist discrimination in terms of structural violence.Methods:In response to the unspeakable nature of racism in Swedish healthcare, we propose a phased participatory process to build a common vocabulary and grammar through a consultative framework involving healthcare providers and service users as well as policy-makers. These stakeholders will be involved in an educational intervention to facilitate discussion around and avoidance of racism in service provision.Discussion:Both the participatory process and outcomes of the process, e.g. educational interventions, will contribute to the social and political conversation about racism in healthcare settings. Creating new ways of discussing sensitive topics allows ameliorative actions to be taken, benefitting healthcare providers and users. The urgency of the project is underlined.
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| 18. |
- Bradby, Hannah, 1966-, et al.
(författare)
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‘You are Still a Guest in This Country!’ : Understanding Racism through the Concepts of Hospitality and Hostility in Healthcare Encounters in Sweden
- 2023
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Ingår i: Sociology. - : Sage Publications. - 0038-0385 .- 1469-8684. ; 57:4, s. 957-974
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Tidskriftsartikel (refereegranskat)abstract
- While regularly applied to globalized migration, conceptualizations of hospitality have rarely been used to understand healthcare settings. Drawing on interviews with healthcare staff in Sweden, our article contributes to the current conceptualization of hospitality accounting for: the internal contradictions of hospitality that racialized staff experience in their everyday interactions with patients and other staff; the shifting boundaries between host and guest in everyday healthcare practices, especially when examined through the lens of racialization and finally; the subtle though troubled coexistence of hostility and un(conditional) hospitality that weakens resistance against racism. The analysis maps the complex contingencies of professional, ethnic and national relations between staff and patients, in light of their racialized and gendered nature, to suggest that the ambivalences theorized as part of the concept of hospitality show how the hurts of racism are so hard to pinpoint.
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| 19. |
- Chikovore, Jeremiah, et al.
(författare)
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HIV/AIDS and sexuality : concerns of youths in rural Zimbabwe
- 2009
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Ingår i: African Journal of AIDS Research. - Grahamstown : National inquiry services centre. - 1608-5906 .- 1727-9445. ; 8:4, s. 503-513
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Tidskriftsartikel (refereegranskat)abstract
- Concerns regarding HIV and AIDS were elicited from 546 school youths (51% female, age range 9-25 years) in a Zimbabwean rural district, through a self-generated question-writing process. Concerns emerged around how to avoid HIV infection at a time when they were undergoing secondary sexual development, had growing feelings of love, and were even engaging in sexual activity, while they had limited access to preventive methods due to denial by the adult world. Fears were expressed in regard to how to tell one's HIV status, even just after sex. HIV and AIDS were visualised in terms of suffering, loneliness, quarantine and death. The youths stressed they would have difficulties communicating with other people should they suspect or find they were infected with HIV, as this would imply they had been sexually active. They seemed to have knowledge about HIV and AIDS which either was incomplete or they could not apply, given a context of silence and denial about their sexuality. Some of their knowledge was coloured with misconceptions, suggesting contradictory information from multiple sources. After more than two decades of the epidemic in Zimbabwe, the scenario portrayed raises questions about HIV/AIDS interventions targeting young people. The question posed is why is the situation of these youths in this state when several stakeholders are actively participating in debates and interventions for the sake of their wellbeing? HIV/AIDS campaigns and interventions may need to consider young people's complex social contexts, the factors generating and sustaining their situation, and what role diverse actors and social-change processes play in this.
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| 20. |
- Chikovore, Jeremiah, et al.
(författare)
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"How Can I Gain Skills if I Don't Practice?'' The Dynamics of Prohibitive Silence against Pre-Marital Pregnancy and Sex in Zimbabwe
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:1, s. e53058-
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Tidskriftsartikel (refereegranskat)abstract
- Young people face sexual and reproductive health (SRH) problems including Human immunodeficiency virus (HIV) and Acquired immunodeficiency syndrome (AIDS). It is critical to continue documenting their situation including the contexts they live in. As part of a larger study that explored perspectives of men to SRH and more specifically abortion and contraceptive use, 546 pupils (51% female; age range 9-25 years) from a rural area in Zimbabwe were invited to write anonymously questions about growing up or other questions they could not ask adults for fear or shame. The pupils were included following descriptions by adults of the violence that is unleashed on unmarried young people who engaged in sex, used contraceptives, or simply suggested doing so. The questions by the young people pointed to living in a context of prohibitive silence; their sexuality was silenced and denied. As a consequence they had poor knowledge and their fears and internal conflicts around sexuality and pregnancy were not addressed. Current action suggests concerted effort at the policy level to deal with young people's SRH in Zimbabwe. It nevertheless remains necessary, as a way to provide support to these efforts, to continue examining what lessons can be drawn from the past, and how the past continues to reflect in and shape present dynamics and relations. There is also need to look more critically at life skill education, which has previously been described as having failed to address adequately the practical needs of young people. Life skill education in Zimbabwe has rarely been systematically evaluated. A fuller understanding is also needed of the different factors co-existing in contemporary African societies and how they have been and continue to be constituted within history, and the implications to the promotion of adolescent SRH.
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| 21. |
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| 22. |
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| 23. |
- Darj, Elisabeth, 1953-, et al.
(författare)
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"The fairer the better?" : Use of potentially toxic skin bleaching products
- 2015
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Ingår i: African Health Sciences. - : African Journals Online (AJOL). - 1680-6905 .- 1729-0503. ; 15:4, s. 1074-1080
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Tidskriftsartikel (refereegranskat)abstract
- Background:Skin bleaching is a widespread phenomenon in spite of their potentially toxic health effects.Objectives:This study aimed to determine if such products are used in Sweden in particular by pregnant women, furthermore to explore immigrant women’s view skin bleaching.Methods:455 pregnant women completed a questionnaire, which were statistically analysed. Focus groups and individual interviews were conducted with immigrant women, content analysis was used to assess the data.Results:Skin bleaching products were used by 2.6% of pregnant women, significantlly more by women born in non-European countries. Motivating factors were associated with the concept of beauty together with social and economic advantages. The women had low awareness of the potential health risks of the products. Regulations on the trade of skin bleaching products have not effectively reduced the availability of the products in Sweden nor the popularity of skin bleaching.Conclusion:There is need for further research especially among pregnant women and possible effects on newborns. Products should be tested for toxicity. Public health information should be developed and health care providers educated and aware of this practice, due to their potential negative health implications.
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| 24. |
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| 25. |
- Eriksson, Elisabet, et al.
(författare)
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Ambivalence, silence and gender differences in church leaders' HIV-prevention messages to young people in KwaZulu-Natal, South Africa
- 2010
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Ingår i: Culture, Health and Sexuality. - : Informa UK Limited. - 1369-1058 .- 1464-5351. ; 12:1, s. 103-114
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Tidskriftsartikel (refereegranskat)abstract
- A series of semi-structured interviews on HIV prevention were conducted with South African clergy with pastoral and liturgical responsibilities from the Roman Catholic Church, the Lutheran Church and the Assemblies of God. The interviews were tape-recorded, transcribed verbatim and analysed by interpretive descriptive analysis. Three themes indicative of church leaders' approach to HIV prevention among youth emerged: dilemmas in breaking the silence on HIV and AIDS; ambivalent HIV-prevention messages from church leaders to young people; and gender differences in HIV-prevention messages. While church leaders had taken steps to overcome the stigma, the dilemmas of balancing theological understanding with resistance from their congregations presented a complex scenario. Ambivalence to HIV prevention concerned whose responsibility it was to educate young people about HIV; talking about sexuality in public; pre-marital abstinence and condom use; and resistance from congregation members towards HIV prevention. Finally, findings indicated a discrepancy between church leaders' belief in gender equality and the HIV-prevention messages they verbalised, which appears to burden girls.
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| 26. |
- Eriksson, Elisabet
(författare)
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Christian Communities and Prevention of HIV among Youth in KwaZulu-Natal, South Africa
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Young people in South Africa, particularly females, are at great risk of acquiring HIV, and heterosexual sex is the predominant mode of HIV transmission. In order to curb the epidemic the Department of Health encourages all sectors in the society, including religious institutions, to respond effectively. The present thesis seeks to increase the understanding of the role of Christian communities in prevention of HIV for young people. Three denominations in KwaZulu-Natal were selected to reflect the diversity of Christian churches in South Africa: the Roman Catholic Church, the Evangelical Lutheran Church in Southern Africa, and the Assemblies of God. Using qualitative interviews the first paper explores how religious leaders (n=16) deal with the conflict between the values of the church and young people’s sexuality. Study II reports on attitudes to HIV prevention for young people among religious leaders (n=215) using questionnaire survey data. Study III investigates how young people (n=62) reflect on messages received from their churches regarding premarital sex by analysing nine focus group discussions. In the fourth paper, based on questionnaire survey data, we report on young people’s (n=811) experiences of relationships with the opposite sex and their perceived risk of HIV infection. The view that young people in churches are sexually active before marriage was common among religious leadership. The majority of religious leaders also reported that they are responsible for educating young people about HIV prevention. Religious leaders who had received training on HIV were more likely to run a life skills programme for young people, however they were ambivalent about prevention messages. Young people reported premarital sexual abstinence as the main HIV prevention message from their churches. The majority responded that they had received information about HIV in church. To be in a relationship was common, more so for males for whom multiple relationships also were viewed more acceptable. To perceive themselves at risk of HIV infection was common. Further training for religious leaders is needed to enable them to manage the conflict between the doctrine of the church and their willingness to assist young people in the transition into adulthood.
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| 27. |
- Eriksson, Elisabet, et al.
(författare)
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Faith, Premarital Sex and Relationships: Are Church Messages in Accordance with the Perceived Realities of the Youth? : A Qualitative Study in KwaZulu–Natal, South Africa
- 2013
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Ingår i: Journal of religion and health. - : Springer Science and Business Media LLC. - 0022-4197 .- 1573-6571. ; 52:2, s. 454-466
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Tidskriftsartikel (refereegranskat)abstract
- Since religious messages on life style have a strong impact in South Africa, it is important to assess how they relate to the situation for young people at risk of HIV infection. Nine focus group discussions were conducted with youth (n=62), aged 13–20 years, from the Roman Catholic Church, the Lutheran Church, and the Assemblies of God. Young people were ambivalent toward sexual contacts since these generally were expected to be part of a relationship even though the church condemns premarital sex. Girls perceived the moral norms to concern them more than the boys for whom sexual needs were more accepted. These moral barriers lead to lack of information about protection and may increase the risk of HIV. The realities young people facing should be a major concern for the faith communities.
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| 28. |
- Faxelid, E, et al.
(författare)
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Quality of STD care in an urban Zambian setting: the providers' perspective
- 1997
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Ingår i: INTERNATIONAL JOURNAL OF NURSING STUDIES. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0020-7489. ; 34:5, s. 353-357
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this paper is to analyse obstacles to optimal STD care in an urban setting in Zambia. Eighty-two health professionals answered a questionnaire with closed and open-ended questions. More than 50% were not satisfied with their working conditions
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| 29. |
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| 30. |
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| 31. |
- Hamed, Sarah, et al.
(författare)
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Powerlessness, Normalization, and Resistance : A Foucauldian Discourse Analysis of Women’s Narratives On Obstetric Fistula in Eastern Sudan
- 2017
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Ingår i: Qualitative Health Research. - : Sage Publications. - 1049-7323 .- 1552-7557. ; 27:12, s. 1828-1841
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Tidskriftsartikel (refereegranskat)abstract
- Eastern Sudan has high prevalence of female circumcision and child marriage constituting a risk for developing obstetric fistula. Few studies have examined gender roles’ relation with obstetric fistula in Sudan. To explore the associated power-relations that may put women at increased risk for developing obstetric fistula, we conducted nine interviews with women living with obstetric fistula in Kassala in eastern Sudan. Using a Foucauldian discourse analysis, we identified three discourses: powerlessness, normalization, and covert resistance. Existing power-relations between the women and other societal members revealed their internalization of social norms as absolute truth, and influenced their status and decision-making power in regard to circumcision, early marriage, and other transformative decisions as well as women’s general behaviors. The women showed subtle resistance to these norms and the harassment they encountered because of their fistula. These findings suggest that a more in-depth contextual assessment could benefit future maternal health interventions.
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| 32. |
- Hamed, Sarah, et al.
(författare)
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Racism in European Health Care: Structural Violence and Beyond
- 2020
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Ingår i: Qualitative Health Research. - : Sage Publications. - 1049-7323 .- 1552-7557. ; 30:11, s. 1662-1673
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Tidskriftsartikel (refereegranskat)abstract
- Research shows how racism can negatively affect access to health care and treatment. However, limited theoretical research exists on conceptualizing racism in health care. In this article, we use structural violence as a theoretical tool to understand how racism as an institutionalized social structure is enacted in subtle ways and how the “violence” built into forms of social organization is rendered invisible through repetition and routinization. We draw on interviews with health care users from three European countries, namely, Sweden, Germany, and Portugal to demonstrate how two interrelated processes of unequal access to resources and inequalities in power can lead to the silencing of suffering and erosion of dignity, respectively. The strength of this article lies in illuminating the mechanisms of subtle racism that damages individuals and leads to loss of trust in health care. It is imperative to address these issues to ensure a responsive and equal health care for all users.
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| 33. |
- Hamed, Sarah, et al.
(författare)
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Racism in healthcare : a scoping review
- 2022
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Ingår i: BMC Public Health. - London. United Kingdom : Springer Nature. - 1471-2458. ; 22
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Forskningsöversikt (refereegranskat)abstract
- BackgroundRacism constitutes a barrier towards achieving equitable healthcare as documented in research showing unequal processes of delivering, accessing, and receiving healthcare across countries and healthcare indicators. This review summarizes studies examining how racism is discussed and produced in the process of delivering, accessing and receiving healthcare across various national contexts.MethodThe PRISMA guidelines for scoping reviews were followed and databases were searched for peer reviewed empirical articles in English across national contexts. No starting date limitation was applied for this review. The end date was December 1, 2020. The review scoped 213 articles. The results were summarized, coded and thematically categorized in regards to the aim.ResultsThe review yielded the following categories: healthcare users’ experiences of racism in healthcare; healthcare staff’s experiences of racism; healthcare staff’s racial attitudes and beliefs; effects of racism in healthcare on various treatment choices; healthcare staff’s reflections on racism in healthcare and; antiracist training in healthcare. Racialized minorities experience inadequate healthcare and being dismissed in healthcare interactions. Experiences of racism are associated with lack of trust and delay in seeking healthcare. Racialized minority healthcare staff experience racism in their workplace from healthcare users and colleagues and lack of organizational support in managing racism. Research on healthcare staff’s racial attitudes and beliefs demonstrate a range of negative stereotypes regarding racialized minority healthcare users who are viewed as difficult. Research on implicit racial bias illustrates that healthcare staff exhibit racial bias in favor of majority group. Healthcare staff’s racial bias may influence medical decisions negatively. Studies examining healthcare staff’s reflections on racism and antiracist training show that healthcare staff tend to construct healthcare as impartial and that healthcare staff do not readily discuss racism in their workplace.ConclusionsThe USA dominates the research. It is imperative that research covers other geo-political contexts. Research on racism in healthcare is mainly descriptive, atheoretical, uses racial categories uncritically and tends to ignore racialization processes making it difficult to conceptualize racism. Sociological research on racism could inform research on racism as it theoretically explains racism’s structural embeddedness, which could aid in tackling racism to provide good quality care.
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| 34. |
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| 35. |
- Hamed, Sarah, et al.
(författare)
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Understanding racial discrimination in healthcare
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- There is little discussion around racism in Sweden although some fragmented evidence on discrimination and minorities’ experience of poor communication and disrespectful attitudes in Swedish healthcare exists. The lack of official data around racialised categories together with the idea of Swedish exceptionalism, and racism’s occluded nature, renders racial discrimination invisible and insidious. The embeddedness of racism in social structures and its invisible workings in healthcare makes it difficult to identify. We argue that racism in healthcare can be framed as structural violence which enables an understanding of the unequal experience of morbidity and mortality. Thus, opportunities of healthcare are not shared evenly: enabling some but disabling others from reaching their full potential. Given the sensitive nature of racism in Sweden, consultation with a range of stakeholders in the provision of healthcare is necessary to address long-standing institutionalised discrimination that damages, patients, staff and the prospect of equal access to services. This method will contribute to supporting changed processes in healthcare provision regarding both individual and institutional racism and other forms of discrimination.
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| 36. |
- Hamed, Sarah, et al.
(författare)
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Understanding racism in Swedish healthcare
- 2019
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Ingår i: European Journal of Public Health. - Oxford : Oxford University Press (OUP). - 1101-1262 .- 1464-360X.
-
Konferensbidrag (refereegranskat)abstract
- BackgroundDespite the removal of the term ’race’ from statutory documents in Sweden, after the Second World War, racism continues to exist in various institutions including healthcare. Racism can persist in the absence of a biological notion of ’race’ but becomes harder to explain when there is no official recognition. There is evidence of discrimination by patients and healthcare professionals, although fragmented and under-researched. As healthcare should be built on equity and solidarity, accounts of racism constitute a serious breach. Our research focuses on conceptualising racism in healthcare in Sweden to develop means of improving equity in care for populations characterised by migration-driven diversity.MethodsData from 28 qualitative interviews with both patients and healthcare professionals in Sweden was collected.ResultsPreliminary results indicate that patients from minority ethnic groups report that healthcare providers deem their symptoms as insignificant, due to their ethnicity. Consequently, they experience a loss of integrity and trust in healthcare, often leading them to avoid seeking healthcare. Healthcare professionals conceptualise racism in varied ways, ranging from denying racism, normalising and individualising racism to viewing racism as a structural problem. Patients did not report their experiences of racism, as racism was often subtle. Likewise, healthcare professionals mostly chose not to report their experiences for fear of being constructed as difficult colleagues.ConclusionsThe lack of space for discussing racism within healthcare constitutes a problem for healthcare professionals and patients and contributes to rendering experiences of racism invisible. This may be detrimental for achieving responsive healthcare and creates an unhealthy working environment for some healthcare professionals.
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| 37. |
- Hertfelt Wahn, Elisabeth, et al.
(författare)
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Becoming and Being a Teenage Mother : How Teenage Girls in South Western Sweden View Their Situation
- 2005
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Ingår i: Health Care for Women International. - : Routledge. - 0739-9332 .- 1096-4665. ; 26:7, s. 591-603
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Tidskriftsartikel (refereegranskat)abstract
- Our aim in this study was to describe the perspectives, experiences, and reasonings about becoming and being a teenage mother by Swedish teenage girls. Twenty pregnant and parenting teenage girls, aged 15 to 19 years, were interviewed. The teenagers described a pattern of early childbirth in their families, lack of opportunity in life, and ambivalence in contraceptive use as reasons for becoming a teenage mother . They experienced being pregnant and a teenage mother as both a positive transition into adulthood but also as a physiological and psychological hardship. Furthermore, the teenagers emphasized the importance of supportive relationships with families, friends, and society as a prerequisite for successful parenting. The results of our study may be viewed as generating a working hypothesis that can be transferred to other settings on the basis of the information gathered.
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| 38. |
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| 39. |
- Huzzard, Tony, et al.
(författare)
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Constructing interorganizational collaboration The action researcher as boundary subject
- 2010
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Ingår i: Action Research. - : SAGE Publications. - 1476-7503 .- 1741-2617. ; 8:3, s. 293-314
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Tidskriftsartikel (refereegranskat)abstract
- This article aims to explore critically the role of an action research team in the social construction of interorganizational collaboration aimed at transgressing organizational and professional boundaries. We argue that the new relationships, actor conceptions and in some cases forms of work organization arising from the change process have been socially constructed through the discursive interventions of the researchers. This has largely occurred through informal interaction with and between the actors engaged in the development process. The action researcher, rather than being a neutral discursive gatekeeper in collaborative development projects, is an active constructor of the discourse shaping the collaboration. A case is presented showing how the researcher role is thus better seen as being an active boundary subject mediating across various professional and organizational perspectives rather than a passive boundary object. Accordingly, by focusing on the discursive role of active researchers as boundary subjects, we can reflect more critically on the roles we adopt in our intervention endeavours and their inevitably political nature.
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| 40. |
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| 41. |
- Kaime-Atterhög, Wanjiku, et al.
(författare)
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Are street children beyond rehabilitation? : Understanding the life situation of street boys through ethnographic methods in Nakuru, Kenya
- 2008
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Ingår i: Children and youth services review. - : Elsevier BV. - 0190-7409 .- 1873-7765. ; 30:12, s. 1345-1354
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Tidskriftsartikel (refereegranskat)abstract
- This paper describes the social organisation of street boys, the complexities and dilemmas of accessing them for interview, and removing the youngest and most vulnerable from the streets. The data were collected from three groups of street boys over a period of eight months: 20 “market boys”; four “plastic bag sellers” and their group leader; and twelve “begging boys” and their group leader. The study employed a reflexive ethnographic approach with participant observation, informal interviews and group discussions as data collection strategies. A participatory workshop was arranged for the highly mobile “begging boys” who could not be interviewed directly on the streets. Key informants helped in gaining access to the three groups of street boys, providing “insider information” about the boys and their contexts as well as in building trust. Through this research process, a deeper understanding of the street culture emerged, showing who the street boys are as well as how they are organised, their hierarchies and socialisation; patterns of substance use, home spaces in the streets, and networks of support.
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| 42. |
- Kaime-Atterhög, Wanjiku, et al.
(författare)
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Burning "Centre Bolt": Experiences of sexually transmitted infections and health care seeking behaviour described by street boys in Urban Kenya
- 2007
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Ingår i: Children and youth services review. - : Elsevier BV. - 0190-7409 .- 1873-7765. ; 29:5, s. 600-617
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Tidskriftsartikel (refereegranskat)abstract
- This paper is about how street boys described their experiences of sexually transmitted infections and the care they sought in Nakuru, Kenya. The data were collected over a six-month period at a Soup Kitchen frequented by street children aged 5 to 18 years. Data were generated using participant observation of 115 children; group discussions with 12 boys; interviews with 20 boys; 17 key informant interviews; two home visits; and clinical records of five boys that had sexually transmitted infections. The findings revealed who the boys' sexual partners were, their sexual practices, and their pattern of condom use, their experience of sexually transmitted infections, how they communicate symptoms and when and how they seek care. Lack of money for treatment delayed care seeking. The study also indicated the existence of strong bonds and support networks as a survival strategy on the streets. In conclusion, understanding the ways the street boys experience, reason and communicate their symptoms as well as their support networks is useful in the prevention of sexually transmitted infections and the promotion of their general health and wellbeing. Moreover, eliminating the barrier to health care is imperative for the sustainable provision of care to this vulnerable group of children.
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| 43. |
- Kaime-Atterhög, Wanjiku, 1963-
(författare)
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From Children of the Garbage Bins to Citizens : A reflexive ethnographic study on the care of “street children”
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the study on which this thesis is based was to gain an understanding of the life situation of street children in Kenya and to investigate how caring institutions care for these children. A reflexive ethnographic approach was used to facilitate entry into the children’s sub-culture and the work contexts of the caregivers to better understand how the children live on the streets and how the caregivers work with the children. A fundamental aim of the research was to develop interventions to care; one of the reasons why we also used the interpretive description approach. Method and data source triangulation was used. Field notes, tape, video, and photography were used to record the data. Participant observation, group discussions, individual interviews, home visits, key informant interviews, participatory workshops and clinical findings were used for data collection in Studies I and II. In addition to observation, interviews were conducted with caregivers for study III, while written narratives from learners attending adult education developed and implemented during the research period provided data for study IV. Study I indicated that food, shelter and education were the main concerns for the children and that they had strong social bonds and used support networks as a survival strategy. Study II provided a deeper understanding of the street culture, revealing how the boys are organised, patterns of substance use, home spaces in the streets and networks of support. The boys indicated that they wanted to leave the streets but opposed being moved to existing institutions of care. A group home was therefore developed in collaboration with members of the category “begging boys”. Study III indicated how the caregivers’ interactions with the children were crucial in children’s decisions to leave the streets, to be initiated into residential care, undergo rehabilitation and to be reintegrated into society. Caregivers who attempted to use participatory approaches and took time to establish rapport were more successful with the children. Study IV suggested that the composition of learners, course content grounded on research, caregivers’ reflections and discursive role of researchers and facilitators, all contributed to adult learning that transformed the learners’ perspectives and practice.
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| 44. |
- Kaime-Atterhög, Wanjiku, 1963-, et al.
(författare)
-
“The training was an eye-opener…” : Transformative Experiences of Caregivers from an Adult Education on Medical and Psychosocial Care of Children in Especially Difficult Circumstances
- 2012
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Tidskriftsartikel (refereegranskat)abstract
- This article describes the transformative experiences observed among social and health care learners in an international training program after they had undergone training focusing on working with children in especially difficult circumstances. Participants were drawn from government departments, non-governmental organizations, community- and faith-based organizations and represented different professional and age groups. The training evolved over time and is built on research conducted among children in especially difficult circumstances and their caregivers. Qualitative methods were used for evaluation and Mezirow’s transformative learning theory served as the framework of reference. Two themes were developed from the process of analysis, namely: Learners’ description of their learning and its impact on their work; and the factors facilitating the transformation. In conclusion, the article indicates that, composition of the learners, course content based on research and the caregivers’ reflections, and discursive role of researchers and facilitators, are critical in adult learning.
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| 45. |
- Kaime-Atterhög, Wanjiku, 1963-, et al.
(författare)
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“With An Open Heart We Receive the Children” : Caregivers’ strategies for reaching and caring for street children in Kenya
- 2017
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Ingår i: Journal of Social Work. - : SAGE Publications. - 1468-0173 .- 1741-296X. ; 17:5, s. 579-598
-
Tidskriftsartikel (refereegranskat)abstract
- Summary: The aim of the study was to explore how caregivers reach out and care for street children and understand their strategies and implication for outreach to the children, removal from the streets, rehabilitation and reintegration into society.. Data was collected over a period of two years using a semi-structured topic guide from seventy caregivers in 35 organisations in Kenya, identified using the snowball sampling strategy. Information generated was discussed with street children to help modify the interview and observation guides. To record interactions between the children and their caregivers, direct observation, video recording and photography were used at the caregivers’ workplaces on the streets and at institutions of care.Findings:Two themes were developed from the data, namely, the dedicated caregiver confronting street realities; and making a difference despite the limitations. The way caregivers interacted with the children on the streets and in the institutions greatly influenced the children’s decision to leave the streets, to be initiated into residential care, and attend rehabilitation and reintegration programmes. Children were more positive to caregivers who took time to understand them and were soft in establishing rapport with them.Application:The results suggest that caregivers’ strategies are potential contributors to declining trends of the street children phenomenon as they influence the children’s decision to leave the streets and undergo rehabilitation at institutions of care. Thus, we recommend the development of educational efforts focusing on helping caregivers develop healthy relationships and positive interactions with the children.
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| 46. |
- Kleijberg, Max, et al.
(författare)
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Conceptualizing impact in community-based participatory action research to engage communities in end-of-life issues
- 2022
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Ingår i: Palliative Care and Social Practice. - : Sage Publications. - 2632-3524. ; 16, s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- Background: A health promotion approach to end-of-life (EoL) care is gaining traction internationally. However, there is a lack of evaluations of the impact of this approach, particularly regarding community-based initiatives. Conceptualizations of impact in participatory action research (PAR) may contribute to understanding ways in which impact can be investigated in community-based health promotion approaches to EoL issues. We aim to investigate impact and the process of impact development in our community-based PAR project, Studio DöBra, a Swedish health promotion initiative to engage communities in EoL issues.Methods: We do this through a qualitative framework analysis expanding on Banks et al.’s theory of co-impact in PAR, based on longitudinal empirical data of Studio DöBra. Studio DöBra was developed in partnership with a range of community organizations and engaged children (9 years old) and older adults (most 80+) with topics related to dying, death, and loss through arts activities. The analyzed empirical data reflect the perspectives of community-partners and academic partners from interviews and meetings spanning 4.5 years.Findings: We present a model of impact development consisting of impact on individual and group development, action-oriented impact, and strategy-oriented impact; ways they relate to and evolve from one another; and how they may be affected by contextual influences.Conclusion: Besides contributing to conceptualizations of impact in PAR, findings contribute a community perspective to the limited literature investigating the impact of health promotion initiatives related to EoL issues.
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| 47. |
- Kleijberg, Max, et al.
(författare)
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Death, loss and community : Perspectives from children, their parents and older adults on intergenerational community-based arts initiatives in Sweden
- 2020
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 28:6, s. 2025-2036
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Tidskriftsartikel (refereegranskat)abstract
- Studio DoBra is a community-based initiative in which children (9 y/o) and older adults (mostly 80+) engaged with topics related to dying, death and loss through shared arts activities (e.g. collage, sculpture, games). In an ageing society, Sweden's end-of-life (EoL) care is increasingly professionalised and specialised, but there is little community involvement. One goal of Studio DoBra was therefore to support community engagement with EoL-related topics. Another goal was to create opportunities for interaction between children and older adults as there are few intergenerational meeting places. Two iterations of Studio DoBra were developed (2016, 2018) in different Swedish cities, utilising a community-based participatory research approach. Project groups comprised first author MK and representatives of community organisations such as meeting places for older adults, after-school centres and artistic organisations. Each iteration engaged eight children and eight older adults in a series of five workshops. This article investigates how children and older adults motivate their participation, their experiences of participating and ways in which they were affected by participation. We also investigate how parents reflect on their child's participation in Studio DoBra. Older adults, children and their parents were interviewed after each Studio DoBra. An inductive qualitative process guided by interpretive description was used to analyse the transcripts. Findings indicate that participants acted as individuals with agency in connecting across generations and in creating spaces for engaging with EoL-topics, not only in Studio DoBra but also in their social networks. Participants reflected on a changing sense of community through new intergenerational connections and social activities, and expressed a desire to maintain these. However, participants indicated sustainability challenges related to lacking agency in maintaining these spaces and sense of intergenerational community, as they rely on support from community organisations.
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| 48. |
- Kleijberg, Max, et al.
(författare)
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Navigating power dynamics in engaging communities in end-of-life issues? : Lessons learned from developing community-based intergenerational arts initiatives about death and loss
- 2021
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Ingår i: Death Studies. - : Routledge. - 0748-1187 .- 1091-7683. ; 45:8, s. 651-664
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Tidskriftsartikel (refereegranskat)abstract
- Lack of community engagement in end-of-life issues and age-segregation in Swedish society motivated us to develop Studio DöBra, a community-based intergenerational arts initiative to support community engagement in end-of-life issues and develop intergenerational meeting places. Representatives from several community organizations formed a project group with first author MK, to develop Studio DöBra. Based on analysis of exploratory interviews with professionals involved in other, similar initiatives and data from Studio DöBra development, we discuss challenges related to power dynamics in developing initiatives to engage communities in end-of-life issues, and how these can inform the development of similar initiatives.
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| 49. |
- Kleijberg, Max, et al.
(författare)
-
Play Elements as Mechanisms in Intergenerational Arts Activities to Support Community Engagement with End-of-Life Issues
- 2021
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Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 9:6
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Tidskriftsartikel (refereegranskat)abstract
- Talking about dying, death, and loss may be difficult. Arts offer alternative ways of engaging with end-of-life (EoL) issues, but little is known about the means through which this occurs. In this article, we aim to explore mechanisms in arts activities that support community engagement with EoL issues, based on the community-based participatory action research project Studio DoBra. Studio DoBra was developed to support community engagement with EoL issues through intergenerational arts workshops involving community partners, children, and older adults. Initial analysis with community partners indicated the importance of play elements in arts activities. Continued analysis was therefore abductive, using play theory and qualitative data from Studio DoBra arts activities. Through iterative examination of theory and data, we modified play theory as we identified mechanisms supporting community engagement with EoL issues in arts activities. Findings can contribute to theory-building that can inform arts activities supporting community engagement with EoL issues.
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| 50. |
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