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      Migrant Women’s Access to Sexual and Reproductive Health Services in Malaysia: A Qualitative Study

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          Abstract

          Providing sexual and reproductive health (SRH) services to migrant workers is key to fulfilling sustainable developmental goals. This study aims to explore key informants’ views on the provision of SRH services for migrant women in Malaysia, exploring the provision of SRH education, contraception, abortion, antenatal and delivery, as well as the management of gender-based violence. In-depth interviews of 44 stakeholders were conducted from July 2018 to July 2019. Data were thematically analysed. Migrant workers that fall pregnant are unable to work legally and are subject to deportation. Despite this, we found that insufficient SRH information and contraceptive access are provided, as these are seen to encourage promiscuity. Pregnancy, rather than sexually transmitted infection prevention, is a core concern among migrant women, the latter of which is not adequately addressed by private providers. Abortions are often seen as the only option for pregnant migrants. Unsafe abortions occur which are linked to financial constraints and cultural disapproval, despite surgical abortions being legal in Malaysia. Pregnant migrants often delay care-seeking, and this may explain poor obstetric outcomes. Although health facilities for gender-based violence are available, non-citizen women face additional barriers in terms of discrimination and scrutiny by authorities. Migrant women face extremely limited options for SRH services in Malaysia and these should be expanded.

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          The contribution of a gender perspective to the understanding of migrants' health.

          In 2005 women represented approximately half of all 190 million international migrants worldwide. This paper addresses the need to integrate a gender perspective into epidemiological studies on migration and health, outlines conceptual gaps and discusses some methodological problems. We mainly consider the international voluntary migrant. Women may emigrate as wives or as workers in a labour market in which they face double segregation, both as migrants and as women. We highlight migrant women's heightened vulnerability to situations of violence, as well as important gaps in our knowledge of the possible differential health effects of factors such as poverty, unemployment, social networks and support, discrimination, health behaviours and use of services. We provide an overview of the problems of characterising migrant populations in the health information systems, and of possible biases in the health effects caused by failure to take the triple dimension of gender, social class and ethnicity into account.
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            Migrant women’s experiences of pregnancy, childbirth and maternity care in European countries: A systematic review

            Background Across Europe there are increasing numbers of migrant women who are of childbearing age. Migrant women are at risk of poorer pregnancy outcomes. Models of maternity care need to be designed to meet the needs of all women in society to ensure equitable access to services and to address health inequalities. Objective To provide up-to-date systematic evidence on migrant women’s experiences of pregnancy, childbirth and maternity care in their destination European country. Search strategy CINAHL, MEDLINE, PubMed, PsycINFO and Scopus were searched for peer-reviewed articles published between 2007 and 2017. Selection criteria Qualitative and mixed-methods studies with a relevant qualitative component were considered for inclusion if they explored any aspect of migrant women's experiences of maternity care in Europe. Data collection and analysis Qualitative data were extracted and analysed using thematic synthesis. Results The search identified 7472 articles, of which 51 were eligible and included. Studies were conducted in 14 European countries and focused on women described as migrants, refugees or asylum seekers. Four overarching themes emerged: ‘Finding the way—the experience of navigating the system in a new place’, ‘We don't understand each other’, ‘The way you treat me matters’, and ‘My needs go beyond being pregnant’. Conclusions Migrant women need culturally-competent healthcare providers who provide equitable, high quality and trauma-informed maternity care, undergirded by interdisciplinary and cross-agency team-working and continuity of care. New models of maternity care are needed which go beyond clinical care and address migrant women's unique socioeconomic and psychosocial needs.
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              Lust, trust and latex: Why young heterosexual men do not use condoms

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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                26 July 2020
                August 2020
                : 17
                : 15
                : 5376
                Affiliations
                [1 ]Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
                [2 ]International Institute for Global Health (UNU-IIGH), United Nations University, Kuala Lumpur 56000, Malaysia; zhie.chan@ 123456unu.edu (Z.X.C.); allarddesmalen@ 123456gmail.com (A.W.d.S.); Nicola.Pocock@ 123456lshtm.ac.uk (N.S.P.)
                [3 ]Maastricht Graduate School of Governance, Maastricht University, 6211 AX Maastricht, The Netherlands
                [4 ]Maastricht Economic and Social Research Institute on Innovation and Technology (UNU-MERIT), United Nations University, 6211 AX Maastricht, The Netherlands
                [5 ]Gender Violence & Health Centre, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
                Author notes
                [* ]Correspondence: drtharani@ 123456ummc.edu.my
                Author information
                https://orcid.org/0000-0001-6690-000X
                https://orcid.org/0000-0001-9320-3437
                https://orcid.org/0000-0002-9633-1976
                Article
                ijerph-17-05376
                10.3390/ijerph17155376
                7432037
                32722563
                dafaca0c-d08b-4c34-af76-ea34ea22b4e1
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 25 June 2020
                : 24 July 2020
                Categories
                Article

                Public health
                migrant health,access to health,sexual and reproductive health,contraception
                Public health
                migrant health, access to health, sexual and reproductive health, contraception

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