Contrasting “back home” and “here”: how Northeast African migrant women perceive and experience health during pregnancy and postpartum in Canada

Abstract

BackgroundInternational migration and the number of migrant women who experience pregnancy and childbirth in receiving countries have significantly increased in the last two decades. Migrant women often have unmet social and economic needs during pregnancy, and are more likely to have problems unaddressed by health care systems. In this qualitative study, we explored migrant women’s perceptions and experiences of health during pregnancy and postpartum, while participating in a perinatal program offered through a community-based organization. Additionally, we examined sociocultural factors that might have shaped women’s health upon migration to the Canadian city of Edmonton, Alberta.MethodsA community-based participatory research approach was used to engage migrant women connected to a community-based perinatal program in Edmonton. A focused ethnography was conducted with four Northeast African communities (Eritrean, Ethiopian, Oromo and Somali), and involved 10 focus groups with women (n = 8, per group) and direct observations of weekly perinatal program activities. Data generation and analysis occurred concurrently, and all generated data were analyzed using qualitative content analysis to inductively derive codes and categories.ResultsWomen expressed their perceptions and experiences of health during pregnancy and postpartum by contrasting their countries of origin with Canada, respectively identified as “back home” and “here”. Differences in social support and the physical environment (both natural and built) between “back home” and “here” were commonly described as factors that shaped their opportunities to eat healthy, be physically active and emotionally well before and after having a baby “here”. Overall, women described that in Canada they lacked the social and environmental factors perceived as key enablers of healthy pregnancies and postpartum.ConclusionA complex network of factors seem to influence Northeast African women’s health during pregnancy and postpartum upon migration to Canada. It is of the utmost importance to provide these women with the immediate sociocultural and environmental factors they need to successfully thrive during pregnancy and postpartum, especially while establishing social and support networks “here”.

The capacity-building role of Community Liaison Workers with refugee communities in Victoria, Australia

“…Similar to other studies, the work of CLWs in trauma-informed capacity-building initiatives is facilitated by their shared identity and ethnicity [1,18,36], shared refugee experience [5,11,21] and skills [5,34,37]. CLWs in this study engaged in many similar approaches to the work of Liaison Workers reported in the literature, including strategies to improve the cultural appropriateness of services [15,17,38], the use of peer review and support [39,40], emphasis on the development of trusting relationships between refugees and service providers [8,18,41], adopting a holistic needs-based approach [39,42,43] and developing various group programs in order to address the needs of the community [3,38]. Consistent with a trauma-informed approach, CLWs in this study expressed that their work is fundamentally based on the principle of empowerment, as demonstrated by their initiatives as community leaders to develop projects that build on their community's strengths in order to achieve particular goals.…”

An Intersection of Two Life Changes in Social-Science Research on Women's Health

“…Ve zkoumaných studiích, které tak činí, je migrace vymezena základním pohybem směřujícím k překročení národních hranic [Essén 2001;Quintanilha et al 2016;Urquia et al 2010a] a je charakterizována jako tranzice [Callister, Birkhead 2002;Collins, Zimmerman, Howard 2011;Zeitlin et al 2004]. Popřípadě ji výzkumníci rozlišují podle příčin a motivací [Adanu, Johnson 2009;Balaam et al 2013;Janevic, Savitz, Janevic 2011].…”

“…Celá řada studií [např. Balaam et al 2013;Mcleish 2005;Hoban, liamputtong 2013;Quintanilha et al 2016;Merry et al 2013;McGlade, Saha, Dahlstrom 2004] ukazuje, že migrantky postrádají podporu širší rodiny a cítí se být v důsledku migrace izolovány [Bollini, Stotzer, Wanner 2007].…”

“…Pokud ženy kojily, ztrácely podle svého přesvědčení vitální energii z těla a vystavovaly se riziku zranitelnosti a zeslábnutí. Jinými stravovacími návyky se vyznačovaly i již zmiňované somálské ženy v Kanadě [Quintanilha et al 2016], které hovořily o chybějící péči rodiny, díky níž by byly schopné stravovat se zdravě a být fyzicky aktivní. Osamělost v cílové zemi a vysoké ceny zdravých potravin jim v tom zabraňují.…”

“…Neregulérnost pobytu se pojí s procesy marginalizace, se zvyšová-ním zdravotních rizik a zkomplikováním přístupu ke zdravotní péči, neboť jedinec se ocitá nejen v nejisté a nestabilní situaci, ale zároveň se snaží skrývat před autoritami [Phillimore 2016;Taylor, Newall 2008]. Základním kritériem pro rozlišení dichotomie legality či ilegality jedince je povolení k pobytu [Bollini, Wanner, Pampllona 2011;Choté et al 2011;Reske, Razum 2011], popřípadě držení legální-ho anebo oficiálního statusu [Merry et al 2016] či držení správných víz k pobytu [Quintanilha et al 2016]. Ve výzkumech má tato zjednodušená dichotomie legality/ilegality jen zřídka mezistupně.…”