Migrant and refugee youth perspectives on sexual and reproductive health and rights in Australia: a systematic review

Abstract

Migrant and refugee youth (MRY) in Australia face specific experiences that inform their sexual and reproductive health and rights (SRHR). Migrant and refugee communities experience poor health outcomes and low service uptake. Additionally, youth are vulnerable to poor sexual health. This review examines the understandings and perspectives of MRY. A systematic review was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol is registered with PROSPERO: CRD42021241213. Nine databases were systematically searched. Inclusion criteria specified literature reporting on migrant and/or refugee youth perspectives and attitudes towards sexual and reproductive health; peer-reviewed qualitative, mixed-methods and/or quantitative studies or grey literature reports; records using Australian research; literature published in English between January 2000 and March 2021. Records that did not report on MRY and did not examine participant views or perspectives; were abstract-only, reviews, pamphlets, protocols, opinion pieces or letters; did not include Australian research; were published before 2000 and/or in a language other than English were excluded. Two reviewers screened titles, abstracts and full-text articles. The Mixed Method Appraisal Tool was used to assess studies' methodological quality. Thematic synthesis methods guided data extraction and analysis. Twenty-eight papers were included in the final review. Three themes were identified in MRY constructions of SRHR: (1) experiences of silence and shame; (2) understandings of and responses to SRHR risks; (3) navigation of relationships and sexual activity. Socioecological factors shaped MRY perspectives at individual, interpersonal, institutional and societal levels. Societal factors and interpersonal relationships significantly influenced decision making.

Barriers to sexual and reproductive health and rights of migrant and refugee youth: An exploratory socio-ecological qualitative analysis

“…The lack of comprehensive SRHR education in the school curriculum reiterated at the microsystem level, is a systemic educational barrier that negatively impacts MRY’s understanding of and access to SRHR information and services (Aibangbee et al, 2023; Napier-Raman et al, 2023; Villa-Torres & Svanemyr, 2015). Various research including Villa-Torres and Svanemyr’s (2015) work consistently demonstrates the significant impact of SRH education on promoting safer sexual practices and mitigating health risks, as evidenced by our findings.…”

Abortion Experiences and Perspectives Amongst Migrants and Refugees: A Systematic Review

“…Secrecy is a common manifestation of abortion stigma [ 52 ]. Moreover, many migrant and refugee communities maintain secrecy, silence and shame around SRH generally [ 7 , 10 ]. The taboos around abortion and the seeming contradictions between outward expression and actual practices seen in this review are therefore unsurprising.…”

“…Previous research has shown that migrant and refugee populations often have inadequate SRH knowledge, attributed to limited SRH education in home countries, disruption of schooling, and stigma surrounding SRH within communities [ 7 ]. In this review, restricted discourse around SRH and lack of knowledge indicate that women’s agency and ability to make informed abortion decisions are impeded.…”

“…These include individual-level factors such as education and beliefs, interpersonal-level factors of family and community networks, institutional-level factors relating to healthcare services, and societal-level factors of abortion legislation and migration policy. Migrants and refugees experience barriers to healthcare, particularly surrounding sexual and reproductive health (SRH) [ 6 , 7 , 8 , 9 ]. Displacement and migration can interrupt SRH education and care access.…”

“…Nevertheless, compared to women born in Australia and New Zealand, the United States, and Northern and Western Europe, immigrant women born in all world regions except Southern Africa were 2–5 times more likely to have an induced abortion [ 13 ]. Low SRH and contraceptive knowledge have been noted among migrant and refugee communities [ 7 ], which may increase the likelihood of unintended pregnancy and abortion. The SEM provides a framework for examining how abortion experiences, attitudes and decision-making among migrants and refugees are influenced by multiple factors across individual, interpersonal, institutional, and societal levels.…”