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Impact of culture on refugee women's conceptualization and experience of postpartum depression in high-income countries of resettlement: A scoping review.

ABSTRACT: BACKGROUND:The global refugee population has reached a staggering 25.9 million. Approximately 16% of global refugees resettle in high-income countries which are often culturally very different from their home countries. This can create cross-cultural challenges when accessing health services, leading to inappropriate assessments, diagnoses and treatments if cultural background is not factored in. The impact of culture on the conceptualization and experience of postpartum depression (PPD) amongst migrant women has received growing attention in recent years, however, a specific focus on refugee and asylum-seeking women is lacking. Given the unique mental health challenges refugee women face, it is hypothesized that the interplay between culture and postpartum depression amongst refugee women may differ from other migrant women. Therefore, a scoping review was conducted to characterize what is known about the impact of culture on the conceptualization and experience of PPD in refugee women resettled in high-income countries. METHODS AND FINDINGS:This study was conducted as a scoping review in accordance with the Joanna Briggs Institute's Methodology for Scoping Reviews. A systematic search of studies addressing the relationship between culture and postpartum depression amongst refugee women (including asylum-seeking women) resettled in high-income countries was conducted across 6 databases including MEDLINE, PsycINFO and SOCINDEX between June 2018 and August 2019. A total of 637 articles were found. Studies were eligible if they focused on refugee women who had a pregnancy during forced migration or upon resettlement in a high-income country and focused on the impact of culture on women's conceptualization and/or experience of PPD. Eight studies met inclusion criteria and were included in the final analysis, the majority of which were qualitatively driven. Four key themes emerged: 1) there are diverse conceptualizations and experiences of postpartum depression amongst refugee women; 2) mental health stigma has a significant impact on women's conceptualizations and experiences of postpartum depression and help-seeking behaviors; 3) cultural traditions and social support play protective roles in postpartum mental wellbeing; and, 4) host culture has a significant influence on the pregnancy and postpartum experience of refugee women. The overall themes align with those seen in the literature on migrant women in general, however significant research gaps remain. CONCLUSION:The studies identified through this scoping review provide a rich description of the significant impact culture has on the conceptualization and experience of postpartum depression among refugee women resettled in high-income countries. Though overall themes align with those seen in the literature on migrant women in general, further research is needed to better characterize how culture impacts refugee women's experiences of PPD as a distinct sub-group of migrant women.

SUBMITTER: Haque S

PROVIDER: S-EPMC7462258 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Impact of culture on refugee women's conceptualization and experience of postpartum depression in high-income countries of resettlement: A scoping review.

Haque Saarah S Malebranche Mary M

PloS one 20200901 9

<h4>Background</h4>The global refugee population has reached a staggering 25.9 million. Approximately 16% of global refugees resettle in high-income countries which are often culturally very different from their home countries. This can create cross-cultural challenges when accessing health services, leading to inappropriate assessments, diagnoses and treatments if cultural background is not factored in. The impact of culture on the conceptualization and experience of postpartum depression (PPD) ...[more]

PMID: 32870929

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Project description:BackgroundWomen's sexual health is generally defined and explored solely in relation to reproductive capacity, and often omits elements of sexual function and/or dysfunction. Concerted focus is given to women's health during pregnancy; however, women's sexual health is largely neglected after childbirth. This scoping review explored how the sexual health of postpartum women has been defined, measured, and researched in low- and middle-income countries (LMICs).MethodsArticles eligible for review were those that investigated women's sexual health during the first 12 months postpartum and were conducted among women aged 15-49 in LMICs. Eligibility was further restricted to studies that were published within the last 20 years (2001-2021). The initial PubMed search identified 812 articles, but upon further eligibility review, 97 remained. At this time, the decision was made to focus this review only on articles addressing sexual function and/or dysfunction, which yielded 46 articles. Key article characteristics were described and analyzed by outcome.ResultsOf the final included articles, five studies focused on positive sexual health, 13 on negative sexual health, and the remaining 28 on both positive and negative sexual health or without specified directionality. The most common outcome examined was resumption of sex after childbirth. Most studies occurred within sub-Saharan Africa (n = 27), with geographic spread throughout the Middle East (n = 10), Asia (n = 5), North Africa (n = 3), and cross-geography (n = 1); notably, all five studies on positive sexual health were conducted in Iran. Negative sexual health outcomes included vaginismus, dyspareunia, episiotomy, perineal tears, prolapse, infection, obstetric fistula, female genital cutting, postnatal pain, uterine prolapse, coercion to resume sex, sexual violence, and loss of sexual desire/arousal. Most studies were quantitative, though eight qualitative studies elucidated the difficulties women endured in receiving information specific to sexual health and hesitance in seeking help for sexual morbidities in the postpartum period.ConclusionsOverall, the evidence base surrounding women's sexual health in the postpartum period within LMICs remains limited, with most studies focusing solely on the timing of resumption of sex. Integration of sexual health counseling into postnatal care and nonjudgmental service provision can help women navigate these bodily changes and ultimately improve their sexual health.

Project description:Empowerment is acknowledged as a process facilitating those who are less powerful to be engaged in their problem identification, decision making and actions to gain control over their life. This is an important goal for women during the perinatal period in their transition to motherhood. A concept analysis of women's empowerment during the perinatal period found that psychological and social dimensions play a role in women's perinatal empowerment and identified several defining attributes. The aim of this study was to identify robust validated instruments that measure all the attributes of women's empowerment during the perinatal period. We did a scoping review of scientific literature following the methodology of the JBI Reviewer's Manual. We searched the database MEDLINE, CINAHL, PsycINFO, PsycARTICLES and SocINDEX and selected papers meeting the inclusion criteria. Instruments measuring empowerment or related concepts were identified in the selected papers. Two authors independently cross referenced the items of each instrument against the defining attributes for empowerment. Our search resulted in 9771 unique hits of which 36 papers were finally included. Studies were from various countries with a wide variety of aims, demographics of cohorts and timepoints across the perinatal period. Twenty-one different instruments were used to measure empowerment, of which 11 were validated among women during the perinatal period. However, no identified instrument was developed specifically for women during the perinatal period or included all the dimensions of empowerment and the defining attributes. There is a need for a theoretically sound valid and reliable instrument measuring all the dimensions of empowerment of women during the perinatal period. Once developed this instrument needs testing with a broad range of women. Results from such a study will inform the development of appropriate interventions that have a coherent theoretical basis and are empirically informed to enhance women's empowerment during the perinatal period.

Project description:IntroductionGlobally, transgender and other gender diverse (trans) people face pervasive stigma, which contributes to health inequities across multiple health outcomes. Stigma is a fundamental cause of health inequities because it simultaneously limits access to resources, contributes to systemic vulnerability and generates chronic stress. Anti-trans stigma occurs across multiple socioecological levels, resulting in multiple possible definitions and measurements of trans stigma. Understanding how trans stigma has been measured in low-income and middle-income countries (LMICs) is critical to health promotion efforts for trans communities. Accordingly, this scoping review will identify and examine how anti-trans stigma has been measured in existing LMIC-specific research to inform best practices for measurement of anti-trans stigma that includes consideration of local context.Methods and analysisThis is the protocol for a scoping review of anti-trans stigma in LMICs. We will search (from January 2001 to December 2021) PubMed, WHO Global Medicus and EBSCO. Study selection will conform to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist. Original studies in English, Spanish, Arabic or Russian will be included. Reviewers will independently screen all citations, full-text articles and abstract data. Data analysis will involve quantitative and qualitative methods. A narrative summary of findings will be conducted.Ethics and disseminationAs a scoping review (no direct interaction with participants), this study is exempt from human subjects oversight. Understanding context-specific ways to measure anti-trans stigma is urgently needed to support trans health globally. The planned scoping review will help to address this gap. Results of the review will be disseminated in a peer-reviewed journal and likely in other media such as conferences, seminars and symposia. PROTOCOL REGISTRATION NUMBER: osf.io/qcs2v.

Project description:Introduction Fertility levels among adolescents remain high in many settings. The objective of this paper was to review the available literature about postpartum and lactational amenorrhoea among adolescents in low-income and middle-income countries (LMICs). Methods We searched Medline, Embase, Global Health and CINAHL Plus databases using terms capturing adolescence and lactational or postpartum amenorrhoea. Inclusion criteria included publication date since 1990, data from LMICs, and topic related to lactational amenorrhoea as a postpartum family planning method or as an effect of (exclusive) breast feeding among adolescents. Thematic analysis and narrative synthesis were applied to summarise and interpret the findings. Results We screened 982 titles and abstracts, reviewed 75 full-text articles and included nine. Eight studies assessed data from a single country (three from India, two from Bangladesh, two from Turkey, one from Nigeria). One study using Demographic and Health Survey data included 37 different LMICs. The five studies measuring duration of postpartum or lactational amenorrhoea reported a wide range of durations across the contexts examined. Four studies (from Bangladesh, Nigeria and Turkey) examined outcomes related to the use of lactational amenorrhoea as a family planning method among adolescents. We did not find any studies assessing adolescents’ knowledge of lactational amenorrhoea as a postpartum family planning method. Likewise, little is known about the effectiveness of lactational amenorrhoea method among adolescents using sufficiently large samples and follow-up time. Conclusion The available evidence on lactational amenorrhoea among adolescents in LMICs is scarce. Given the potential contribution of lactational amenorrhoea to prevention of short interpregnancy intervals among adolescents and young women, there is a need for a better understanding of the duration of lactational amenorrhoea, and the knowledge and effective use of lactational amenorrhoea method for family planning among adolescents in a wider range of LMIC settings.

Dataset Information

Impact of culture on refugee women's conceptualization and experience of postpartum depression in high-income countries of resettlement: A scoping review.

Publications

Impact of culture on refugee women's conceptualization and experience of postpartum depression in high-income countries of resettlement: A scoping review.

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