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- Creators: Arizona State University
Description
Most studies on refugee populations tend to focus on mental health issues and communicable diseases. Yet, reproductive health remains a major aspect of refugee women's health needs. African refugee women in the United States continue to experience some difficulties in accessing reproductive health services despite having health insurance coverage. The purpose of this study was to understand the reproductive health journey of African refugee women resettled in Phoenix, Arizona. This study also explored how African refugee women's pre-migration and post-migration experiences affect their relationships with health care providers. The study was qualitative consisting of field observations at the Refugee Women's Health Clinic (RWHC) in Phoenix, verbally administered demographic questionnaires, and semi-structured one-on-one interviews with twenty African refugee women (between the ages of 18 and 55) and ten health care providers. The findings were divided into three major categories: pre-migration and post migration experiences, reproductive health experiences, and perspectives of health care providers. The themes that emerged from these categories include social isolation, living between two cultures, racial and religious discrimination, language/interpretation issues and lack of continuity of care. Postcolonial feminism, intersectionality, and human rights provided the theoretical frameworks that helped me to analyze the data that emerged from the interviews, questionnaire and fieldnotes. The findings revealed some contrasts from the refugee women's accounts and the accounts of health care providers. While refugee women spoke from their own specific social location leading to more nuanced perspectives, health care providers were more uniform in their responses leading to a rethink of the concept of cultural competency. As I argue in the dissertation and contrary to conventional wisdom, culture per se does not necessarily translate to resistance to the American health care system for many African refugee women. Rather, their utilization (or lack thereof) of health services are better conceived within a broader and complex context that recognizes intersectional factors such as gender, racialization, language, displacement, and class which have a huge impact on the reproductive health seeking patterns of refugee women.
ContributorsJatau, Mary (Author) / Koblitz, Ann Hibner (Thesis advisor) / James, Stanlie (Committee member) / Robillard, Alyssa (Committee member) / Johnson, Crista (Committee member) / Arizona State University (Publisher)
Created2011
Description
Despite the extensive research on the consequences of migration, little is known about the effects of seasonal migration on fertility, contraception and sexually transmitted diseases in the countries of former Soviet Union, that have undergone vast demographic changes in the last two decades. Using cross-sectional data from two surveys conducted in Armenia in 2005 and 2007, this dissertation is exploring the effects of seasonal migration on reproductive behavior and outcomes, as well as sexual health among women left-behind. The dissertation is constructed of three independent studies that combined draw the broad picture of the consequences of seasonal migration in this part of the world. The first study, "Seasonal migration and fertility in low-fertility areas of origin" looks at the effect of seasonal migration on yearly pregnancy rates, lifetime fertility, and fertility preferences among women and their husbands. The models are fitted using discrete-time logistic regression, and random-intercept logistic regression for negative binomial and binary outcomes, correspondingly. The findings show that seasonal migration in low-fertility settings does not further disrupt fertility levels in a short-, or long-run, contradicting to the findings from high-fertility settings. However, the study provides some evidence that seasonal migration is associated with increased fertility preferences among migrant men. The second study, "Seasonal migration and contraception among women left-behind", examines the associations between migration and modern contraceptive use, by looking at current contraceptive use and the history of abortions. A series of random-intercept logistic regression models reveal that women with migrant partners are significantly less likely to use modern contraceptives, than women married to non-migrants. They also have higher rates of abortions; however this effect is moderated by the socioeconomic status of the household. The third study, "Seasonal migration and risks of sexually transmitted diseases (STDs) among women left-behind", looks at the effects of seasonal migration on the diagnosed STDs in the last three years, and self reported STD-like symptoms in the last twelve months. The results of random-intercept logistic regression for negative binomial and binary outcomes provide strong evidence of increased STD risks among migrants' wives; however, this effect is also moderated by the household income.
ContributorsSevoyan, Arusyak (Author) / Agadjanian, Victor (Thesis advisor) / Haas, Steven (Committee member) / Yabiku, Scott (Committee member) / Arizona State University (Publisher)
Created2011
Description
This dissertation examines associations between religious affiliation, religious community context and health of women and their children in Mozambique focusing on the following issues: (1) attending prenatal consultations and delivering children in a health facility; (2) women's symptoms of STDs; and (3) under-five mortality. Estimation of random intercept Poisson regression for the outcome about attending prenatal consultations demonstrated a favorable effect of affiliation to Catholic or Mainline Protestant and Apostolic religious groups. The concentration of Zionist churches in the community had a negative influence. Random intercept logistic regression was used to estimate the relationship between religion and institutional child delivery. Affiliation to Catholic or Mainline Protestant denominations as well as concentration of Catholic or Mainline Protestant churches in the community had some beneficial effect on giving birth in health clinics. The presence of Zionist churches in the community had some negative effect and that of other groups no significant influence. Random intercept logistic regression was also employed for investigating the influence of religion on women's symptoms of STDs. Belonging to the Catholic or Mainline Protestant church had some protective effect on reporting symptoms of STDs. There was no effect of religious context, except that the concentration of Other Pentecostal churches had a positive effect on reporting symptoms of SDTs. Event-history analysis was conducted for examining relationships between maternal religious affiliation with under-five mortality. Affiliation to Catholic or Mainline Protestant churches and to Apostolic denominations increased the odds of child survival, although, the influence of having a mother belonging to Catholic or Mainline Protestant churches lost statistical significance after accounting particularly for the average level of education in the community, for the period of 5 years preceding the survey date. Taken together, the results in this dissertation show some protective effect of religion that varies primarily by denominational group to which women are affiliated. They also indicate that religious community context may have some negative effect on health of women and children. The nature of the effect of religious community context varies with the type of outcome considered and the type of religious mixture in the community.
ContributorsCau, Boaventura Manuel (Author) / Agadjanian, Victor (Thesis advisor) / Hayford, Sarah (Committee member) / Yabiku, Scott (Committee member) / Arizona State University (Publisher)
Created2011
Description
Nearly seven decades ago, the US government established grants to the states for family planning and acknowledged the importance of enabling all women to plan and space their pregnancies, regardless of personal income. Since then, publicly-funded family planning services have empowered millions of women, men, and adolescents to achieve their childbearing goals. Despite the recognized importance of subsidized family planning, services remain funded in a piecemeal fashion. Since the 1940s there have been numerous federal funding sources for family planning, including the Title V Maternal and Child Health Services Program, Office of Economic Opportunity grants, Title XX Social Services Program, Title X Family Planning Program, Medicaid, and the State Children’s Health Insurance Program, alongside state and local support. Spending guidelines allow states varying degrees of flexibility regarding allocation, to best serve the local population. With nearly two billion dollars spent annually on subsidized family planning, criticism often arises surrounding effective local program spending and state politics influencing grant allocation. Political tension regarding the amount of control states should have in managing federal funding is exacerbated in the context of family planning, which has become increasingly controversial among social conservatives in the twenty-first century. This thesis examines how Arizona’s political, geographic, cultural, and ethnic landscape shaped the state management of federal family planning funding since the early twentieth century. Using an extensive literature review, archival research, and oral history interviews, this thesis demonstrates the unique way Arizona state agencies and nonprofits collaborated to maximize the use of federal family planning grants, effectively reaching the most residents possible. That partnership allowed Arizona providers to reduce geographic barriers to family planning in a rural, frontier state. The social and political history surrounding the use of federal family planning funds in Arizona demonstrates the important role states have in efficient, effective, and equitable state implementation of national resources in successfully reaching local populations. The contextualization of government funding of family planning provides insight into recent attempts to defund abortion providers like Planned Parenthood, cut the Title X Family Planning Program, and restructure Medicaid in the twenty-first century.
ContributorsNunez-Eddy, Claudia (Author) / Maienschein, Jane (Thesis advisor) / Hurlbut, James (Committee member) / O'Neil, Erica (Committee member) / Arizona State University (Publisher)
Created2018
Description
ABSTRACT
The aim of the study is to examine the impact of international male labor migration on the sexual and reproductive health of women who stay back home in Tajikistan. The data for this study was gathered as a result of ethnographic field works conducted on several occasions from 2011 to 2013.
The results of the study suggest that male migration does not have an impact on fertility levels of the left-behind women. Although similarly to previous studies this study shows that wives of migrants are less likely to use contraception, it nevertheless demonstrates changes in contraceptive behaviors of wives of migrants such as seasonal removal and insertion of an intrauterine device (IUD) and shift from long-term to short-term contraception use. However, despite the availability of numerous forms of contraception in the country, the pattern of contraceptive use such as the reliance on IUDs dominant during the Soviet period continues to exist among wives of non-migrants. One of the most important findings of this study is women’s ability to use condoms for a short term with husbands after their return and asking spouses to have an HIV test. This finding challenges the dominant discourses in HIV and migration literature focusing on the inability, impossibility and failure on the part of the wives to negotiate HIV prevention due to various factors impeding the promotion of HIV prevention skills and measures among women.
Moreover, the study demonstrates that, on the one hand, male migration worsens reproductive health of the left-behind women, but, on the other hand, it improves/increases their access to reproductive health institutions thanks to remittances. Although self-reported symptoms of women show a slight difference in reproductive morbidity, including STIs of wives of migrants and non-migrants, health care providers believe that this difference is significant and wives of migrants are more likely to have complications during pregnancy, delivery and post-delivery periods.
The study also shows that the majority of HIV prevention and family planning programs target only wives of migrants and non-migrants, however it is crucial that migrant men should also be targets of these programs.
The aim of the study is to examine the impact of international male labor migration on the sexual and reproductive health of women who stay back home in Tajikistan. The data for this study was gathered as a result of ethnographic field works conducted on several occasions from 2011 to 2013.
The results of the study suggest that male migration does not have an impact on fertility levels of the left-behind women. Although similarly to previous studies this study shows that wives of migrants are less likely to use contraception, it nevertheless demonstrates changes in contraceptive behaviors of wives of migrants such as seasonal removal and insertion of an intrauterine device (IUD) and shift from long-term to short-term contraception use. However, despite the availability of numerous forms of contraception in the country, the pattern of contraceptive use such as the reliance on IUDs dominant during the Soviet period continues to exist among wives of non-migrants. One of the most important findings of this study is women’s ability to use condoms for a short term with husbands after their return and asking spouses to have an HIV test. This finding challenges the dominant discourses in HIV and migration literature focusing on the inability, impossibility and failure on the part of the wives to negotiate HIV prevention due to various factors impeding the promotion of HIV prevention skills and measures among women.
Moreover, the study demonstrates that, on the one hand, male migration worsens reproductive health of the left-behind women, but, on the other hand, it improves/increases their access to reproductive health institutions thanks to remittances. Although self-reported symptoms of women show a slight difference in reproductive morbidity, including STIs of wives of migrants and non-migrants, health care providers believe that this difference is significant and wives of migrants are more likely to have complications during pregnancy, delivery and post-delivery periods.
The study also shows that the majority of HIV prevention and family planning programs target only wives of migrants and non-migrants, however it is crucial that migrant men should also be targets of these programs.
ContributorsMiskinzod, Dilofarid (Author) / Agadjanian, Victor (Thesis advisor) / Koblitz, Ann (Committee member) / Weitz, Rose (Committee member) / Arizona State University (Publisher)
Created2015
Description
This research project analyzes women’s dynamic pathways to pregnancy prevention and termination in Arizona. Two levels of analysis guide the study: The first is a cultural analysis of the socio-legal conditions that shape the channels to birth control and abortion. During this historical moment, I analyze the fight over increasing (and calls for more) legal constraints against contraception and abortion, coupled with decreasing individual access to reproductive health care information and services. This dissertation includes an examination of the struggle over reproductive health on the ground and in the legal arena, and real pushbacks against these constraints as well. The second is an analysis of how women seek out contraception or abortion within the US socio-legal landscape. The study qualitatively examines narratives from 33 women in the greater Phoenix, Arizona area, a region emblematic of the political contest over the legal regulation of women’s reproductive health currently unfolding nationally. Ultimately, the state is implicated in the various resources and barriers—people, places, processes and policies—that inform women’s pregnancy prevention. These experiences can illuminate the ways that reproductive health care is shaped by intersecting and sometimes competing ideologies, and how women encounter them in their daily lives. The study theorizes the embodiment of women’s local encounters with the state within a cultural context of contested law and policy reform.
ContributorsMartinez, Melissa Janel (Author) / Adelman, Madelaine (Thesis advisor) / Provine, Doris Marie (Committee member) / Hibner Koblitz, Ann (Committee member) / Arizona State University (Publisher)
Created2016
Description
While abortion is a vital reproductive right, its absence is not the only threat to bodily autonomy. This thesis utilizes a reproductive justice lens to showcase how religion and politics have contributed to centering a ‘choice’ binary that limits a more nuanced understanding of reproductive freedom. This has led to the dominance of the abortion narrative, which overshadows discussions on other forms of reproductive healthcare. Religion and politics have also cultivated a pro-birth – rather than pro-life – approach to women’s reproductive health. This is particularly true in Oklahoma, where no previous research has been conducted on women’s broader reproductive healthcare experiences – consequently, this research turns to women and amplifies their voices to better understand the current state of reproductive healthcare. Participant survey responses were analyzed in the areas of contraception, abortion, prenatal care, and postnatal care. A t-test shows that there is not a statistically significant difference in care quality between birth and non-birth categories. However, the analysis of variance (ANOVA) test results do reveal that prenatal care in Oklahoma is rated much more highly than other forms of reproductive healthcare, and with much less variation than ratings in other categories. Additional findings reveal that more pain management is needed during intrauterine device (IUD) insertion, that finances are a major barrier to all forms of reproductive healthcare, and that sterilization is much more difficult to obtain than any other form of contraception. The study concludes that the experiences of respondents are reflective of a pro-birth approach to reproduction and motherhood. Findings from this research broaden existing scholarship on reproductive health and justice by contributing new knowledge that is relevant to women inside and outside of Oklahoma. The study recommends that additional research should be conducted to improve women’s reproductive healthcare in Oklahoma and beyond, particularly in a post-Roe world.
ContributorsStewart, Alexandra Noelle (Author) / Goksel, Nisa (Thesis advisor) / Comstock, Audrey (Thesis advisor) / Funk, Kendall (Committee member) / Arizona State University (Publisher)
Created2022
Description
In the US, menstrual education, which provides key information about menstrual hygiene and health to both young girls and boys, historically lacks biologically accurate information about the menstrual cycle and perpetuates harmful perceptions about female reproductive health. When people are unable to differentiate between normal and abnormal menstrual bleeding, based on a lack of quality menstrual education, common gynecological conditions often remain underreported. This raises a question as to how girls’ menstrual education experiences influence the ways in which they perceive normal menstrual bleeding and seek treatment for common abnormalities, such as heavy, painful, or irregular menstrual bleeding. A mixed methods approach allowed evaluation of girls’ abilities to recognize abnormal menstrual bleeding. A literature review established relevant historical and social context on the prevalence and quality of menstrual education in the US. Then, five focus groups, each including five to eight college-aged women, totaling thirty-three participants, allowed for macro-level analysis of current challenges and gaps in knowledge related to menstruation. To better examine the relationship between menstrual education and reproductive health outcomes, twelve semi-structured, one-on-one interviews allowed micro-level analysis. Those interviews consisted of women diagnosed with endometriosis and polycystic ovary syndrome, common gynecological conditions that include abnormal menstrual bleeding. Developing a codebook of definitions and exemplars of significant text segments and applying it to the collected data revealed several themes. For example, mothers, friends, teachers, the Internet, and social media are among the most common sources of information about menstrual hygiene and health. Yet, women reported that those sources of information often echoed stigmatized ideas about menstruation, eliciting feelings of shame and fear. That poor quality of information was instrumental to women’s abilities to detect and report abnormal menstrual bleeding. Women desire and need biologically accurate information about reproductive health, including menstruation and ovulation, fertility, and methods of birth control as treatments for abnormal menstrual bleeding. Unfortunately, menstrual education often leaves girls ill-equipped to identify and seek treatment for common gynecological conditions. Those findings may influence current menstrual education, incorporating biological information and actively dismissing common misconceptions about menstruation that influence stigma.
ContributorsSantora, Emily Katherine (Author) / Maienschein, Jane (Thesis advisor) / Ellison, Karin (Committee member) / Hurlbut, Ben (Committee member) / Arizona State University (Publisher)
Created2021