Access to Reproductive Health Services for Asylum Seeker and Refugee Women in Scotland.

Abstract

Refugees and asylum seekers flee their home countries worldwide as a result of conflict and other reasons, and Scotland is home to thousands of refugees and asylum seekers. The aim of this study was to find out possible issues which may arise for refugee and asylum seekers in Scotland when accessing reproductive health (RH) services. The literature search on the rest of the United Kingdom (UK) in relation to access to RH services for asylum seeking and refugee women showed seven key access issues which comprised: communication and the language barrier, missed appointments or late antenatal care (ANC) booking, immigration status, dispersal, insufficient information, provider attitudes and health systems and cultural differences. The UK findings formed the basis for the study questions of the second part of the study which was done through primary data collection. Initial interview questions were more general, followed by questions related to the seven UK findings. Responses from three providers who were interviewed, one from Glasgow (2-6 Sandyford Place) and two in Edinburgh (Pennywell Resource Centre) revealed similarities with the UK findings except in the area of the provider attitude that did not come up during interviews with providers. A web-based search for information materials together with a visit to two facilities in Edinburgh and Glasgow was done in order to analyse how and the type of material on RH services are shared with women and the type of information provided. The findings revealed that although most asylum seeking and refugee women (ASARW) cannot speak or read English, most of the materials were predominantly written in English, which is another challenge to accessing information for these women and the type of information provided. Even though National Health Service (NHS) and Sandyford provide translation and interpretation services, challenges were still experienced in terms of the limited number of key languages that materials can be translated into and the lack of: interpreters for some languages or interprteters of the desired gender, and their limited availability in some cases. Finally, the Liverpool gender analysis framework for health was adapted for discussing the findings in relation to: the environment, bargaining position, resources, activities and gender norms, and Paul Farmer's theory on structural violence was also used. The further broader research was recommended to include ASARW from different countries and groups in order to get a broader perspective on the findings.