Table 2.
First Author, (Year); HC; CO |
Stated study objectives | Recruitment method; Setting; Data collection method |
Sample size; Classification; Age range; Yrs since arrival |
Outcome measures | Data analysis | Main results; Conclusions |
Quality score |
---|---|---|---|---|---|---|---|
SRH topic: Family planning (FP) | |||||||
Morrison (2000) [47]; HC Thailand; CO Cambodia | As outlined in Table 1 |
Walking through camps women were randomly asked to participate; Khao Phlu refugee camp Thailand maternal and child health centre; survey |
n = 102; As outlined in Table 1 |
Contraceptive knowledge, beliefs and practices. Perceptions about FP | N/S |
Contraceptive knowledge and use: • 82% of married women wanted to stop or delay childbearing, • 12% reported using a modern method of contraception, • 61% mentioned fear of side effects, • 24% cited lack of information on contraception, • 42% reported discomfort over seeking contraceptives, • 32–48% of women unaware contraceptive methods were available at refugee health centre and none knew about emergency contraception. |
.64 |
Raheel et al. (2012) [65]; HC Pakistan; CO Afghanistan | Measure differences in knowledge and practice of contraception between healthcare subsidised and unsubsidised groups |
Systematic random sampling to select households; Karachi settlements of Afghan refugees; questionnaire survey |
n = 650; refugees; subsidy/no subsidy mean 33%/ 30%; yrs. since arrival subsidy/no subsidy mean 10/13 |
Knowledge and practice about FP and contraceptive use with and without healthcare subsidies |
SPSS Mean/SD Binary logistic regression Adjusted odds ratios 95% CIs |
Family planning awareness and use: • 90% in subsidised group aware of FP, compared to 45% in unsubsidised group, • use of contraceptives > 2-fold in subsidised group versus unsubsidised, • access to subsidised care more likely resulted in contraceptive use with advancing age as compared to unsubsidised care. Positive attitude towards FP and higher contraceptive use among Afghan women receiving a healthcare subsidy compared to those not receiving a subsidy despite their conservative background and marginal economic status. |
1.0 |
Kisindja et al. (2017) [66]; HC Congo; CO Congo | Investigate reproductive health and FP knowledge and needs of newly internally displaced women in North Kivu province. | Convenience sampling door to door; two Mugunga displacement camps; verbally administered survey |
n = 155; internally displaced; 14-45 yrs. (mean 28); yrs. since arrival < 1 yr (34%) < 2 yrs. (95%) |
Reproductive health history, contraceptive use, and FP exposures, knowledge and desires | N/S |
Contraceptive knowledge and use: • 84% previously received information on contraception, • 35% women knew of at least two contraceptive methods, • 31% reported ever using contraception, • 62% cited lack of interest, 21% lack of knowledge and 12% religious’ opposition for never using contraception Contraceptive knowledge was moderate actual usage was low. |
.73 |
Tanabe et al. 2017 [51], HC Bangladesh Jordan Djibouti Kenya Malaysia Uganda; CO Myanmar, Iraq, Democratic Republic of Congo, Somalia | As outlined in Table 1 |
Sampling frame – UNHCRs database and registered mobile phone and spatial sampling; Multiple country locations - refugee camps, settlements, urban areas; household survey |
n = 2733; refugees; 15–49 yrs.; yrs. since arrival N/S |
Contraception- awareness, ever use, current use, and unmet need for FP | Descriptive frequencies Binary logistic regression |
Contraceptive awareness and use: • 74% reported awareness of at least 1 modern method of contraception, • 48% married women reported ever use of modern contraceptives significantly < unmarried women 16%, • 26% married women reported currently using any modern method to avoid or delay pregnancy, significantly > unmarried women 3%, • 7% of women reported unmet need for contraception, • Married women were over 7 x more likely to report unmet need compared with unmarried women. |
1.0 |
Raben and van den Muijsenbergh (2018) [67]; HC Nether-lands; CO various | Examine the extent Netherlands General Practitioners discuss and prescribe contraceptives to female refugees compared with other female migrants and native Dutch women |
Extracted data from General Practice surgery databases; Nigmegen, Rotterdam and Amsterdam, five General Practices; database searches |
n = 104; refugees; 15–49 yrs.; yrs. since arrival mean 6.5 yrs. (range < 1–34) |
Contraceptive method discussed or prescribed with General Practitioner |
Two-tailed Pearson chi-squared test, independent samples t-test, one-way ANOVA, binary logistic regression |
Contraception access: • 51% General Practitioners reported discussing contraceptives with women refugees, significantly < other migrants, 66% and < native Dutch women, 84%, • in women from Sub Saharan Africa, contraception was significantly less often discussed, 29% compared with refugee women from other regions 68%. Contraceptives were discussed or prescribed significantly < with refugees and other migrant women compared with native Dutch women. |
.86 |
Pierce (2019) [68]; HC Jordan; CO Palestine | Examine regional coverage, source, and method of contraceptives; variation in reproductive health and social experiences by source of contraception; influences on utilisation of reproductive health services |
Recruitment method N/S; Jordan- urban area refugee camp households; demographic and health survey |
n = 10,105; refugees; 15–24 (13%) 25–39 (56%) 40–49 (31%); yrs. since arrival: multi-generational displacement |
Modern contraceptive use, FP education at a health facility, contraceptive advice from medical personnel, source of contraception | Descriptive statistics Logistic regression of reproductive health odds ratios for background variables |
Contraceptive use and intention: • 14–43% used contraception, 15–55% contraceptive source (govt, pharmacy, private) used, 5–13% modern contraceptive method used, • educational attainment, age, employment, number of living children, and wealth had a significant effect on modern contraception use, • refugee camp existence significantly increases the likelihood of talking about FP at a health facility, • women with large numbers of children > 13 x more likely to utilise UN relief agencies for contraception than those with fewer children. Women living in refugee camps have greater access to FP resources |
.91 |
SRH topic: cervical cancer screening and breast cancer screening | |||||||
Barnes et al. (2004) [69]; HC USA; CO Cuba, Bosnia, Vietnam, and others | Explore reproductive health concerns of Bosnian, Cuban, Vietnamese and other refugee women in the US |
Recruitment method N/S; Refugee Health Screening Program at local health department; review of medical charts |
n = 283; refugees; 18–74 yrs. (mean 34); yrs. since arrival N/S |
Self-reported medical history, reproductive health problems identified, referrals made, and prescriptions written | Descriptive statistics, z approximation test |
Breast and cervical screening practices: • 14% had at least one mammogram, • 86% had never had a mammogram, • 67% of women in the US had at least one mammogram for screening, • rates of mammogram differed between US and refugee women significantly, • 24% of refugee women had a Pap test within the past 3 yrs. compared to US women 79%. |
.77 |
Redwood- Campbell et al. (2008) [70]; HC Canada; CO Albania | Describe reproductive health and mental health-related issues among Kosovar refugees settling in Hamilton, Ontario Canada |
Random selection of phone numbers - fieldworkers contacted families; Hamilton, Ontario (not further described); survey questionnaire |
n = 161; refugees; (18-49 yrs) > 18 yrs. 85 18-49 yrs. 65 > =50 yrs. 19; yrs. since arrival N/S |
Ever had a Pap smear, ever heard of a Pap smear, use of contraception, how to access contraception, ever had or heard of a mammogram | Descriptive statistics |
Contraceptive use: • 14% reported using some form of contraception Screening awareness and access: • > 50 yrs., 5% of Kosovar women had ever received a mammogram, • 34% of women had ever received a Pap smear, of these 85% had received service in Canada, • Kosovar women reported cervical and breast cancer screening rates in the home country or since arrival were significantly < Canadian rates. Women have little or no history of routine preventive care similar to that which exists in Canada |
.50 |
Lofters et al. (2011) [71]; HC Canada; CO Middle East, North Africa, East Asia, the Pacific, Sub-Saharan African |
Determine the independent effects on cervical cancer screening of; sociodemographic factors, health care system, culture and migration for immigrant women in Ontario. |
Recruitment method N/S; Ontario’s central metropolitan areas; Data extraction from Landed Immigrant Data System database |
n = 455,864; refugees; 18–66 yrs.; yrs. since arrival N/S |
Women identified as appropriately screened - at least one Pap test in the 3 yr study period | Stratified multi-variate analysis Multi-variate Poisson models stratified SAS for adjusted relative risks |
Factors associated with lack of screening: • not being in the 35–49 yr age group, • resident in lowest-income neighbourhoods, • not being in a primary care patient enrolment model, • not having a provider from the same region, • not having a woman provider. For all women, the highest population-attributable risk was seen for not having a woman provider: • 17% for Middle East and North Africa, • 27% for East Asia and the Pacific. Immigrant class was only significant for Sub-Saharan African women and Western European women, with refugees being at > risk of non-screening in these two groups. Women should connect with the health care system soon after arrival and find a regular source of primary care. |
1.0 |
Haworth et al. (2014) [57]; HC USA; CO Bhutan | As outlined in Table 1 |
Convenience sampling; Burmese community venues and residences Omaha; online survey tool |
n = 42; As outlined in Table 1 |
Perceived susceptibility to and severity of disease and perceived barriers and benefits to screening | Descriptive statistics |
Cervical cancer and screening practices: • 22% reported ever hearing of a Pap test, • 14% reported ever having Pap test, • 33% perceived susceptibility to cervical cancer, • 71% women who had heard about Pap tests tended to believe more strongly about curability if discovered early compared to 45% of women who never heard about the test A significant lack of knowledge exists in this community regarding cervical cancer and screening practices. Community health workers as health interventionists was well received. |
.64 |
SRH topic: General physical examination | |||||||
Odunukan et al. (2015) [72]; HC USA; CO Somalia | Understand Somali women’s comfort with components of physical exam by providers and interpreters of different genders and races |
Convenience sample; Mid-west United States, Primary Care Internal Medicine Clinics; pictorial survey |
n = 50; refugees; 18–90 yrs. (median 46); yrs. since arrival median 11 yrs. (range 0.2–30) |
Participant comfort level with body parts being examined by the pictured physician Patient–interpreter gender concordance acceptability | Descriptive statistics Paired ratings of discomfort Bowker’s test of symmetry Simple linear regression |
Physical examination: • 98% reported “no problem” to physical examination by a woman provider, • genitalia/pelvic examination (82%), breast examination (81%), and abdominal examination (71%) by male providers was “definitely a problem”, • chest/back examination (29%), extremity examination (28%), and head/neck examination (25%) by male providers was “definitely a problem”. Women preferred a woman provider for conducting examination for the pelvic, breast, and abdominal examinations and preferred woman interpreters to be present. |
.77 |
SRH topic: Female genital cutting | |||||||
Banke-Thomas et al. (2019) [73]; HC USA; CO Somalia | Assess factors that influence maternal and reproductive health access across four health care dimensions |
Community networks using snowball sampling; Franklin County, Ohio – participants residences; community-based survey |
n = 427; refugees; 18–19 yrs. 46 20–34 yrs. 215 35–49 yrs. 166; yrs. since arrival < 4 yrs. 139 > 4 yrs. 288 |
Willingness to seek care, gaining entry to the health system, seeing a primary provider and seeing a specialist | Descriptive statistics Multivariate analyses. Cross tabs bivariate analysis odds ratios 95% CI and p values |
Factors unique to Somali refugee population: • younger, single women were more willing to seek care vs older, married women. • 81% stated not having insurance was the most frequent reason for postponing public or private care • minors were 2.5 x more willing to seek care than those who arrived in the US as adults Those with insurance were at least: • 2 x more willing to seek care • 3 x more likely to enter the health system • 3 x less likely to have difficulty in seeing a primary provider • odds of Somali women not able to speak English well, being willing to seek care was almost 80% < those who were able to speak English very well • odds of Somali women with female genital cutting being willing to seek care were about 50% < those who were not circumcised |
1.0 |
N/S not stated, HC host country, CO country of origin