Between a woman and her fetus: Bedouin women mediators advance the health of pregnant women and babies in their society.

INTRODUCTION: Bedouin women in Israel confront a challenging circumstance between their traditional patriarchal society and transition to modernity. In terms of reproductive health, they face grave disparities as women, pregnant women and mothers. In this article we aim to understand the challenges of Bedouin women who work as mediators in the promotion of Bedouin women's perinatal health. We explore their challenges with the dual and often conflictual role as health peer-instructors-mediators in mother-and-child clinics, and also as members of a Bedouin community, embodying a status as women, mothers, and family caretakers. Drawn upon a feminist interpretative framework, the article describes their challenges in matters of perinatal health. Our research question is: how do women who traditionally suffer from blatant gender inequality utilize health-promotion work to navigate and empower themselves and other Bedouin women. METHODS: Based on an interpretive feminist framework, we performed narrative analysis on eleven in-depth interviews with health mediators who worked in a project in the Negev area of Israel. The article qualitatively analyses the ways in which Bedouin women mediators narrate their challenging situations. RESULTS: This article shows how difficult health mediators' task may be for women with restricted education who struggle for autonomy and better social and maternal status. Through their praxis, women mediators develop a critical perspective without risking their commitments as women who are committed to their work as well as their society, communities, and families. These health mediators navigate their ways between the demands of their employer (the Israeli national mother and child health services) and their patriarchal Bedouin society. While avoiding open conflictual confrontations with both hegemonic powers, they also develop self-confidence and a critical and active approach. CONCLUSIONS: The article shows the ways by which the mediator's activity involved in perinatal health-promotion may utilize modern perinatal medical knowledge to increase women's awareness and autonomy over their pregnant bodies and their role as caregivers. We hope our results will be applicable for other women as well, especially for women who belong to other traditional and patriarchal societies.

To connect between worlds, to bridge over gaps: learning about the complex role of cultural mediators in perinatal health promotion from a case in Israel.

BACKGROUND: Reduction of health gaps between ethno-cultural groups has become a major concern for health services, with a strong emphasis on eliminating social and cultural barriers and improving accessibility for diverse populations. METHODS: The study is based on a Participatory Action Research where an involved researcher accompanied the project for a decade, as well as on eleven in-depth interviews with Bedouin women-mediators working in a perinatal health promotion project in Israel. RESULTS: The research analyzes the work of Bedouin women health mediators who mediate between their Bedouin community and institutional health services and bridge over cultural gaps. The study presents the complex task of transferring messages across cultures, dealing with socio-cultural imperatives and the intricacy of multilayered power relations. The findings reveal an evolving process, beginning with a pragmatic mediation model in which the mediators are limited to instruction of pre-defined health materials, toward a transformative model of creating a ground for encouraging the mediators to act creatively according to socio-cultural circumstances. CONCLUSION: The research elaborates on the adoption and implementation of the transformative approach in mediation and provides further understanding of the complexity of mediation role in sensitive issues such as pregnancy, birth and infant care.

Why Do Holocaust Survivors Remember What They Remember?

Purpose of the Study: The ability to integrate traumatic memories into a coherent life narrative is one factor associated with the mental health and well-being of Holocaust survivors. In the present study, reminiscences reported by survivors in Israel were collected to identify themes arising in positive and negative memories and experience. Design and Methods: Participants (M = 80.4 years; SD = 6.87) were asked to describe memories that typify a reminiscence function in which they frequently or very frequently engage. Open-ended responses were collected from 269 Holocaust survivors and thematic analyses were conducted in English (translated) and Hebrew. Results: Thematic analyses of these data suggest three overarching themes related to bridging the past and present, rebuilding families and the Jewish state, and the duty to share. These suggest how integral endurance, survival, and resilience were to participants during the war and how these themes defined their choices and understanding of their lives. Implications: The results of this study demonstrate how reminiscence serves many functions. Participants appear to have integrated memories of horror and loss as part of coherent life narratives. Resilience and memory are ongoing and intertwined processes whereby survivors juxtapose their early lives to the present.

Holocaust Survivors' Memories of Past Trauma and the Functions of Reminiscence.

PURPOSE OF THE STUDY: Existing research suggests that specific ways of recalling autobiographical memories of one's past cluster in self-positive, self-negative, and prosocial reminiscence functions. We undertook the present qualitative study to gain understanding of reminiscence functions as described by 269 Israeli Holocaust survivors and to see whether groupings of themes that emerged would correspond to our tripartite model of the reminiscence functions. DESIGN AND METHODS: Participants (M = 80.4 years; SD = 6.87) were asked to describe memories that typify a reminiscence function in which they frequently or very frequently engage. Thematic analyses were conducted in English (translated) and Hebrew. RESULTS: Responses reflect the range of ways in which Holocaust survivors reminisce. The task of describing early life memories was difficult for some participants, while others' lived experiences enabled them to teach others to ensure that their collective memory remains in the consciousness of the next generation of Israelis and the Jewish state. Data are imbued with examples of horror, resilience, generativity, and gratitude. IMPLICATIONS: As hypothesized, survivors' memories cluster in self-positive, self-negative, and prosocial groupings consistent with the tripartite model of reminiscence functions.

Understanding utilization of outpatient clinics for children with special health care needs in southern Israel.

To understand the pattern of utilization of ambulatory care by parents of children with special health care needs (CSHCN) and to explore parental challenges in coping with health maintenance of their infants after discharge from a neonatal intensive care unit (NICU). CSHCN require frequent utilization of outpatient ambulatory clinics especially in their first years of life. Multiple barriers are faced by families in disadvantaged populations which might affect adherence to medical referrals. Our study attempts to go beyond quantitative assessment of adherence rates, and capture the influence of parental agency as a critical factor ensuring optimal utilization of healthcare for CSHCN. A prospective, mixed-methods, cohort study followed 158 Jewish and Bedouin-Arab infants in the first year post discharge from NICU in southern Israel. Rates of utilization of ambulatory clinics were obtained from medical records, and quantitative assessment of factors affecting it was based on structured interviews with parents at baseline. Qualitative analysis was based on home visits or telephone in-depth interviews conducted about 1 year post-discharge, to obtain a rich, multilayered, experiential perspectives and explained perceptions by parents. Adherence to post-discharge referrals was generally good, but environmental, cultural, and financial obstacles to healthcare, magnified by communication barriers, forced parents with limited resources to make difficult choices affecting utilization of healthcare services. Improving concordance between primary caregivers and health care providers is crucial, and further development of supportive healthcare for CSHCN in concordance with parental limitations and preferences is needed.