"Help Children Walking on the Right Path": Understanding Parents' and Grandparents' Perceptions on Violence Against Children in Cambodia and Prevention Strategies.

This study examined parents' and grandparents' understanding of violence against children (VAC) strategies to prevent VAC in the home. Research questions: What do parents and grandparents understand about VAC? Which child discipline practices are violent? What are strategies to prevent VAC? Participants: 30 parents and grandparents from a small rural community. Six focus group discussions (FGDs) in which participants shared their perceptions and practices relating to child discipline, forms of VAC, and proposed intervention strategies. In two community forums, participants discussed intervention strategies produced in separate FGDs and agreed on three priority strategies. During the FGDs and community meetings, none of the participants ever mentioned any laws, regulations, or government strategies to address VAC in the home. Participants expressed confusion and mixed feelings and responses on forms of VAC. Some agreed on deception, manipulation, intimidation (som lot), threats (Kom ream, harsh words, scolding (je), and physical punishment (i.e., beating or beating with an object) as an unacceptable discipline that would adversely impact children's well-being. Others agreed on cautiously using such disciplines to a certain degree and context. Participants proposed three priority strategies to address VAC in the home, of which two-community awareness and education and community-based efforts-fit with the Cambodia 2017 to 2024 Action Plan Strategies to Prevent and Respond to VAC. The third strategy, addressing alcohol harm-related violence, though not regarded in the 2017 to 2024 Action Plan, was considered pivotal in preventing VAC. Parents and grandparents have a substantial role in child protection at home. Nevertheless, without a clear definition of VAC or articulation of protecting children from violence in the home, it would be challenging to involve parents/grandparents for effective intervention. Participants' three priority strategies have a substantial policy and program implications for Cambodia's primary prevention of VAC action strategy. Community-based mobilization, education, and capacity building need to start and sustain the community.

Improving health equity among the African ethnic minority through health system strengthening: a narrative review of the New Zealand healthcare system.

BACKGROUND: In New Zealand, health equity is a pressing concern and reaching disadvantaged populations has become the goal to close the inequity gap. Building and strengthening health systems is one way to secure better outcomes. However, the discourse to date has predominately focussed on inequities in health outcomes for Maori. This study has interest in the African ethnic minority community in New Zealand. It undertakes a narrative review of the New Zealand health system which aims to identify literature around the attainment of health equity of African minority by: (i) providing a critical overview of the healthcare delivery system using World Health Organization's six inter-related building blocks of health system strengthening; (ii) developing a summary and discussions of the research results and; (iii) identifying priorities and recommendations for future research. METHOD: A narrative review of 27 articles published between January 2010 and June 2019 were selected from CINAHL, PubMed, Scopus, Google Scholar. Grey literature also informed the review. Articles excluded studies: (i) non-related to New Zealand; (ii) with no focus on equity on ethnic minority in the delivering of healthcare; (iii) had no full text available. FINDINGS: Literature on Africans health outcomes were scarce regarding the six building blocks. However, findings show inequities in accessibility of health services, a non-ethnic inclusive health workforce, a leadership and governance which lack political will on migrant health and resultantly an under-performing health information system which influences resource allocation. RECOMMENDATION AND CONCLUSION: An improvement and well-functioning health information system is pivotal to capture the unmet needs of the African population. There is a need for research and political will to invest in African minority health and diverse workforce that understands the background of the African population; and action to address structural and institutional racism and white privilege to address root causes of inadequate access and care processes for ethnic minorities.

Women's experiences of disrespectful and abusive maternal health care in a low resource rural setting in eastern Zimbabwe.

BACKGROUND: There has been an increase in recent publications, in high and medium resource settings, documenting women's dissatisfaction with the quality of maternity care they receive. Their discontent is mostly related to their midwives' disrespectful or negative attitudes. OBJECTIVE: To explore women's experiences and perceptions of disrespect and abuse from their maternity care providers in a low resource rural setting in Zimbabwe. DESIGN: A critical, qualitative research methodology, using in-depth interviews and two focus group discussions, was employed to capture rural women's experiences during antenatal care, postpartum care, and the use of maternity waiting homes' services. SETTING: Three rural health centres in Mutare district, Manicaland Province in eastern Zimbabwe. PARTICIPANTS: A total of 20 purposively sampled women, 16-30 years of age, who were accessing various stages of maternal health services, were recruited from three conveniently selected rural health centres. Eight women participated in the in-depth interviews. A further eight women were discussants in the first focus group, and a further four women participated in the second focus group. FINDINGS: Multifaceted and interconnected factors contribute to midwives' attitudes and behaviours towards their clients. Midwives' subjective perceptions, women's social status, and health system constraints (i.e., availability of trained midwives and quality of midwifery training) in rural and poorly resourced community, often result in inappropriate services, negative attitudes, abusive treatment, and disrespectful behaviour towards women. Poor treatment in maternity care directly contribute to adverse health outcomes and women's satisfaction with services. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Women's social status, level of education and age, were perceived to influence the quality of care or treatment they received. Improving women's experience of maternal care requires targeted interventions at the interpersonal level between a woman and her health care providers, as well as at the level of the health care facility and the health system. The results of this study challenge all tiers of health personnel including policy makers, in low resource settings to reappraise the present situation thereby challenging these established behaviours, to ensure that the continuum of maternity care is respectfully and socio-culturally delivered.

Setting the stage: reviewing current knowledge on the health of New Zealand immigrants-an integrative review.

The growth of migrant communities continues to rise globally, creating unique and complex health challenges. Literature on immigrant health in New Zealand (NZ) remains scant. This integrative literature review was conducted drawing on peer-reviewed research articles on immigrant health in NZ published between 2012 and 2018. The objectives were to: (i) provide a critical overview of immigrant health in NZ; (ii) identify general trends in health research conducted in NZ on immigrants; (iii) compare, contrast, and evaluate the quality of the information; (iv) develop a summary of research results and; (v) identify priorities and recommendations for future research. A search yielded more than 130 articles with 28 articles constituting the foundation of the review. This review is timely following the rapid increase in the scale, speed, and spread of immigration and its potential for changing NZ's national health patterns and priorities. This integrative review led to the four primary conclusions. Firstly, migration in NZ is a gendered phenomenon, as there has been more women and girls arriving as migrants in NZ and being at risk of poor health in comparison with their male counterparts. Secondly, studies on infectious diseases take precedence over other health problems. Thirdly, research methodologies used to collect data may not be relevant to the cultural and traditional customs of the migrant populations. Furthermore, a number of research findings implemented have failed to meet the needs of NZ migrants. Lastly, policy initiatives are inclined more towards supporting health practitioners and lack a migrant centred approach. What is already known about this topic? Despite NZ becoming more ethnically and linguistically diverse, there is limited literature on the health of migrants living in NZ. What this paper adds? This integrative literature review provides a critical overview of refugee and migrant health in NZ through reviewing and critiquing the current literature available. This paper identifies research trends, the general health of migrants in NZ, recommendations that could inform future migrant and refugee health research and health policies and initiatives to ensure effective and relevant health service provision to migrants.

Engaging community volunteers in participatory action research in Tamaki community of Auckland, New Zealand.

This article discusses the experiences of community volunteers' participation in a community-based participatory research project in Tamaki, a low socio-economic and ethnically diverse suburban community within greater Auckland City, New Zealand. In the Tamaki Community Action Research project, community volunteers were recruited and trained to conduct random household surveys (RHS) and asset mapping commissioned by community groups and government agencies in that area. The volunteers were involved in planning, coordination and ongoing governance of the project and ∼70 residents and local university students participated at different stages of the 2-year project. Over 600 RHS were completed and the volunteers' experiences were recorded in field notes, informal group discussions, daily team meetings and individual interviews and form the basis of this article. Only their experiences are discussed here, not the survey results which will be presented elsewhere. The project reflected the inherent asset-rich nature of the community via examples of individual volunteer empowerment and collective social/community capacity building. Volunteers increased their interpersonal and organizational skills, their understanding of the complexity of their community's logistics and cultural diversity, and gained an increased sense of community purpose and commitment. There was very strong endorsement of culturally sensitive research practice to recognize cultural differences and to engage productively within their richly ethnically diverse community. Full community volunteer participation in the project's governance (i.e. through design, training, implementation and ongoing consultation/management phases) was considered key to sustaining the life of project.

Complex emotions, complex problems: understanding the experiences of perinatal depression among new mothers in urban Indonesia.

In this article, we explore how Javanese women identify and speak of symptoms of depression in late pregnancy and early postpartum and describe their subjective accounts of mood disorders. The study, conducted in the East Java region of Indonesia in 2000, involved in-depth interviews with a subgroup of women (N = 41) who scored above the cutoff score of 12/13 on the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy, at six weeks postpartum, or on both occasions. This sample was taken from a larger cohort study (N cohort = 488) researching the sociocultural factors that contribute to women's emotional well-being in early motherhood. The women used a variety of Indonesian and Javanese terms to explain their emotional states during pregnancy and in early postpartum, some of which coincided with the feelings described on the EPDS and others of which did not. Women attributed their mood variations to multiple causes including: premarital pregnancy, chronic illness in the family, marital problems, lack of support from partners or family networks, their husband's unemployment, and insufficient family income due to giving up their own paid work. We argue for the importance of understanding the context of childbearing in order to interpret the meaning of depression within complex social, cultural, and economic contexts.

The social dynamics of the interview: age, class, and gender.

Researchers have paid only limited attention to how social structural factors influence the course and content of interviews. Speech, comportment, and values inherent to gender and other social, structural, and contextual factors, such as age, socioeconomic positioning, and ethnicity, all influence the direction, flow, and content of interviews, informing how we might interpret the information collected in the process. Drawing on interviews conducted within an Australian study on chronic illness and disability, the authors explore the performative nature of the interview and how interviewers and interviewees respond to the structural factors shaping the social dynamics of the interview to produce accounts of social life.

Perceived personal, social and environmental barriers to weight maintenance among young women: A community survey.

BACKGROUND: Young women are a group at high risk of weight gain. This study examined a range of perceived personal, social and environmental barriers to physical activity and healthy eating for weight maintenance among young women, and how these varied by socioeconomic status (SES), overweight status and domestic situation. METHODS: In October-December 2001, a total of 445 women aged 18-32 years, selected randomly from the Australian electoral roll, completed a mailed self-report survey that included questions on 11 barriers to physical activity and 11 barriers to healthy eating (relating to personal, social and environmental factors). Height, weight and socio-demographic details were also obtained. Statistical analyses were conducted mid-2003. RESULTS: The most common perceived barriers to physical activity and healthy eating encountered by young women were related to motivation, time and cost. Women with children were particularly likely to report a lack of social support as an important barrier to physical activity, and lack of social support and time as important barriers to healthy eating. Perceived barriers did not differ by SES or overweight status. CONCLUSIONS: Health promotion strategies aimed at preventing weight gain should take into account the specific perceived barriers to physical activity and healthy eating faced by women in this age group, particularly lack of motivation, lack of time, and cost. Strategies targeting perceived lack of time and lack of social support are particularly required for young women with children.

Stillbirth, neonatal death and reproductive rights in Indonesia.

Globally, newborn deaths account for two-thirds of all deaths in the first year of life and 40% of under-five mortality. As infant mortality declines, the proportion of neonatal deaths has been increasing because of the failure to address the causes. The data in this paper derive from a longitudinal study of motherhood and emotional well-being of women in Indonesia; 488 women were interviewed in late pregnancy, and 290 at six weeks post-partum. This paper reports on in-depth interviews with four women who reported a stillbirth and six who reported a neonatal or infant death. They were asked about their understanding of why their baby had died and the information, care and support given to them. The study suggests that maternal and child health clinics fail to protect and fulfill pregnant women's reproductive rights, specifically the right to information and care for themselves and their infants, informed consent, counselling and to be treated with respect. This can be achieved through training and education for health professionals and policymakers, and by educating women about their rights as patients. It is essential that countries with high infant and maternal mortality provide post-partum care that includes support for those who experience stillbirth and neonatal death, including information, counselling and home visits.