Just Accepted
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Primary health care providers’ knowledge, practices and beliefs relating to preventive sexual and reproductive health care for women from refugee and asylum-seeking backgrounds in Australia: A national cross-sectional survey
Abstract
Background: Many refugee women and women seeking asylum arrive in high-income countries with unmet preventive sexual and reproductive health (SRH) care needs. Primary health care providers (HCPs) are usually refugee and asylum seekers' first point of care in resettlement countries. The study aims were to describe the HCP characteristics associated with: 1) initiating conversations on preventive SRH and 2) discussing SRH opportunistically. In this study, the aims have been considered in two contexts: 1) initiating conversations by intentionally starting a dialogue with women about SRH within a SRH consultation and 2) opportunistically discussing SRH within the context of other healthcare discussions with women. Methods: An anonymous online survey with questions relating to preventive SRH was disseminated nationally to representatives of national- and state-based health professional organisations and Primary Health Networks. Hierarchical logistic regression was used to analyze data. Thirteen factors including demographic characteristics, HCPs knowledge and awareness, perceived need for training and having or not having direct professional experience with refugee women and women seeking asylum were included in the models. Results: Of the 163 HCPs who completed the survey and reported initiating conversations by intentionally starting a dialogue with women, results ranged from 27.3% (contraceptive care) to 35.2% (cervical screening). Providers who reported discussing preventive SRH opportunistically ranged from 26.9% (breast screening) to 40.3% (contraceptive care) when these topics were naturally presented within the context of other healthcare discussions with women. Health care provider characteristics positively associated with the two outcomes included: offering care to refugee women or women seeking asylum at least once every two months rather than less than every two months (7.64, 95% CI 2.41;24.22, p<0.001, 2.82, 95% CI 1.07;740, P<0.05), working part-time rather than full-time (8.01, 95% CI 2.34;27.86, p<0.001, 2.43, 95% CI 1.02;5.76, p<0.05) and practising in Australia for more than 10 years rather than less than 10 years (2.20, 95% CI 0.71;6.87, p<0.001, 0.40, 95% CI 1.66;0.95, p<0.05). Most HCPs believed women’s cultural beliefs (76%), women’s lack of SRH knowledge (72.4%), women’s religious beliefs (67.5%) and women’s lack of English language skills (54.6%) were barriers
PY23171 Accepted 12 August 2024
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