Afghan Refugee Women Research Articles

Beyond Resettlement: Sociocultural Factors Influencing Breast and Colorectal Cancer Screening Among Afghan Refugee Women.

Immigrants and refugees have an increased risk for developing chronic health conditions, such as breast and colorectal cancer, the longer they reside in the USA. Moreover, refugees are less even likely to use preventive health services like mammography and colonoscopy screening when compared with US-born counterparts. Focused ethnography was employed to examine sociocultural factors that influenced cancer screening behaviors among aging Afghan refugee women. We conducted 19 semi-structured interviews with Afghan women 50 and older and their family member/caregivers. Interview transcripts were inductively coded using Atlas.ti, where focused codes were sorted and reduced into categories, and we extracted meaning around groups of categories. Findings of this study revealed factors like fear of cancer, pre-migration experiences, family involvement, provider recommendation, and provider gender concordance influenced women's cancer screening behaviors. This study also found that women who have had a recent mammogram or colonoscopy described empowerment factors that helped them withstand the stressful process of screening, through encouragement and reminders from providers, support from adult family members, and finding strength through duaas (prayers). As refugee women continue to age in the USA, clinicians should incorporate multi-level strategies, including family-centered and faith-based approaches to promote preventive screening behaviors in this population.

Perspectives of Afghan refugee mothers on the experience of caring for a child with cancer: a qualitative analysis.

Cancer in children causes many challenges for the family. When a refugee family experiences it, its impacts may be different and more specific considerations for care may be needed. This study aimed to explore the experiences of Afghan mothers living in the Islamic Republic of Iran who had a child with cancer. This was a qualitative study, conducted in 2017, of Afghan refugee women with children diagnosed with cancer and referred to a cancer referral hospital in Tehran; they were selected through purposive sampling. Face-to-face, semi-structured and in-depth interviews were conducted for data collection until data saturation was reached. Conventional content analysis was done. MAXQDA 10 was used for organizing the data. Nine Afghan mothers were interviewed. They were aged 24-44 years and the children were aged 2-9 years. A primary theme called "passive acceptor" was found with five subthemes: chronic suffering, health issues, lack of skills, maladaptive coping and enthusiasm. The mothers were struggling to cope with the challenges of caring for a child with cancer both financially, physically and emotionally. In spite of many issues in common with similar groups in other countries, Afghan mothers appear to need to greater assistance when it comes to seeking help and understanding for the care for their child with cancer, possibly because of cultural barriers to self-empowerment. Tailored care plans are recommended for Afghan refugee mothers in the Islamic Republic of Iran.

Prevalence of intimate partner violence and reproductive health outcomes among Afghan refugee women in Iran

Refugee women are at high risk of experiencing high level of Intimate Partner Violence (IPV) and its negative impacts. We conducted a cross-sectional population-based household survey with refugees in a settlement in the city of Semnan, Iran, from 2016 to 2017. Afghan refugee women (n = 188) with ages between 15 and 49 years were recruited for the survey. Overall, about 79.8% of the participants reported to have experienced a form of IPV in the past 12 months. IPV exposure is associated with a negative reproductive health outcome. The high prevalence of IPV found among refugee women in the present research and its strong links with poor reproductive health outcomes, underline the urgent need for the development and testing of appropriate interventions in refugee settlements.

‘Her cry is my cry’: resettlement experiences of refugee women at risk recently resettled in Australia

ObjectivesRefugee women entering resettlement countries on woman-at-risk visas represent a particularly vulnerable population. While their specific gender-based resettlement will likely differ from the general refugee population, little is known about their experiences of early resettlement, with which to inform resettlement policy and practice. This research aimed to explore lived experiences of recently resettled refugee women at risk in Australia. Study designQualitative research used focus groups and a framework approach to identify and explicate common themes in participants' experience. MethodsTwo focus groups with a purposive sample of African and Afghan refugee women at risk (N = 10), aged 22–53 years, were conducted in South East Queensland, Australia (October 2016), recruited with the assistance of a local resettlement service. Discussions were audiotaped, transcribed, and themes explicated. ResultsSix superordinate themes emerged: (1) sentiment of gratitude; (2) sense of loneliness and disconnection; (3) feeling incapable; (4) experiencing distress and help-seeking; (5) experiencing financial hardship; and (6) anticipating the future. ConclusionsFindings indicate that resettlement policy, programs, and practice that explicitly target the needs of women-at-risk refugees are warranted, including a longer period of active service provision with specific attention to strategies that address the women's social connection, self-efficacy, emotional well-being, and financial hardships.

Knowledge, Attitudes and Practices of Contraception among Afghan Refugee Women in Pakistan: A Cross-Sectional Study

BackgroundDuring the 1980s, approximately three million people migrated from Afghanistan to Pakistan and sought refuge in several cities including the city of Karachi. After the initial settlement of the refugees, the international organizations transitioned the health care of these refugees to the two local non-profit service agencies in Karachi. One of these agencies subsidized health care to the refugees under their care and the other agency encouraged the refugees under their care to utilize governmental and non-governmental private health resources at the disposal of general public. Our objective was to measure the effect of health subsidy on the uptake of contraception among Afghan refugee women and compare them to the group of Afghan women without such a subsidy.Methodology/Principal FindingsA randomly selected group of 650 married Afghan women-325 women in each group-participated in a detailed survey regarding the knowledge, attitude and practices of family planning and contraceptive use. 90 percent of the women in the health subsidy group had had heard of family planning, compared to the 45 percent in the non-subsidized group. The use of contraceptives was greater than two-fold in the former versus the latter. Results of logistic regression analysis revealed that the refugee women who had had access to subsidized healthcare were significantly more likely to use the contraceptive methods with advancing age as compared to the women in the non-health subsidy group. The difference remained significant after adjusting for other variables.Conclusions/SignificanceRefugee women who are provided subsidized healthcare are more inclined to use contraceptives. It is therefore important that Afghan refugee women living elsewhere in Pakistan be provided healthcare subsidy, whereby their reproductive health indicators could improve with reduced fertility. We strongly encourage facilities introducing such subsidies to refugees in resource poor settings to assess the impact through similar inquiry.

Interview with Dr Sima Samar

Dr Sima Samar was born in Jaghoori, Ghazni, Afghanistan, on 3 February 1957. She obtained her degree in medicine in February 1982 from Kabul University, one of the few Hazara women to do so. She practised medicine at a government hospital in Kabul, but after a few months was forced to flee for her safety to her native Jaghoori, where she provided medical treatment to patients throughout the remote areas of central Afghanistan.One year after the communist revolution in 1978, her husband was arrested and was never heard from again. Some years later, Dr Samar and her young son fled to the safety of nearby Pakistan. She then worked as a doctor at the refugee branch of the Mission Hospital in Quetta. In 1989, distressed by the total lack of healthcare facilities for Afghan refugee women, she established the Shuhada Organization and Shuhada Clinic in Quetta. The Shuhada Organization was dedicated to the provision of health care to Afghan women and girls, the training of medical staff, and education. In the following years, further branches of the clinic/hospital were opened in central Afghanistan.After living in Quetta as a refugee for over a decade, Dr Samar returned to Afghanistan in December 2001 to assume a cabinet post in the Afghan Interim Administration led by Hamid Karzai. In the interim government she served as Deputy Chairperson and first ever Minister for Women's Affairs. She was forced to resign from her post after receiving death threats and being harassed for questioning conservative Islamic laws, especially sharia law, during an interview in Canada with a Persian-language newspaper. During the 2002 Loya Jirga, several religious conservatives published an advertisement in a local newspaper calling Dr Samar the Salman Rushdie of Afghanistan.She currently heads the Afghanistan Independent Human Rights Commission (AIHRC).1 She was a nominee for the Nobel Peace Price in 2009.

Teaching and Learning Guide for: Women and War: Militarism, Bodies, and the Practice of Gender

Teaching and Learning Guide for: Women and War: Militarism, Bodies, and the Practice of Gender

Women, religion and the ‘Afghan Education Movement’ in Iran

Ongoing resistance to gender equality in Muslim societies, despite considerable industrialisation and development in many of them, has supported the assumption that Islam, itself, poses a formidable barrier to gender equality. In recent years, the treatment of Afghan women by the Taliban has only reinforced that assumption. However, it happens that certain social transformations have taken place in some Muslim societies, sometimes in unlikely corners, which deserve our close attention. There are lessons that we can draw from them regarding strategies for the further promotion of gender equity and women's empowerment. This paper reviews the experience of Afghan refugee women whose exposure to different visions of Islam in the Islamic Republic of Iran led them to embrace a different vision of Islam and ‘Muslim-ness’. The internalisation of this new Islamic understanding empowered Afghan women, first, to envisage a different and transformed Afghan community. This vision led to the creation of an educational movement in which tens of thousands of Afghan boys and girls – but also adults – were educated without external financial or institutional support. It is a process very different from previous Afghan governments' top-down educational policies, or transplanted international agencies' programs, or other elite-based movements. A vibrant civil society has been created and the women, themselves, have changed. This educational movement transformed gender roles in ways that few social scientists or policy makers could foresee. Significantly, new configurations of various levels of empowerment at personal, community and transnational levels have arisen. Analysis of this case suggests that perhaps development practitioners and policy makers need to re-examine the potential for Muslim women, using their indigenous resources, to challenge their exclusion from the power structure of their communities and to transform their cultures and societies. Given the experience of once rightless, disempowered Afghan refugee women, why should we assume that, given the right circumstances, other Muslim women could not internalise a more egalitarian vision of Islam empowering them to take charge of their own lives and embarking on a process of societal development?

Afghan Women in Exile and Repatriation

In-depth interviews with 60 repatriated Afghan refugee women on their experiences before and duringwar and exile revealed their significant roles and responsibilities. Thewomen were active in protection, safety, survival, and the reestablishment of their families during this time. Contrary to media presentations of Afghan women as helpless victims, they were social actors who used their networks to face the challenges of war, supported their families during exile, and participated in repatriation. Themes that emerged included the significance of cultural and religious norms and expectations, the social entitlement to receive support, and the obligation to provide support within the family and within their ethnic community. The women's stories reflect resilience in times of stress and optimism for the future that were based on their religious faith. Religion and culture are two important elements in developing social work practice with Afghan women in the aftermath of war and during repatriation.

Finding a way: Afghan women's experience in community participation.

Community participation is embedded in primary health care and is key to improving the health and well-being of communities. The concept has not, however, been well studied particularly from the perspective of community members who participate. This article describes findings from qualitative interviews with five Afghan refugee women to explore their experience and the meaning of community participation. From data analysis, two themes emerged: Becoming active encompasses their stories of home, flight, resettlement, learning, and coming together; and being active reflects what they are doing and why they are doing it. Nascent themes and questions that need further elucidation are also discussed.

Families on the Move: The Changing Role of Afghan Refugee Women in Iran

AbstractIn their attempts to "modernize" and bring about socio-economic change, Afghan governments have been preoccupied with restructuring the institutions of marriage and family, and women's role within them, since the 1880s. Serious commitment to introduce legal reform and democratize the family and gender roles cost King Amanullah his throne (1919–1929). From 1930 to 1976 the government attempted a gradual approach introducing reforms piecemeal which had little impact beyond the capital and major cities. After the coup d'état in 1973 and the installation of socialism, the regime introduced a new family decree (known as Number 7) in October 1978 and aggressively pursued women's education and the reform of family laws. This policy incensed the conservative communities and tribal societies, who rebelled against the government; the ensuing Russian occupation brought about the resistance movements and subsequent civil war that has wreaked havoc on Afghanistan for more than two decades. Many conservatives who had tried to resist the intended changes regarding family law and education for girls and "protect" their women, who represented the males honor, decided to leave the country with their families. More than six million Afghans moved to neighboring countries, mostly to Iran and Pakistan. Examining data collected among Afghan refugees in Iran from 1999 to 2002, this paper argues that, ironically, living in exile has brought about the very changes resistance to which had forced them into the refugee situation. Forced to cope with a crisis situation, they developed economic and social survival strategies that altered women's role. Moreover, that exposure to an Islamic society very different from their own brought about structural and ideological changes in the family and in gender roles which legal reforms in Afghanistan had failed to induce. Given the considerable size of the refugee population in Iran (but also in Pakistan and elsewhere) and the destruction of the old fabric(s) of Afghan society, this paper argues that these changes may be irreversible.

Afghan Refugee Women's Experience of Conflict and Disintegration

Afghan women and children make up the majority of refugees who have fled to Iran and Pakistan after 1979 (Collett 1998, 325; Afghan Women's Summit for Democracy 2001). This paper analyzes the experiences of Afghan women refugees in Pakistan in terms of the disintegration of their family, community, and state support structures due to the ongoing war. Privileging the voices and experiences of refugee women, the research on which this paper is based allows Afghan women to be heard as powerful advocates for their own needs, and illuminates their complex survival strategies despite enormous adversity. Over years of civil strife and life in exile, refugee women in Pakistan have watched their old support mechanisms collapse but yet they live to tell their stories of survival. Their narratives deepen our insights into the lives of Afghan refugees today and what can be expected in the years to come if they remain unable to reconstruct their homes, communities, and country. While the situation in Afghanistan is still in transition, refugee women's experiences highlight in particular the importance of specific refugee policy reforms to address the consequences of long-term conflicts on societies. Despite the change of government and the new phase of the war that began in the fall of 2001, which precipitated a fresh flight of Afghans from their homes, the majority of Afghan refugees in Pakistan today remain part of the previous caseload that arrived before September 2001 (Crisp and Stigter 2001a, 3). Refugee women's perspectives, together with those of Afghan women activists outside the camps, must be included to shape refugee and reconstruction policy today.

Maternal mortality among Afghan refugees in Pakistan, 1999-2000

Estimated at 3.6 million, Afghans are the largest population of refugees in the world. Information on the magnitude, causes, and preventable factors of maternal deaths among Afghan refugees may yield valuable information for prevention. Deaths were recorded between Jan 20, 1999, and Aug 31, 2000, during a census carried out in 12 Afghan refugee settlements in Pakistan. Deaths among women of reproductive age (15-49 years) were further investigated by verbal autopsy interviews to determine their cause, risk factors, and preventability, and to ascertain the barriers faced to obtaining health care. The census identified 134406 Afghan refugees and 1197 deaths; a crude mortality rate of 5.5 (95% CI 5.2-5.8) per thousand population. Among the 66 deaths among women of reproductive age, deaths due to maternal causes (n=27) exceeded any other cause (41% [95% CI 29-53]). 16 liveborn and nine stillborn infants were born to women who died of maternal causes; six of the liveborn infants died after birth. Therefore, 60% (15 of 24) of infants born to these women were either born dead or died after birth. Compared with women who died of non-maternal causes, women who died of maternal causes had a greater number of barriers to health care (p=0.001), and their deaths were more likely to be preventable (p<0.05). Maternal deaths account for a substantial burden of mortality among Afghan refugee women of reproductive age in Pakistan. The high prevalence of barriers to health care access indicates opportunities for reducing maternal deaths in refugee women and their children.

Results of a reproductive age mortality survey (RAMOS) among Afghan refugee women in Pakistan, 1999–2000

Results of a reproductive age mortality survey (RAMOS) among Afghan refugee women in Pakistan, 1999–2000

Results of a reproductive age mortality survey (RAMOS) among Afghan refugee women in Pakistan, 1999-2000

Results of a reproductive age mortality survey (RAMOS) among Afghan refugee women in Pakistan, 1999-2000

Changing roles of Afghan refugee women in the United States.

Refugee women face many challenges, such as traumatic flight, loss of family members and property, and dramatic cultural differences in the country of resettlement. We examined the adjustment issues and role changes of Afghan women refugees in northern California. Afghans comprise the largest refugee population in the world, and continuing political turmoil prevents most Afghans in the United States from returning home. Data are presented from interviews with 32 Afghan women. These interviews were conducted as part of a larger ethnographic study that included participant observation and interviews with 90 Afghans and the American health and social service providers who worked with them. Although similar issues were expressed by most Afghan women, generation influenced the experience of such issues. The elderly suffer from social isolation and lack of respect; the middle generation shoulders the triple burden of housewife, employee, and mediator between children and spouse; and young and single women face culture conflict and the lack of appropriate mates.