South Asian Women's Experiences Research Articles

South Asian women’s views on and experiences of maternity care services in Hong Kong: A qualitative study

BackgroundHealth disparities among ethnic minority and migrant women can lead to adverse maternal and neonatal outcomes. This study explores the maternity care experiences of South Asian women in Hong Kong, providing insights for woman-centred and culturally responsive care in the East Asia. ObjectiveTo understand South Asian women’s views and experiences regarding maternity care services in Hong Kong. MethodsA qualitative descriptive study was conducted with 20 English-speaking South Asian women who had used maternity care services in Hong Kong within the past 5 years. Data were analysed by thematic analysis. FindingsFour themes were identified: 1) Comparing maternity care services in their home country versus Hong Kong; birth location, mode of birth and care. 2) Navigating Hong Kong maternal medical care system; including private public dual care and learning information from other South Asians. 3) The discrepancy in perception of optimum care; including a preferring for assistance with daily tasks, epidural anaesthesia, doctor-led care, and priority to infants’ health. 4) The impact of the COVID-19 pandemic on maternity care experiences, including the cancellation of translation services and limited visiting hours. DiscussionSouth Asian appreciate Hong Kong’s public maternity services due to its perceived greater cost-effectiveness. The major incongruence between expectations and services provided being women-staff communication. ConclusionThe quality of healthcare in Hong Kong is appreciated. Individualized care should be offered to cater to diverse needs. Improvements in staff attitude and provision of detailed information should help alleviate feelings of differential treatment.

The Sociology of South Asian Women’s Health

In this lucidly written book, The Sociology of South Asian Women’s Health, Sara Rizvi Jafree, emphasises how health policies have left out the cultural knowledge about the unique circumstances and experiences of South Asian women. The author deftly explored the importance of re-conceptualising health policy development with a culturally and socially appropriate background for women in South Asia. In the introductory chapter of the book, Jafree starts by giving a concise structural description of how South Asian women’s health behaviour and health outcomes are affected by social systems of family, gender, faith, culture, government, schooling, and the media. Sara Rizvi Jafree aims to connect health policy efforts with knowledge of socio-environment and structural factors to propose better health policies for women. The book consists of nine chapters that are co-authored by different scholars with Jafree.

Girls just wanna have fun! South Asian women in the UK diaspora: Gradations of choice, agency, consent and coercion

Much literature views South Asian women in the UK through the prism of arranged marriage and, when discussing gender-based violence, forced marriage. Little attention is paid to South Asian women's experiences of dating, with no commitment to marriage. This paper is based on qualitative research using the theoretical framework of Black Feminist Theory and Intersectionality to analyse how women, who feel they are making their own choices and exercising agency by dating, can, through gendered power dynamics be pressured into marriages. This paper explores how such experiences can elucidate the manifestations of forced marriage and adds to this complex picture of how women entering an intimate relationship of choice, can be entrapped into forced marriage.

"You Can't Be Too Skinny. You Can't Be Too Fat. I Don't Know What You Are Supposed To Be.": A qualitative focus group study exploring body image experiences of South Asian women in the UK

British South Asian women may experience unique appearance pressures associated with their intersecting (racialised and gendered) identities; yet qualitative investigations of intersectional understandings of their body image are scarce. The aim of this study was to explore sociocultural factors influencing British South Asian women’s body image using an intersectional framework. Seven focus groups were conducted with 22 women of South Asian heritage living in the UK between the age of 18 and 48 years old who were comfortable speaking in English. Data were analysed using reflexive thematic analysis. We generated four themes (1) navigating (often marriage-related) appearance pressures from South Asian elders and aunties (2) negotiating cultural and societal standards across different aspects of one’s identity (3) representation of South Asian women in the wider context and (4) forms of healing from the pressures imposed on South Asian women. The findings have important implications for the body image experiences of South Asian women by acknowledging the need for tailored and nuanced responses to their complex needs in the sociocultural, political and relational context such as family, peers, education, health, media and the wider consumer landscape.

Reaching Out: Using Social Media to Recruit ‘Invisible Groups’: The Case of South Asian Women in the UK Experiencing Gender-Related Violence

The rise of social media use has been phenomenal, particularly during the recent COVID-19 pandemic. Furthermore, Facebook has also seen its share of users rise at a meteoric rate. At the same time, the academy is producing a growing body of literature concerning the use of online methods for primary data collection. Yet, despite the increase in the use of the internet as a research tool, very little still exists on the use of social media to recruit research participants, particularly those deemed “socially invisible”. This paper addresses this gap. Another research project explored the experiences of South Asian women who had departed the social norms of arranged marriage to form an intimate relationship with a partner of choice and who then experienced forms of gender-related violence (GRV). The project encountered difficulties in recruiting participants from this marginalised and often invisible group in UK society, who are often too frightened or ashamed to come forward. This study demonstrates how to use Facebook ethically and methodologically, highlighting some of the methods used to overcome the challenges that were presented. The research was undertaken before the COVID-19 pandemic (which prompted a widespread use of social media in social science research). We argue that, despite the ethical challenges, the advantages of using social media to recruit participants when researching a highly sensitive topic such as GRV with ‘invisible groups’ was highly beneficial. We therefore suggest that social media should be an integral part of the research recruitment process, alongside non-digital methods, so that other ‘invisible groups’ are not created comprising those who cannot access technology. We share the lessons learned for the benefit of researchers using a similar approach today when recruiting research participants from invisible and marginalised groups. The authors caveat their recommendation of using social media with suggesting that those who do not have high levels of experience of data collection with such cohorts instead consider working with gatekeepers to facilitate the recruitment.

Exploring Black and South Asian women's experiences of help-seeking and engagement in perinatal mental health services in the UK.

In the United Kingdom (UK), Black and South Asian women are less likely than White British women to access support from perinatal mental health services, despite experiencing similar, or higher, levels of distress. This inequality needs to be understood and remedied. The aim of this study was to answer two questions: how do Black and South Asian women experience (1) access to perinatal mental health services and (2) care received from perinatal mental health services? Semi-structured interviews were conducted with Black and South Asian women (n = 37), including four women who were interviewed with an interpreter. Interviews were recorded and transcribed line-by-line. Data were analyzed using framework analysis, by an ethnically diverse multidisciplinary team of clinicians, researchers and people with lived experience of perinatal mental illness. Participants described a complex interplay of factors that impacted on seeking, and receiving help, and benefiting from services. Four themes emerged that captured the highly varied experiences of individuals: (1) Self-identity, social expectations and different attributions of distress deter help-seeking; (2) Hidden and disorganized services impede getting support; (3) The role of curiosity, kindness and flexibility in making women feel heard, accepted and supported by clinicians; (4) A shared cultural background may support or hinder trust and rapport. Women described a wide range of experiences and a complex interplay of factors impacting access to, and experience of, services. Women described services as giving them strength and also leaving them disappointed and confused about where to get help. The main barriers to access were attributions related to mental distress, stigma, mistrust and lack of visibility of services, and organizational gaps in the referral process. These findings describe that many women feel heard, and supported by services, reporting that services provide a high quality of care that was inclusive of diverse experiences and understandings of mental health problems. Transparency around what PMHS are, and what support is available would improve the accessibility of PMHS.

Views, attitudes and experiences of South Asian women concerning sexual health services in the UK: a qualitative study

Objective To explore the views, attitudes, and experiences of South Asian women in the UK regarding sexual health services. Methods We performed virtual semi-structured interviews with South Asian women 18 and over living in the UK. We explored participants’ experiences of accessing sexual health services, including contraception, smear tests and sexually transmitted infection (STI) tests. We coded interview transcripts and analysed them thematically. Results From February to April 2021, we conducted 14 interviews with South Asian women between the ages of 18 and 40 living in England and Wales, from February to April 2021. We identified four overarching themes: Access to sexual health services, entry to sexual health services, quality of sexual health services and stigma associated with sexual health services. Important barriers to sexual health services include limited knowledge of local provision, stigma and shame, and concerns about confidentiality. Participants found it difficult to discuss their sexual health (with anyone) and were often being met with judgement and a lack of partnership from clinicians. Conclusion Our results suggest that South Asian women are uncomfortable accessing sexual health services and communicating their sexual health concerns with health care professionals. Service providers should collaborate with community-based organisations to ensure that services are discrete, confidential, and culturally appropriate.

An exploratory study of South Asian women’s experiences of mental health services in England: a thematic analysis of cultural sensitivity

Purpose Despite government and national health service demands for equality within mental health (MH) services, racial inequalities remain. South Asian (SA) women underutilise MH services, yet research regarding their experiences and the cultural sensitivity (CS) of services is sparse. The purpose of this study was to explore the experiences of SA women who have used MH services and the cultural sensitivity of the latter. Design/methodology/approach Thematic analysis was used for data analysis of semi-structured interviews carried out with 16 SA women. Findings Analysis yielded an overarching theme of “degree of understanding” and three main themes: “shared background and understanding” “humanity” and “cultural factors” and their subsequent subthemes. Results demonstrated mixed experiences, illustrating varied levels of CS and the impacts of this upon experiences. Cultural understanding underpins CS: participants’ experiences demonstrated the benefit of significant understanding and the detriment of limited understanding. Research limitations/implications All participants were well educated, English-speaking and from psychology, health or research backgrounds. SA culture is nuanced; thus, the demographic of “South Asian” could be too broad. However, because current understanding is limited, this research provides fundamental empirical knowledge. Practical implications Clear recommendations were co-produced with participants, highlighting strong impacts for service development and best practice. Social implications The research provides valuable insight into SA women’s experiences of MH services and wider understanding of CS. This raises cultural awareness in a field lacking understanding. Findings and recommendations can, therefore, provide foundational knowledge for broader societal issues experienced by people from this demographic and challenge preconceptions. Originality/value This research offers unique recommendations for more culturally sensitive practice, co-produced with participants.

Exploring the disability experiences of South Asian Women living with HIV in Southern Ontario, Canada

Purpose Given the steady rise in HIV incidence among South Asian women in Canada their health-related challenges and disability are not well understood. Our aim was to understand the “lived experiences” of disability among South Asian women living with HIV in Southern Ontario, Canada. Methods We conducted a qualitative study using an interpretive phenomenological approach. We recruited immigrant South Asian women living with HIV in Ontario and conducted one-on-one semi structured interviews. Following the first interview, participants were invited to participate in a second interview. Interviews were audio recorded and transcribed verbatim. Results Eight participants completed the first interview; six completed a second interview (14 interviews total). The mean age of participants was 47.1 years (standard deviation (sd) = 5.8) and mean length of time since HIV diagnosis was 15.1 years (sd = 6.7). We identified two overarching themes, “experiencing disability” and “experiencing discrimination”. Apart from the physical and mental health impairments, the complex intersection of illness, gender, ethnicity, HIV-stigma and discrimination influenced disability experiences. Conclusion Understanding the disability experiences of marginalized women living with HIV through a phenomenological lens can help to facilitate the development of culturally safe treatment approaches and health care policies to lessen disability and improve their quality of life. Implications for rehabilitation Developing culturally safe treatment approaches may help to improve rehabilitation service provision for ethnically and culturally diverse populations. Rehabilitation professionals need to adopt a trauma-informed care when treating people living with HIV. Rehabilitation professionals should consider cultural safety by considering the role of religion, dependency, and gendered-power relations while treating South Asian women living with HIV.

Gestational diabetes mellitus: a qualitative study of lived experiences of South Asian immigrant women and perspectives of their health care providers in Melbourne, Australia

BackgroundSouth Asian women are at a high risk of developing gestational diabetes mellitus than other women in Australia. Gestational diabetes affects up to 14–19% of all pregnancies among South Asian, South East Asian, and Arabic populations placing women at risk of adverse pregnancy outcomes. Although, gestational diabetes resolves after childbirth, women with gestational diabetes are up to seven times more likely to develop type 2 diabetes within five to ten years of the index pregnancy. Increasingly, South Asian women are being diagnosed with gestational diabetes in Australia. Therefore, we aimed to gain a better understanding of the lived experiences of South Asian women and their experiences of self-management and their health care providers’ perspectives of treatment strategies.MethodsUsing an ethnographic qualitative research methodology, semi-structured one-on-one, face-to-face interviews were conducted with 21 health care providers involved in gestational diabetes management and treatment from the three largest tertiary level maternity hospitals in Melbourne, Victoria, Australia. In-depth interviews were conducted with 23 South Asian women post diagnosis between 24–28 weeks gestation in pregnancy.ResultsHealth care providers had challenges in providing care to South Asian women. The main challenge was to get women to self-manage their blood glucose levels with lifestyle modification. Whilst, women felt self-management information provided were inadequate and inappropriate to their needs. Women felt ‘losing control over their pregnancy’, because of being preoccupied with diet and exercise to control their blood glucose level.ConclusionsThe gestational diabetes clinical practice at the study hospitals were unable to meet consumer expectations. Health care providers need to be familiar of diverse patient cultures, rather than applying the current ‘one size fits all’ approach that failed to engage and meet the needs of immigrant and ethnic women. Future enabling strategies should aim to co-design and develop low Glycaemic Index diet plans of staple South Asian foods and lifestyle modification messages.

Beyond the barriers: South Asian women’s experience of accessing and receiving psychological therapy in primary care

Purpose A number of initiatives have been developed to ensure easy access to mental health services for Black and Asian Minority Ethnic (BAME) communities. Improving Access to Psychological Therapies (IAPT) is a service that delivers first line interventions for South Asian women; however, little is known about what makes IAPT accessible for this population. This paper aims to explore South Asian women’s experiences of accessing psychological therapy and whether therapy within IAPT helps individuals to re-frame their experiences within their own cultural context. Design/methodology/approach A qualitative approach was used. Semi-structured interviews were carried out with South Asian women who accessed an IAPT service. Ten participants took part in the study and interviews were analysed using thematic analysis. Findings Six themes were identified; access, experience, cultural framework, therapist characteristics, expectations and “sticking with it”. Having a good therapeutic relationship with the therapist was key. While cognitive behavioural therapy (CBT) enabled clients to manage their symptoms, manualised CBT led to a sense of dissatisfaction for some. Clients spoke of having to make a forced choice to either deny their culture or leave their culture at the door to access therapy. Cultural and religious exclusion had a negative impact on therapy particularly for those whose difficulties were related to their cultural or religious context. Practical implications Culture and religion continues to be excluded from psychological therapy for South Asian Women. A cultural shift is required from within IAPT services to maintain engagement for this group. Further clinical implications are discussed. Originality/value While the experiences of Black and Asian ethnic minority groups accessing secondary mental health services has been explored, this study explores and highlights the experiences of South Asian Women accessing therapy in primary care, and uniquely identifies the processes that enable women to engage in therapy.

Identification of abuse experiences of South Asian women in the US and women in Mumbai, India

The authors describe the experiences of abuse drawn from in-depth interviews conducted with 20 South Asian women in the United States and a sample of 21 abused women in Mumbai, India. We describe five major themes that identify the nature of domestic violence experienced in these two contexts, barriers to help-seeking and exiting abuse, and the process of ending the abusive relationship. The research sheds light on the similarities and differences in the two contexts. We outlined the similarities in the following themes (a) type of abuse, (b) treatment of children (c) abandonment. We found differences in the following themes (d) joint meeting, (e) back and forth between natal and marital home.

Engagement barriers and service inequities in the NHS Breast Screening Programme: Views from British-Pakistani women.

ObjectivesPrevious research has largely attempted to explore breast screening experiences of South Asian women by combining opinions from Pakistani, Bangladeshi, and Indian women. This research often fails to reach the most underserved sub-groups of this population, with socioeconomic status not routinely reported, and English fluency being a participation requirement. With uptake low amongst British-Pakistani women, this study explores the experiences these women encounter when accessing the NHS Breast Screening Programme.Methods19 one-to-one semi-structured interviews were carried out with British-Pakistani women from East Lancashire, UK. 14 interviews were conducted via an interpreter.ResultsData were analysed using thematic analysis. Three themes were identified: ‘Absence of autonomy in screening and healthcare access’ describes how currently the screening service does not facilitate confidentiality or independence. Access requires third-party intervention, with language barriers preventing self-expression. ‘Appraisal of information sources’ makes distinctions between community and NHS communication. Whereas community communication was invaluable, NHS materials were deemed inaccessible due to translation incongruences and incomprehensible terminology. ‘Personal suppositions of breast screening’ explores the subjective issues associated with disengagement, including, the cultural misalignment of the service, and perceiving screening as a symptomatic service.ConclusionsBritish-Pakistani women face some unique challenges when accessing breast screening. To promote uptake, the service needs to address the translation of screening materials and optimize upon community networks to disseminate knowledge, including knowledge of the screening environment within the context of culture to promote informed choice about attendance.

Exploring South Asian Women's Experiences of Domestic Violence and Help-Seeking Within the Sociocultural Context in Hong Kong.

Data are reported from a survey of 49 South Asian women who self-identified as having experienced domestic violence from an intimate partner within the past 12 months. Logistic regression analysis reveals that perceived social support and having children emerged as the strongest predictors for seeking help. This study also demonstrates that women's approach to help-seeking is shaped and embedded by a combination of individual and structural factors. The findings of this study may be used to help enhance efforts to promote and provide resources and support for victims of domestic violence from an intimate partner.

Social contexts and HIV vulnerabilities among South Asian women in the greater Toronto area: Examining social norms

ABSTRACTWe explored how social norms interact with beliefs and social structures (power relations, emotional relations, and gendered division of labor) to influence the experiences of South Asian women with HIV in Canada. The first author conducted semi-structured interviews, and identified five themes using thematic analysis: connection to community/religious institutions, family honor, and restrained/prohibited discussion of sexuality. These norms reproduce hegemonic masculinity; constrain women's social, relational, and economic power; and elevate HIV vulnerability. We present findings to challenge hegemonic masculinity at the international level, and of developing strategies to address both interfamily gender-based violence and racism faced by the South Asians in Canada.

Cultural considerations for South Asian women with breast cancer.

Cultural values shape a woman's experience of disease and introduce novel stressors that influence psychosocial needs and adaptation. This literature review examines the psychosocial impact of breast cancer in South Asian women, a large group that has received little attention in this regard. We conducted a comprehensive review of the literature published before April 2014 using Ovid MEDLINE, PsychINFO, PubMED, CINHAL, EMBASE, and Sociological Abstracts. We searched for articles about the psychosocial impact of breast cancer in South Asian women. We retained 23 studies for review. The literature concerning South Asian women's experiences identified culturally linked themes that play significant roles in shaping the illness experience; e.g., stigma and breast cancer, low priority of women's health, collective experience of disease, and religion and spirituality. There is a growing need for culturally sensitive care for South Asian women. By understanding the core cultural values and integrating them into clinical practice, Western healthcare providers may improve the quality of care they deliver and help women to extract the maximum benefit. Developing culturally competent support services may enhance effectiveness in addressing the healthcare needs of South Asian women and may serve other ethnic minorities in North America.

Domestic Violence: Intersection of Culture, Gender and Context.

This study examines South Asian women's experience of domestic violence in Hong Kong. Despite the proliferation of literature on domestic violence, this issue remain unexplored in the discourse of domestic violence in Hong Kong. A qualitative research approach through face to face interview with 14 women was employed. Participants were recruited through purposive and snowball sampling. Findings from this study highlight the importance of considering the social and cultural influence on how women perceived and construct their experiences of abuse.Implications for practice and policies are highlighted.

Exploring the social and interpersonal experiences of South Asian women with a diagnosis of Systemic Lupus Erythematosus

Systemic Lupus Erythematosus (SLE) negatively impacts life quality, disproportionately affecting women and UK ethnic minorities. The study aimed to explore how UK South Asian women with SLE make sense of their social and interpersonal experiences, within the context of their ethnicity and perceived cultural influences. A qualitative design was employed to collect data from a homogenous sample of six South Asian women with SLE. Semi-structured interviews elicited participants’ experiences of living with SLE and data were analysed using Interpretative Phenomenological Analysis. Master themes were (1) ‘SLE: Complexities and Ironies’, (2) ‘The Power of SLE’, (3) ‘A Sense of Personal Responsibility and Accountability’, (4) ‘Essential Relationships: Qualities and Consequences’ and (5) ‘Struggling in Public View’. Findings revealed that illness, function and emotion were experienced as interrelated, and psychosocial issues were a powerful feature in SLE illness processes. Body image concerns, difficulties maintaining roles and the perceived views of others, triggered embarrassment and withdrawal, negatively influencing social function and relationships. Interestingly, explicit references to ethnicity and culture were minimal, suggesting that for these women, the key features of experience tended to reflect those of other SLE groups. These findings call for an integrated, biopsychosocial and multidisciplinary approach to health care provision in this area.

‘Breast is not always best’ South Asian women's experiences of infant feeding in the UK

In this section, brief synopses of a range of recently published articles that may be of interest to health visitors are presented. The aim of this roundup is to provide an overview, rather than a detailed summary, of the research papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided.

‘Breast is not always best’: South Asian women's experiences of infant feeding in the UK within an acculturation framework

Acculturating to a host country has a negative impact on immigrant women's breastfeeding practices, particularly when coming from countries where breastfeeding rates are higher than Western countries. Whether this is true of those immigrating to the UK remains to be investigated. The study aimed to explore whether acculturating to the UK had detrimental effects on breastfeeding practices of South Asian women, and to provide explanations as to how acculturation may have exerted its influence. Twenty South Asian women completed semi-structured interviews exploring infant feeding experiences. Data were thematically analysed. A bidimensional measure assessed women's acculturation status. Women displaying low acculturation levels were aware of living in a formula-feeding culture but this had little influence on breastfeeding intentions/behaviours; drawing upon South Asian cultural teachings of the psychological benefits of breast milk. These women opted to formula-feed in response to their child's perceived demands or in a bid to resolve conflict; either when receiving information about the best feeding method or between their roles as a mother and daughter-in-law. Highly acculturated women also experienced such conflict; their awareness of the formula-feeding culture governed feeding choice. The findings provide a picture of how acculturation may affect South Asian women's breastfeeding intentions and behaviours; encouraging health service providers to meet the varying needs of an acculturating population. If breastfeeding is to be encouraged, it is necessary to understand factors influencing feeding choice; with particular attention to the acculturation pathways that may govern such decisions. This paper highlights ways to tailor information for South Asian women depending on levels of acculturation.