Somali Refugees Research Articles

Global But Not Regional? The Role of African Regional Migration Regimes in the International Governance Architecture

Regional organisations and migration regimes are increasingly being acknowledged in global migration policies. The global compacts for migration and on refugees adopted in December 2018 recognise the migration-related expertise and important function of regional organisations in the implementation of international guidelines and policies. But the compacts’ wording is vague on the division of labour between global and regional migration regimes, and important questions remain unanswered regarding the added value and ideal role of regional migration regimes in the international system. This is particularly true for regions of the global South, whose institutional arrangements, substantive focus and performance in migration-related norm setting and implementation remain understudied. The authors contribute to filling this knowledge gap by considering two migration policy processes in the context of their overall (regional) migration governance systems and regimes – the ECOWAS Protocol for the Free Movement of Persons and the IGAD Regional Framework for Durable Solutions for Somali Refugees. Based on a qualitative research design, they find that regional migration regimes possess some comparative advantages compared with global ones, which enhance their agency. However, depending on institutional path dependencies, the degree of legalisation and the interests of powerful internal and external actors, levels of agency with regards to different migration types might show significant variation.

Avoiding obstetrical interventions among US-based Somali migrant women: a qualitative study

ABSTRACT Objective: Somali refugee women are known to have poor health-seeking behavior with a higher proportion of adverse pregnancy outcomes compared to US-born women. Yet unknown is how they avoid obstetrical interventions. This study sought to identify perceived protective mechanisms used to avoid obstetric interventions as well as the underpinning factors that influence aversion to obstetrical interventions by Somali refugee women. Design: A descriptive, exploratory qualitative study purposively sampled Somali refugee women recruited via snowball technique in Franklin County, Ohio, United States. Data were collected through audio-recordings of individual interviews and focus groups conducted in English and Somali languages. The collected data were transcribed and analyzed using thematic analyses. Results: Forty Somali refugee women aged 18–42 years were recruited. Participants reported engaging in four perceived protective mechanisms to avoid obstetrical interventions during pregnancy and childbirth: (1) intentionally not seeking or misleading prenatal care, (2) changing hospitals and/or providers, (3) delayed hospital arrival during labor, and (4) refusal of care. Underpinning all four avoidance mechanisms were their significant fear of obstetrical interventions, and perceived lack of choice in their care processes as influenced by cultural and/or religious beliefs, feeling judged or undervalued by service providers, and a lack of privacy provided to them while receiving care. Conclusion: Like every woman, Somali women also have a right to choose or refuse care. If the intention is to improve access to and experiences with care for this population, building trust, addressing their fears and concerns, and respecting their culture is a critical first step. This should be well established prior to the need for critical decisions surrounding pregnancy and childbirth wherein Somali women may feel compelled to refuse necessary obstetrical care. Bridging gaps between Somali women and their providers is key to advance health equity for this vulnerable population.

Refusing cesarean sections to protect fertile futures:

ABSTRACTWhile cesarean sections are increasingly used worldwide, Somali refugee women in Kenya are rejecting the operation in attempts to protect their future reproductive capacities. In a context of displacement and insecurity, women's reproductive bodies can be crucial to their security and strategies for onward migration. Somali women's resistance to C‐sections mirrors prevalent practices of female circumcision, since they are both perceived by physicians as medically harmful but by women as essential to achieving gendered expectations of marriage and motherhood. The strategic modification and protection of reproductive capacities are situated in multifaceted social and political ruptures, and women's refusal of surgery is part of a long‐term, future‐oriented pursuit of motherhood and survival. [motherhood, refugees, cesarean section, female circumcision, migration, resistance, Somalia, Kenya]

Communicative resources and credibility in public discourse on refugees

AbstractThis article examines how communicative resources affect the construction of credible texts and identities in a public debate on Australia's treatment of a refugee. It centres on two key written statements—one from the Immigration Minister, and another from a Somali refugee. The analysis is divided into four levels, exploring the parties’ respective linguistic, material, identity, and platform resources, and how these impact their statements’ creation and reception, and their participation in discourse creation more generally. The article finds that there are inequalities on all four resource levels that largely undermine the refugee's ability to present a credible text and identity and challenge mainstream discourse on refugees. The article demonstrates how a multi-level analysis of communicative resources can challenge assumptions about participation and uncover inequalities invisible in the prevailing discourse. (Asylum, Australia, communicative resources, discourse, intercultural communication, media, power, refugee)*

Decision Making and Communication About Child Spacing Among Somali Couples in Minnesota.

Since civil unrest broke out in Somalia in the 1990s, large numbers of Somalis have immigrated to Western countries, including the United States. It is unknown whether these immigrants maintain their cultural norms of low contraceptive use and high fertility when they live in settings with different norms. In 2016, interviews were conducted in Minnesota with Somali immigrants and refugees to explore couple communication and decision making regarding child spacing. Nineteen married men and women aged 25-51 were interviewed. After a coding scheme was developed, key themes were identified and examined by participants' sex, number of children and age of arrival in the United States. Most participants discussed child spacing with their spouse and had positive or neutral experiences. Some participants, especially those with multiple children, stated that living in their new country had influenced their fertility desires. Only those who had arrived after the age of 20 mentioned that experiencing closely spaced births had motivated them to discuss child spacing. Participants emphasized the importance of information sharing, compromise and joint decision making with their spouse. Priority for child-spacing decision making was granted to women, largely because of their primary role in childbirth. Men who had arrived in the United States before turning 20 were more definitive about giving women decision-making priority. These findings provide insight into how Somali immigrant and refugee couples communicate and make decisions about child spacing, and may be helpful in informing the development of culturally specific reproductive health programs.

A Qualitative Exploration of Somali Refugee Women's Experiences with Family Planning in the U.S.

The purpose of our study was to explore the knowledge, attitudes, and experiences of Somali refugee women with family planning in the U.S. We conducted focus groups of Somali refugee women and used grounded theory methodology to identify emergent themes. Fifty-three women, aged 18-49years, participated. Somali refugee women's cultural and religious beliefs and social identities strongly influence their conceptualization of family planning. Participants agreed that a woman's fertility is ultimately decided by Allah and identified environmental changes after immigration and the desire to optimize maternal health as facilitators to modern contraceptive use. Misconceptions about and fear of side effects of modern contraceptive methods, including a fear of infertility, were identified as barriers to use. To deliver patient-centered family planning counseling to Somali refugee women, it is essential that healthcare providers approach these discussions with cultural humility and consider employing community partners or cultural brokers to help provide family planning education.

Ethiopia and the Refugees: The History, Current Situations and Legal Frameworks

This paper aimed to assess the history and current status of refugees from in Ethiopia. To put into the context of understanding the underlying concepts and assumptions behind refugees and to understand the current status of refugees in Ethiopia, the qualitative research approach is employed. The paper relied on extensively secondary data as a means of collecting relevant and required information. The history of refugees in Ethiopia, Ethiopian legal framework on Refugees and the Current situation of refugees in Ethiopia are the core points assessed through strict textual analysis of the available literature. Moreover, Ethiopia as a host over 166,000 refugees from Somalia (55%), Eritrea (28%), and Sudan (15%), the status of the three corridors of refugee camps i.e. the north camp (Eritrean refugee camps), the east camp (Somali refugee camps) and the west camp (Sudanese refugee camps) discussed in detail. Keywords: Ethiopia, Refugee, legal framework, a refugee camp DOI : 10.7176/IAGS/71-01 Publication date : April 30 th 2019

\u201cThe more children you have, the more praise you get from the community\u201d: exploring the role of sociocultural context and perceptions of care on maternal and newborn health among Somali refugees in UNHCR supported camps in Kenya

BackgroundMaternal and neonatal survival are key components of population health and may be particularly vulnerable in humanitarian contexts of civil unrest and displacement. Understanding what factors contribute to poor health outcomes throughout the reproductive life cycle and across the continuum of care is crucial for improving health programming in acute and protracted refugee settings.MethodsWe undertook a mixed-methods baseline assessment of factors related to maternal and neonatal health among refugees living in the Dadaab refugee complex in eastern Kenya. The qualitative component included 23 focus group discussions with 207 community members and 22 key informant interviews with relevant UN and non-governmental organization staff, community leaders, health managers, and front-line health care providers. We analysed qualitative data for content and themes using inductive and deductive techniques.ResultsTaking a life course perspective, we found that the strong desire for large families and the primary social role of the woman as child bearer impacted maternal and neonatal health in the camps through preferences for early marriage, low demand for contraception, and avoidance of caesarean sections. Participants described how a strong fear of death, disability, and reduced fecundity from caesarean sections results in avoidance of the surgery, late presentation to the health facility in labour, and difficulty gaining timely informed consent. Mistrust of health service providers also played a role in this dynamic. In terms of newborn care practices, while breastfeeding is culturally supported and women increasingly accept feeding colostrum to the newborn, mixed feeding practices and application of foreign substances to the umbilicus continue to present risks to newborn health in this community.ConclusionsThe findings from our study showcase the role that specific sociocultural beliefs and practices and perceptions of health care services have on maternal and neonatal health. An in-depth understanding of how these factors impact the utilization of biomedical health services provides valuable information for targeted improvements in health service provision that are tailored to the local context.

A Domains Approach to Perceived Problems and Solutions for Community Empowerment in an Urban Refugee Community in Kenya

Urban refugees resettled in low- and middle-income countries face diverse stressors exacerbating individual problems and stifling community empowerment. This study utilized a thematic analysis informed by the domains approach to community empowerment to better understand how urban Somali refugees in Kenya describe community functioning. This Somali community identified multiple beliefs, needs, and barriers related to communal and individual functioning, relating these to the intersection of community competence, engagement, and capacity. Intersections are cause and solution to mental health problems, psychosocial dysfunction, and impeded development of community structure, necessitating prioritization of community development in any interventional efforts with this community.

Cost-effectiveness of birth-dose hepatitis B vaccination among refugee populations in the African region: a series of case studies

BackgroundHepatitis B affects 257 million people worldwide. Mother-to-child hepatitis B virus (HBV) transmission is a preventable cause of substantial morbidity and mortality and poses greatest risk for developing chronic HBV infection. The World Health Organization recommends that all countries institute universal hepatitis B birth dose (HepB BD) vaccination during the first 24 h of life, followed by timely completion of routine immunization. The objective of this analysis was to assess the cost-effectiveness of adding HepB BD vaccination among sub-Saharan African refugee populations where the host country’s national immunization policy includes HepB BD.MethodsWe performed a cost-effectiveness analysis of three hepatitis B vaccination strategy scenarios for camp-based refugee populations in the African Region (AFR): routine immunization (RI), RI plus universal HepB BD, and RI plus HepB BD only for newborns of hepatitis B surface antigen-positive mothers identified through rapid diagnostic testing (RDT). We focused analyses on refugee populations living in countries that include HepB BD in national immunization schedules: Djibouti, Algeria and Mauritania. We used a decision tree model to estimate costs of vaccination and testing, and costs of life-years lost due to complications of chronic hepatitis B.ResultsCompared with RI alone, addition of HepB BD among displaced Somali refugees in Djibouti camps would save 9807 life-years/year, with an incremental cost-effectiveness ratio (ICER) of 0.15 USD (US dollars) per life-year saved. The RI plus HepB BD strategy among Western Saharan refugees in Algerian camps and Malian refugees in Mauritania camps would save 27,108 life-years/year with an ICER of 0.11 USD and 18,417 life-years/year with an ICER of 0.16 USD, respectively. The RI plus RDT-directed HepB BD was less cost-effective than RI plus delivery of universal HepB BD vaccination or RI alone.ConclusionsBased on our model, addition of HepB BD vaccination is very cost-effective among three sub-Saharan refugee populations, using relative life-years saved. This analysis shows the potential benefit of implementing HepB BD vaccination among other camp-based refugee populations as more AFR countries introduce national HepB BD policies.

Somali refugees’ wellbeing: the role of socio-culturally mediated agency

Although there is substantial research on refugees and their wellbeing, there is limited research that examines the role of refugees‘ agency in their lives. Using Doyal and Gough‘s (1991) theory of human need, the study analyses Somali refugees‘ wellbeing by examining the satisfaction of their human needs. Drawing on data from 70 Somali refugees in Kisenyi, Kampala, the study found that Somali refugees exercised their socio-culturally mediated agency to promote their wellbeing. The socioculturally mediated agency was demonstrated in form of an individual‘s/family‘s ability to start and maintain small and medium-scale business enterprises, and develop social networks with the host community, fellow Somalis within Uganda and abroad. Individuals/families that engaged in either or both of the agency actions were able to adequately meet their human needs, thus romoting their wellbeing because adequate satisfaction of human needs leads to human wellbeing.

Refuge and Security Panics

The discourse of humanitarianism presumes that the resettlement of refugees into a space of permanent refuge by humanitarian organizations and host country governments represents the end of their experience of loss, displacement, and forced mobility. But many Black Muslim refugees in the u.s. inhabit a prism in which they are targets of misinformation, scrutiny, surveillance, and suspicion that refract gender, race, and faith through security panics. The refuge of resettlement, for the Black Muslim refugees discussed in this paper, is not something given; it is something made, by them, in difficult and even dangerous circumstances. Through a series of vignettes that illustrate the felt and lived effects of racism and surveillance at the gender/race/faith-security nexus on Somali refugees in Maine, the paper explores one context in which refuge is made.

Alcoholic Beverage Use Among Somali Youth Living in Eastleigh, an Urban Suburb in Nairobi, Kenya

Background: Harmful use of alcohol causes a large disease, social and economic burden to societies. Alcohol use is the third largest disease risk factor for deaths among youths between 15-29 years that contribute to 4% of the global burden of disease. Eastleigh also is known as “Little Mogadishu” is a suburb in Nairobi that is mostly inhabited by both Somali Community from Kenya and majorly from migrations from Somalia. It hosts about 30,000 Somali refugees and characterized by extremes of wealth and poverty. Objective: The aim of this study is to identify the prevalence of alcohol use and the patterns of use among Somali Youth living in Easteigh suburb in Nairobi. Method: This is an exploratory cross-sectional study among youth aged between 18-25 years of age that used a face-to-face interview. Results: Findings indicated a high prevalence among those who are male, of younger age, with married parents, born in Eastleigh, with lower educational level, the singles, the unemployed and those with high family income. Alcohol use is comorbid with other licit psychoactive substances that include tobacco products, miraa and shisha. Conclusion: These participants have relatively high alcohol use that is comorbid with other licit psychoactive substances. Recommendations include further studies to be done in this community using standardized instruments to cover a larger area and interventions to target younger youth of below 15 years of age and policy on treatment of young people with mental disorders to include substance abuse as well.

Seeking Refuge: An Exploration of Unaccompanied Women, Minors from Somalia and Families from Pakistan Experiences of Services in Bangkok, Thailand

The number of unprotected urban refugees in Bangkok has grown over the past few years with new migrations of young women, men and families from Somalia and Pakistan. An urban environment can mean opportunity for some but for many the environment can increase vulnerability to exploitation and detention. This study aimed to explore refugees’ experiences in Bangkok, assess agencies’ service delivery models, and strengthen their capabilities to address service gaps. Participants were recruited using purposeful sampling and snowball. Using CBPR, focus groups discussion with Somali and Pakistani refugees (n=63) and individual interviews (n=42) were conducted. Agencies’ staff (n=23) were interviewed regarding challenges in providing services to refugees. Qualitative data analysis revealed four major themes: lack of basic need, problems with legal services, agencies revealed urgent need for shifting from emergency services towards long-term strategies given the protracted immigration status of urban refugees, and the need for a collaborative approach in service provision emerged as an urgent call. Implications to social work practice with urban refugees focusing on potentials for innovative service provision and collective agency responses are discussed.

Factors Associated with Access to Maternal and Reproductive Health Care among Somali Refugee Women Resettled in Ohio, United States: A Cross-Sectional Survey.

This study examined maternal and reproductive health (MRH) access of Somali refugees in the U.S. across four access dimensions (willingness to seek care, gaining entry to the health system, seeing a primary provider and seeing a specialist). We conducted a cross-sectional survey of 427 Somali refugee reproductive-age women in Franklin County, Ohio. Following descriptive statistics of demographics, we conducted multivariate analyses to test associations between demographics and the four access dimensions. Most Somali refugee women were married (68%), attained primary education (92%), employed (64%) and were circumcised (82%). Young (OR 2.61, 95% CI 1.25-5.60), single (OR 1.78, 95% CI 1.15-2.78), and minors upon arrival (OR 2.36, 95% CI 1.44-3.90) were more willing to seek care. Lack of insurance, limited language fluency and being circumcised limited access to care across all dimensions. Barriers to access need to be systematically addressed. Deconstructing beliefs regarding health systems may improve access, especially among older Somali women.

Leading refugee lives together: Familial agency as a political capacity

Family life is constituted by affective relationships and emotional bonds between individuals connected through kinship, yet in many cases involving people from beyond the lineal descent group as well. In precarious migratory processes and situations, the significance of these relations often grows. Even if put under increased pressure, they encompass important resources that individuals alone could not possess. Then again, for some people certain familial relations are part of the problematized life situation, challenging rather than reinforcing their personal agency. This paper explores political dimensions of refugee agency and discusses how mundane familial political agency is acquired and practiced in refugee situations. Specifically, analyzed are intimate relationships as unfolding in some young male refugees' transnational lives, as personal and shared experiences and practices. The paper takes notice of conflicted familial relations, too, to create a better understanding about the manifoldness of intergenerational political agencies. Drawing from interviews with Iraqi, Afghan and Somali refugees, it demonstrates how familial agency is irreducible to the personal agencies of family members yet does not exist beyond subjective stances. In conclusion, the paper proposes that familial mundane politics remain poorly noticed in refugee situations, which harmfully effects on the humanitarian aid system as well as refugee lives.

Facilitators and Barriers of Cervical Cancer Screening and Human Papilloma Virus Vaccination Among Somali Refugee Women in the United States: A Qualitative Analysis.

Eastern Africa has the highest rates of cervical cancer incidence (42.7 per 100,000) and mortality (27.6 per 100,000), substantially higher than worldwide incidence (14.0 per 100,000) and mortality (6.8 per 100,000). The purpose of this study was to explore facilitators and barriers to cervical cancer screening and human papilloma virus (HPV) vaccination among Somali refugee women and their children. Focus group discussions were conducted in August of 2016. Investigators performed systematic, comparative, and thematic data analyses. The 31 Somali refugee participants ranged from 23 to 64 years old. Four major themes emerged: (1) knowledge, (2) facilitators, (3) decision making, and (4) views on intervention strategies. Doctor recommendation and family support were important facilitators. Community education was the most popular strategy in promoting screening and vaccine uptake. Multilevel targeted interventions should increase knowledge and include family members to increase cervical cancer screening and HPV vaccination uptake in the Somali community.

Health Realization Community Coping Intervention for Somali Refugee Women.

Health Realization (HR) is a strengths-based stress and coping intervention used to promote the use of internal and external coping resources. Our three-arm comparison group trial examined the effects of a culturally adapted Somali HR intervention on coping and mental health outcomes in 65 Somali refugee women post-resettlement. Subjects participated one of three conditions: HR intervention, nutrition attention-control, and evaluation-control. The HR intervention significantly affected multiple dimensions of coping: WAYS-distancing (p = 0.038), seeking social support (p = 0.042), positive reappraisal (p = 0.001); and Refugee Appraisal and Coping Experience Scale-Internal subscale (p = 0.045). The HR intervention also demonstrated improvement in depression symptom ratings (p = 0.079). We discuss findings from the pilot, challenges encountered conducting a three-arm comparison group trial, and implications for further research involving the HR intervention with culturally diverse refugee communities.

The “Somalinisation” of terrorism and counterterrorism in Kenya: the case of refoulement

ABSTRACT Kenya’s state discourse on terrorism and counterterrorism securitises Somali refugees and refugee camps. Using the securitisation theory, a perspective of social constructivism as a theoretical framework, the article attempts to establish the relationship between the securitisation of Somali refugees and refugee camps and refoulement as a measure to counter the securitisation. The arguments raised are the speech acts of Kenya’s securitising actors expressed in the terrorism discourse present Somali refugees and refugee camps as existential threats to peace and security in the country. Consequently, their speech acts expressed in the counterterrorism discourse present non-refoulement of the refugees as an existential threat to national security so as to justify, to the targeted audience, the adoption of refoulement, a norm-violating measure, to counter the fear of the threat of terrorism from Somali refugees and refugee camps. Terrorism and counterterrorism in Kenya have, therefore, been “Somalinised”. The conclusion offers ways of preventing the “Somalinisation” of terrorism and counterterrorism in Kenya.

Animating ‘refugeeness’ through vulnerabilities: worthiness of long-term exile in resettlement claims among Somali refugees in Kenya

AbstractRefugees are generally viewed as a transitory problem. In many African countries, however, protracted refugee situations have turned the temporary refugee state into a more or less permanent phenomenon. In this article, I draw on the concept of uncertainty, and on claims that suspicion structures humanitarianism, to examine how long-term residents in Dagahaley refugee camp in Kenya attempted to make themselves worthy of being considered for resettlement. I demonstrate how the incompatibility between the UNHCR's resettlement criteria and Somali refugees’ lived realities provided both sets of actors with a resource: they used understandings of vulnerability as a means for making or denying resettlement claims. Refugeeness is a process of becoming, premised on how earlier arrivals deployed long-term suffering as a justification for being prioritized for resettlement. These dynamics resulted in the emergence of ‘new’ and ‘old’ refugee distinctions through which the meanings of vulnerability were redefined.