Article Text
Abstract
Introduction In 2015, among 65.3 million displaced worldwide were 1.53 million people displaced from Burma, awaiting re-settlement. Primary care practitioners (PCP) in settlement areas of Melbourne, Australia, have limited understanding of reproductive health literacy of refugees from Burma. Prior to migration they face significant human rights violations creating a culture of silence, and have no experience of informed decision making or voluntary consent. Based on this need articulated by PCP, we examined factors affecting sexual health literacy, to determine areas of priority and potentially effective strategies for delivering sexual health education to this refugee group.
Methods We conducted 27 semi-structured interviews on sexual health consultations with PCP involved with refugees from Burma. A conceptual framework based on principles of “humanization”, and “sustainable development” underpinned interview guide development. Interviews were audio-recorded and transcribed. Content and thematic analysis followed independent coding and consensus discussion by team members.
Results Preliminary analysis suggests that although people from Burma originate from the same country, their diverse cultural and linguistic backgrounds impacts the entire spectrum of reproductive health related literacy. Knowledge of people who had lived in the plains appeared greater compared to people from hills or remote areas. Time in refugee camps and access to schooling also affects health literacy. All PCP prioritised winning the trust of patients over preventive health endeavours. PCP noted that Burmese refugees were not embarrassed by sexual health discussions and were eager to learn about it. Finally, ‘word of mouth’ was the most effective health engagement strategy. Actively involving clients in communication activities such as using drawings of reproductive organs to stimulate discussions were helpful.
Conclusion Health education delivered using culturally appropriate strategies focusing on patient engagement will definitely improve the uptake of reproductive health services.