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Eriksson, L., Dudas, V., Carlbom, A. & Essén, B. (2023). Perceived religious discrimination in healthcare. In: Daniel Enstedt, Lisen Dellenborg (Ed.), Culture, Spirituality and Religious Literacy in Healthcare: Nordic Perspectives (pp. 90-107). Routledge
Open this publication in new window or tab >>Perceived religious discrimination in healthcare
2023 (English)In: Culture, Spirituality and Religious Literacy in Healthcare: Nordic Perspectives / [ed] Daniel Enstedt, Lisen Dellenborg, Routledge, 2023, p. 90-107Chapter in book (Refereed)
Abstract [en]

Swedish healthcare providers must comply with the Patient Act's principles of equal and accessible care and account for patients’ religious backgrounds by offering culturally sensitive care. This chapter explores what characterizes patients’ and their relatives’ expectations in healthcare encounters perceived as religiously discriminatory in the diverse Swedish healthcare system. It analyses perceived religious discrimination in healthcare through the interpretative phenomenological analysis of complaints submitted to the Equality Ombudsman in Sweden from 2012 to 2021, which registered 92 complaints as religious discrimination in healthcare, 66 of which were included in this study's analytical sample. The complaints addressed unfulfilled expectations related to cultural and religious literacy, equal treatment in relation to religious symbols or medical records, affirmative action in medical treatment that takes beliefs into account, and a secular environment that forbids religious symbols in healthcare encounters. One-third of the complaints were submitted by Muslims or individuals presumed to be Muslim. Several complaints concerned healthcare providers’ reactions to patients wearing hijabs or other ethnic or religious attributes. The study indicates that healthcare providers face difficulties in conforming to the partially contradictory ideals of equal treatment and cultural sensitivity, whose relation to religious diversity has not yet been clearly defined.

Place, publisher, year, edition, pages
Routledge, 2023
Series
Routledge Advances in the Medical Humanities, ISSN 2767-8121, E-ISSN 2767-8113
National Category
Religious Studies
Identifiers
urn:nbn:se:mau:diva-64254 (URN)10.4324/9781003450573-7 (DOI)2-s2.0-85173859740 (Scopus ID)9781032320540 (ISBN)9781003450573 (ISBN)
Available from: 2023-12-11 Created: 2023-12-11 Last updated: 2023-12-11Bibliographically approved
Carlbom, A. (2021). Islamisk aktivism och konkurrensen om sexuella normer i det mångkulturella samhället (1ed.). In: Pernilla Ouis (Ed.), Sexualitet och migration i välfärdsarbete: (pp. 201-224). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Islamisk aktivism och konkurrensen om sexuella normer i det mångkulturella samhället
2021 (Swedish)In: Sexualitet och migration i välfärdsarbete / [ed] Pernilla Ouis, Lund: Studentlitteratur AB, 2021, 1, p. 201-224Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2021 Edition: 1
Keywords
Islamisk aktivism, konkurrens, normer, sexualitet, relationer
National Category
International Migration and Ethnic Relations
Identifiers
urn:nbn:se:mau:diva-41918 (URN)9789144133720 (ISBN)
Projects
Islamistisk paketering av budskap
Funder
Swedish Civil Contingencies Agency
Available from: 2021-04-20 Created: 2021-04-20 Last updated: 2021-04-21Bibliographically approved
Arousell, J., Carlbom, A., Johnsdotter, S. & Essen, B. (2019). Are 'low socioeconomic status' and 'religiousness' barriers to minority women's use of contraception?: A qualitative exploration and critique of a common argument in reproductive health research. Midwifery, 75, 59-65
Open this publication in new window or tab >>Are 'low socioeconomic status' and 'religiousness' barriers to minority women's use of contraception?: A qualitative exploration and critique of a common argument in reproductive health research
2019 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 75, p. 59-65Article in journal (Refereed) Published
Abstract [en]

Objective: 'Low socioeconomic status' and 'religiousness' appear to have gained status as nearly universal explanatory models for why women in minority groups are less likely to use contraception than other women in the Scandinavian countries. Through interviews with pious Muslim women with immigrant background, living in Denmark and Sweden, we wanted to gain empirical insights that could inform a discussion about what 'low socioeconomic status' and 'religiousness' might mean with regard to women's reproductive decisions. Design: Semi-structured interviews were conducted in Denmark and Sweden between 2013 and 2016. Findings: We found that a low level of education and a low income were not necessarily obstacles for women's use of contraception; rather, these were strong imperatives for women to wait to have children until their life circumstances become more stable. Arguments grounded in Islamic dictates on contraception became powerful tools for women to substantiate how it is religiously appropriate to postpone having children, particularly when their financial and emotional resources were not yet established. Conclusion: We have shown that the dominant theory that 'low socioeconomic status' and 'religiousness' are paramount barriers to women's use of contraception must be problematized. When formulating suggestions for how to provide contraceptive counseling to women in ethnic and religious minority groups in Denmark and Sweden, one must also take into account that factors such as low financial security as well as religious convictions can be strong imperatives for women to use contraception. Implications for practice: This study can help inform a critical discussion about the difficulties of using broad group-categorizations for understanding individuals' health-related behavior, as well as the validity of targeted interventions towards large heterogeneous minority groups in Scandinavian contraceptive counseling. (C) 2019 The Authors. Published by Elsevier Ltd.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Muslim women, Immigrant women, Contraceptive use, Reproductive health, Denmark, Sweden
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Health and society
Identifiers
urn:nbn:se:mau:diva-39195 (URN)10.1016/j.midw.2019.03.017 (DOI)000470962400011 ()31005014 (PubMedID)2-s2.0-85064430894 (Scopus ID)
Available from: 2021-01-15 Created: 2021-01-15 Last updated: 2024-02-05Bibliographically approved
Arousell, J., Carlbom, A., Johnsdotter, S. & Essen, B. (2019). Does Religious Counselling on Abortion Comply with Sweden's 'Women-Friendly' Abortion Policies?: A Qualitative Exploration Among Religious Counsellors (ed.). Sexuality & Culture, 23(4), 1230-1249
Open this publication in new window or tab >>Does Religious Counselling on Abortion Comply with Sweden's 'Women-Friendly' Abortion Policies?: A Qualitative Exploration Among Religious Counsellors
2019 (English)In: Sexuality & Culture, ISSN 1095-5143, E-ISSN 1936-4822, Vol. 23, no 4, p. 1230-1249Article in journal (Refereed) Published
Abstract [en]

The abortion discourse in Sweden is marked by historically liberal ideals about women's inviolable right to make autonomous reproductive decisions. However, to respond to the increase in cultural and religious pluralism building up over several decades, religious organizations have been given opportunities to provide so-called spiritual care in affiliation with Swedish hospitals since the 1980s. In this study we asked: in what ways do religious counsellors, affiliated with Swedish hospitals, construct their ideas on abortion, and how well do their ideas comply with Sweden's 'women-friendly' abortion policies? Through interviews with Protestant, Catholic, Muslim, and Buddhist religious counsellors, we wanted to empirically test the presumption underlying the decisions to grant space to religious actors in Swedish healthcare, i.e., that religious counselling serves to complement existing services. We found that it cannot be expected that religious advice on abortion will always comply with Swedish abortion law and with the women-friendly abortion policy that the Swedish state seeks to impose. When policy-makers open up possibilities for diverse norms on abortion to manifest in close affiliation with healthcare institutions, they must be aware that some religious counsellors argue that only God-and not the woman herself-can decide whether a woman can terminate a pregnancy. We argue that the findings in this study speaks to what researchers have referred to as the "diversity-equality paradox", which highlights the tension between the promotion of religious ideas on abortion on the one hand and the promotion of liberal ideas about women's reproductive freedom on the other.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Abortion, Women's rights, Religious counselling, Diversity promotion, The diversity-equality paradox, Healthcare, Sweden
National Category
Social Sciences
Research subject
Health and society
Identifiers
urn:nbn:se:mau:diva-5220 (URN)10.1007/s12119-019-09614-6 (DOI)000490290000011 ()2-s2.0-85066497279 (Scopus ID)30728 (Local ID)30728 (Archive number)30728 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
Arousell, J., Carlbom, A., Johnsdotter, S. & Essén, B. (2018). Are 'Low Socioeconomic Status' and 'Religiousness' barriers to minority women's contraceptive use in Sweden and Denmark?: A qualitative interrogation of a common argument in health research (ed.). Paper presented at 1st World Congress on Migration, Ethnicity, Race and Health, Edinburgh, UK (17-19 May 2018). European Journal of Public Health, 28(Suppl 1), 121-121
Open this publication in new window or tab >>Are 'Low Socioeconomic Status' and 'Religiousness' barriers to minority women's contraceptive use in Sweden and Denmark?: A qualitative interrogation of a common argument in health research
2018 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl 1, p. 121-121Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: ‘Low socioeconomic status’ and ‘religious barriers’ have been presented as nearly universal explanatory reasons for why minority women are less likely than majority women in Scandinavian countries to use contraception. Recent studies have warned against giving such statistically ‘objective’ theories undue importance in the formulation of clinical recommendations. Drawing on this recent critique, the aim of this study was to qualitatively explore how ‘low socioeconomic status’ and ‘religiousness’ intersect with Muslim minority women’s contraceptive decisions. Methods: Semi-structured interviews were conducted in Denmark and Sweden between 2013 and 2016. Data analysis was inspired by naturalistic inquiry. Findings: We found that a low level of education and low income were not necessarily obstacles for women’s use of contraception, but strong imperatives for women to wait having children until their life circumstances were more stable. Arguments grounded in Islamic dictates on contraception became powerful reasons for women to decide it was religiously correct to postpone having children, in case the financial and emotional resources were not yet at hand. Conclusions: We have shown that the dominant theory about that ‘low socioeconomic status’ and ‘religiousness’ are paramount barriers to minority women’s use of contraception must be challenged. When formulating suggestions for how to provide contraceptive counselling to minority women in Denmark and Sweden, one must also take into account factors such as low financial security as well as religious convictions which can be strong imperatives for women to use contraception. Main messages: The use of broad group-categorisations for understanding individuals’ contraceptive behaviours should be challenged The validity of initiating ‘targeted interventions’ towards large heterogeneous minority groups in Scandinavian contraceptive counselling should be critically discussed

Place, publisher, year, edition, pages
Oxford University Press, 2018
Keywords
Public, Environmental & Occupational Health, contraceptive agents, denmark, socioeconomic factors
National Category
Social Sciences
Research subject
Health and society
Identifiers
urn:nbn:se:mau:diva-5508 (URN)10.1093/eurpub/cky048.028 (DOI)000432430700343 ()2-s2.0-85064430894 (Scopus ID)26566 (Local ID)26566 (Archive number)26566 (OAI)
Conference
1st World Congress on Migration, Ethnicity, Race and Health, Edinburgh, UK (17-19 May 2018)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2023-12-22Bibliographically approved
Arousell, J., Carlbom, A. & Essen, B. (2018). Is multiculturalism bad for swedish abortion care? Exploring the diversity of religious counselling in public healthcare institutions (ed.). Paper presented at 1st World Congress on Migration, Ethnicity, Race and Health, Edinburgh, UK (17-19 May 2018). European Journal of Public Health, 28(Suppl 1), 122-122
Open this publication in new window or tab >>Is multiculturalism bad for swedish abortion care? Exploring the diversity of religious counselling in public healthcare institutions
2018 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl 1, p. 122-122Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Sweden has one of the most liberal abortion laws in the world, granting women extensive rights to make autonomous reproductive decisions. At the same time, Swedish policy-makers are keen to protect society’s religious diversity. This ambition is reflected in decisions to grant religious leaders the possibility to provide ‘spiritual care’ in public hospitals. Through interviews with religious representatives in public healthcare institutions, we asked: In what ways would they counsel a religious woman who is seeking their advice about abortion? And how does this advice correspond with Swedish policies on, and provision of, abortion care? Methods: Individual interviews were conducted with religious representatives of the Swedish Church, the Catholic Church, and the Buddhist and Muslim communities. Interviews took place in 2016 and 2017. Findings: We found that informants saw it as their obligation to provide religious people with abortion advice according to religious norms, giving them limited opportunities to harmonise the content of their counselling with Swedish healthcare laws or regulations. Most informants argued that it was their responsibility to inform women about the wrongdoing of terminating a pregnancy, and to provide suggestions about how women could mitigate the sin in order to gain God’s forgiveness. Conclusion: Informants appeared inclined to deliver religious recommendations on abortion that were more conservative than what is established in the Swedish Abortion Act. Main messages: ‘Spiritual care’ in the question of abortion favours the delivery of religious norms at the possible expense of women’s right to non-judgmental abortion counselling. ‘Spiritual care’ is now an integral part of Swedish healthcare institutions. A critical discussion is needed about the extent to which such services should be in compliance with Swedish laws and public health aims on abortion.

Place, publisher, year, edition, pages
Oxford University Press, 2018
Keywords
Public, Environmental & Occupational Health, abortion, induced, abortion, spontaneous, counseling, cultural diversity
National Category
Social Sciences
Identifiers
urn:nbn:se:mau:diva-4845 (URN)10.1093/eurpub/cky048.031 (DOI)000432430700346 ()26567 (Local ID)26567 (Archive number)26567 (OAI)
Conference
1st World Congress on Migration, Ethnicity, Race and Health, Edinburgh, UK (17-19 May 2018)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2023-12-14Bibliographically approved
Arousell, J., Carlbom, A., Larsson, E., Johnsdotter, S. & Essen, B. (2018). Unintended consequences of gender equality promotion in Swedish contraceptive counselling (ed.). Paper presented at 1st World Congress on Migration, Ethnicity, Race and Health, Edinburgh, UK (17-19 May 2018). European Journal of Public Health, 28(Suppl 1), 105-105
Open this publication in new window or tab >>Unintended consequences of gender equality promotion in Swedish contraceptive counselling
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2018 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl 1, p. 105-105Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Sweden stands out as an interesting example of potential cross-cultural tensions in reproductive healthcare. On the one hand, most people agree that gender equality between men and women should apply to everyone. On the other hand, people in Sweden report a high level of respect for cultural diversity, emphasising people’s ‘right to be different’. The aim of this study was to explore how midwives communicate gender equality perspectives in encounters with non-Western patients, many of whom have migrated from countries expressing less support for gender equality. Methods: Semi-structured individual interviews as well as focus group interviews were conducted in Denmark and Sweden between 2013 and 2016. Carol Bacchi’s ‘What’s the Problem Represented to be’ approach guided the analysis. Findings: We found that it is difficult for health care providers who are ideologically motivated to promote gender equality in clinical encounters, to simultaneously value and tolerate traditions that are considered to uphold gender-unequal structures. The gender equality standard is thus one example of a liberal, egalitarian value that health care providers appeared to give priority to at the expense of others. Conclusions: That the gender equality ideology is given priority is not necessarily undesirable but nevertheless appears to generate unintended consequences. We argue that a high level of ideological persuasion upon female patients may negatively influence their experience of the encounter, and negatively influence women’s possibilities to obtain adequate support in relation to their individual needs. Main messages: Healthcare providers are also part of cultural systems of norms — such as pertinence to gender equality — although these are seldom problematized ‘Reflexivity’ as a working tool can assist healthcare providers to reflect upon how gender equality norms influence clinical encounters.

Place, publisher, year, edition, pages
Oxford University Press, 2018
Keywords
Public, Environmental & Occupational Health, contraceptive agents, counseling, gender, double effect
National Category
Social Sciences
Research subject
Health and society
Identifiers
urn:nbn:se:mau:diva-4952 (URN)10.1093/eurpub/cky047.254 (DOI)000432430700299 ()26569 (Local ID)26569 (Archive number)26569 (OAI)
Conference
1st World Congress on Migration, Ethnicity, Race and Health, Edinburgh, UK (17-19 May 2018)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2023-12-14Bibliographically approved
Mohammadi, S., Carlbom, A., Taheripanah, R. & Essen, B. (2017). Experiences of inequitable care among Afghan mothers surviving near-miss morbidity in Tehran, Iran: a qualitative interview study (ed.). International Journal for Equity in Health, 16
Open this publication in new window or tab >>Experiences of inequitable care among Afghan mothers surviving near-miss morbidity in Tehran, Iran: a qualitative interview study
2017 (English)In: International Journal for Equity in Health, E-ISSN 1475-9276, Vol. 16Article in journal (Refereed)
Abstract [en]

Background: Providing equitable maternal care to migrants is a seriously challenging task for hosting countries. Iran, the second-most accessed country for refugees from Afghanistan, has achieved maternal health improvement. However, Afghan women with near-miss morbidity faced pre-hospital delays and disparity in maternal care at hospitals. This study explores experiences of maternal care among Afghan women surviving near-miss morbidity to increase insight into healthcare improvements for migrants. Methods: A qualitative study was conducted at university hospitals in Tehran, from April 2013 to May 2014. A total of 11 Afghan women and 4 husbands were interviewed when women recovered from near-miss morbidity that occurred around the childbirth period. Mothers were identified prospectively using the WHO maternal near-miss approach. Thematic analysis was used along with a data-driven approach to organize data guided by the 'three delays model' theoretical framework. Results: Mistreatment in the form of discrimination and insufficient medical attention were key experiences. Participants commonly perceived poor women-professional communication and delays in recognizing obstetric complications despite repeated care-seeking. Financial constraints, costly care, lack of health insurance, and low literacy were experienced barriers to accessing care to a lesser extent. Non-somatic consequences of near-miss morbidity affected mothers and families for extended periods. Conclusions: Near-miss survivors' experiences provided remarkable insights into maternal care of Afghans in Iran. The challenge for the health system and professionals is to provide equitable care with dignity and improve communication skills with caring attitudes toward ethnic minorities. Antenatal visits provide the best and most appropriate opportunities to tackle health illiteracy in Afghan women.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Maternal near miss, Care experiences, Afghan migrants, Mistreatment, Discrimination, Iran
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-4359 (URN)10.1186/s12939-017-0617-8 (DOI)000405686600002 ()28687082 (PubMedID)2-s2.0-85022214599 (Scopus ID)23668 (Local ID)23668 (Archive number)23668 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
Carlbom, A. (2017). Jämställdhet versus kulturell mångfald, en svårhanterlig motsättning (ed.). In: Bodil Liljefors Persson, Nils-Åke Tidman (Ed.), Bodil Liljefors Persson, Nils-Åke Tidman (Ed.), Feminism och jämställdhetssträvanden i religioner i världen: (pp. 24-38). : Föreningen lärare i religionskunskap (FLR)
Open this publication in new window or tab >>Jämställdhet versus kulturell mångfald, en svårhanterlig motsättning
2017 (Swedish)In: Feminism och jämställdhetssträvanden i religioner i världen / [ed] Bodil Liljefors Persson, Nils-Åke Tidman, Föreningen lärare i religionskunskap (FLR) , 2017, p. 24-38Chapter in book (Other academic)
Place, publisher, year, edition, pages
Föreningen lärare i religionskunskap (FLR), 2017
Series
Årsbok / Föreningen Lärare i religionskunskap, ISSN 0348-8918 ; 2016/48
Keywords
jämställdhet, mångfald, paradoxer, religion
National Category
Social Sciences
Identifiers
urn:nbn:se:mau:diva-8817 (URN)22902 (Local ID)22902 (Archive number)22902 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2022-06-27Bibliographically approved
Arousell, J., Carlbom, A., Johnsdotter, S., Essén, B. & Larsson, E. C. (2017). Unintended consequences of gender equality promotion in Swedish multicultural contraceptive counseling: a discourse analysis (ed.). Qualitative Health Research, 27(10), 1518-1528
Open this publication in new window or tab >>Unintended consequences of gender equality promotion in Swedish multicultural contraceptive counseling: a discourse analysis
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2017 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 27, no 10, p. 1518-1528Article in journal (Refereed) Published
Abstract [en]

In this article, we explore how reproductive health care providers in Sweden, a country often described as one of the most gender-equal countries in the world, incorporate gender equality ideals in multicultural contraceptive counseling. In the tension between gender equality promotion on one hand and respect for cultural diversity and individualized care on the other, we will demonstrate that values of gender equality were often given priority. This is not necessarily undesirable. Nevertheless, our proposal is that the gender equality ideology may inhibit providers’ ability to think differently about issues at stake in contraceptive counseling, which may negatively influence women’s possibilities to obtain adequate support. At the end of the article, we suggest how health care providers’ reflexivity might be used as a working tool for increased awareness about the taken-for-granted cultural norms that exist in their clinical milieu.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
gender equality, cultural diversity, women, reproductive health, contraceptive counselling, discourse analysis, qualitative method, Sweden
National Category
Social Sciences
Research subject
Health and society
Identifiers
urn:nbn:se:mau:diva-5184 (URN)10.1177/1049732317697099 (DOI)000406057500007 ()28728532 (PubMedID)2-s2.0-85025458385 (Scopus ID)22630 (Local ID)22630 (Archive number)22630 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
Projects
The role of values for equity in sexual and reproductive health: clinical encounters as contentious space in a multicultural society; Uppsala University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-2620-7152

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