In The Democratic Contradictions of Multiculturalism, Jens-Martin Eriksen and Frederik Stjernfelt elaborate on the concept of “culturalism.” In Telos 163 (Summer 2013), Eriksen continues to analyze its intricacies under the heading “Culturalism: When the Culture becomes Political Ideology.”2 Horizontal class divisions are out, vertical cultural barriers are in. Seemingly, culture has squeezed out all other concepts. The present essay shall broaden this discussion by asking the question: What is the relation between the Counter-Enlightenment of the early nineteenth century and today's culturalism?

BACKGROUND: Experiences from the COVID-19 pandemic may help to better understand resilience, competences and skills for healthcare providers and the healthcare system. Within sexual and reproductive health inequalities for migrants exist and it is an area where promoting both cultural competency and healthcare equity in the clinical encounter is expected of healthcare providers yet can create tension. The aim is to explore healthcare providers experiences of encounters with migrants in the context of the pandemic and the subsequent changes in routines and norms.

METHODS: A qualitative study based on semi-structured interviews with 31 healthcare providers working in sexual and reproductive healthcare in southern Sweden. Interviews were conducted during the COVID-19 pandemic influencing how healthcare providers reflected on their experiences. Analysis was done using reflexive thematic data analysis.

FINDINGS: Healthcare providers reflected on how changes in routines increased the understanding of challenges and enablers in the intercultural encounter including the impact on communication and role of relatives and male partners. They emphasized the dynamics of culture in the clinical encounter and healthcare system through highlighting the importance of structural awareness, self-reflection and the flexibility of conducts and norms, often given a cultural connotation.

CONCLUSION: The COVID-19 pandemic resulted in changes of previously established routines directly affecting clinical encounters, which provided a unique opportunity for healthcare providers to reflect, with communication and self-reflection being discussed as central in complex encounters. It highlighted the dynamics of presumed deeply rooted cultural norms and the interplay with social factors affecting healthcare providers and patients alike.

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.

An increasing number of contemporary research publications acknowledge the influence of religion and culture on sexual and reproductive behavior and health-care utilization. It is currently hypothesized that religious influences can partly explain disparities in sexual and reproductive health outcomes. In this paper, we will pay particular attention to Muslims in sexual and reproductive health care.Successful outcomes in sexual and reproductive health of Muslims require both researchers and practitioners to acknowledge religious heterogeneity and variability, and individuals' possibilities to negotiate Islamic edicts. Failure to do so could lead to inadequate health-care provision and, in the worst case, to suboptimal encounters between migrants with Muslim background and the health-care providers in the receiving country.

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.

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.

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

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.

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.

This article argues that multiculturalism, as an ideology, is a problem when it comes to understanding Islam and Muslims in contemporary Sweden. The ideology, which is built upon powerful norms that demand acceptance and tolerance of the Muslim Other, forms an ideational structure that makes Swedish scholars describe all Muslim individuals and groups in terms of Blue-and-Yellow Islam (the colors of the Swedish flag). In the article, with the help of empirical examples mainly from Sweden, it will be shown how the politically good intention to include Muslims and Islam in a new imagined community may have the consequence of silencing social processes among Muslims that would hamper integration. The notion of Blue-and-Yellow Islam has no fixed content. It is an empty signifier used in the ideological struggle of Muslims against Islamophobia. However, scholars use this category in a way that neglects the real problems for Muslims and thus they are creating a situation that has serious consequences for policymaking. The knowledge produced may seem morally/politically correct, but in the end it may be counterproductive for the integration of Islam and Muslims in the Swedish nation-state.

Discussion of the pluralistic paradox of being culturally different while at the same time being an equal member of the majority society.

Discussion of how young Muslims in Sweden re-think Islam in a Swedish context.

Analysis of how ethnic enclavisation challenges the sovereignty of the nation-state.

A critique of the reductionist argument that explains ethnic and/or religious segregation only in terms of discrimination/xenophobia.

Ethnic segregation

Diskussion om individualistiska respektive kollektivistiska strategier att hantera och förstå psykisk ohälsa.

A discussion of Islamic activism and its pros and cons in segregated neighbourhoods.

An analysis of how multiculturalism is used by Islamists in order to mobilize politically for Islam.

In this article I argue that the strategy to conduct dialogue and cooperation with self-appointed Muslim leaders has unintended consequences. These leaders are often part of the Islamic/Islamist movement and these have as a political goal to separate Muslims from the non-Muslim majority population.

Discussion of ethnic enclavisation and de-industrialisation in the city of Malmö, Sweden.

Review of "Islam in Denmark - the challenge of diversity" / edited by Jørgen S. Nielsen, Lexington Books, c2011, ISBN 978-0739150924

Description of how an individual Islamist (male) are integrated in a transnational political network.

The article discusses ideological and social problems with political Islam. It is argued that moderate Islamism builds on a totalitarian thinking with a political goal to establish a parallell Islamic sphere in European societies. It is also discussed that statements like these are omitted from mainstream research of Islam.

Inledning till temanummer i Socialvetenskaplig tidskrift (nr 3-4/2009) om religion och social förändring.

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.

In this paper, we discuss traditional Somali concepts of mental ill health.Qualitative interviews were conducted with some 20 Swedish Somali interviewees about factors causing mental ill health, traditional classification, strategies to deal with mental ill health, and attitudes to the mental health care services in Sweden. Social mobilisation and religious healing are cornerstones of traditional Somali measures to deal with mental suffering. Traditional Somali views of mental ill health stand in stark contrast to classification of mental ill health in the western biomedical model. These views deserve attention since they may have an impact on health-seeking behaviour among Somali immigrants in western countries. Yet a too strong focus on cultural aspects may over-shadow the fact that much mental suffering among Somali migrants must be understood within social, economic, and political contexts.

To explore attitudes toward female genital cutting (FGC) in a migration perspective, qualitative interviews were conducted with men and women from Ethiopia and Eritrea in Sweden. We found firm rejection of all forms of FGC and absence of a guiding motive. Informants failed to see any meaning in upholding the custom. We conclude that children of Ethiopian or Eritrean parents resident in Sweden run little risk of being subjected to FGC. A societal structure prepared to deal with suspected cases of FGC with a high level of alertness should be combined with a healthy sceptical attitude toward exaggerations of risk estimates.

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.

In the present paper, the objective is to investigate if multiculturalism is good for children. The method is to use secondary sources, as well as current examples from Swedish society, to show how multiculturalist policies have negative consequences for minority children's rights. The paper, as well as previous research, reveals that parents of immigrant origin often forbid children to attend school activities such as camps, gymnastics, swimming, and lessons in music and religion. Parents motivate their actions with reference to their traditions and religion, and a fear that their children might learn sexual immorality. The wishes of parents are accepted by schools because of the prevailing multiculturalist policy in Sweden. The result shows that by not attending schools activities like other children, these children will be disqualified for higher education as they do not get grades in all disciplines due to their absence. Furthermore, it is argued in the paper that the prohibitions by their parents violate the rights of these children. The policy of equal treatment is transformed into a practice of unequal treatment of children with immigrant origin. The conclusion of this policy analysis suggests that this approach is not in the best interest of the child and is a case of real discrimination.