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Table 1 Summary of information from reviewed articles

From: A review of the literature on sexual and reproductive health of African migrant and refugee children

Author name and year of publication Title Summary of findings
Agbemenu, K., M. Hannan., J. Kitutu., M. A. Terry., and W. Doswell. 2017. [6] “Sex will make your fingers grow thin and then you die”: The interplay of culture, myths, and taboos on African immigrant mothers’ perceptions of reproductive health education with their daughters aged 10–14 years (1) Mothers in this study were from cultures that did not condone premarital sex—or boy-girl relationships in adolescence. Although it might appear contradictory, as per conversation with the mothers, an element of protectiveness was to be open with their daughters. Because of the perceived permissiveness of sexual behaviours in America, mothers articulated a desire to ward off negative consequences of sexual activity by providing reproductive health education early when daughters were at a younger age and not limit conversations initiated by daughters
(2) Myths and taboos about sexual issues are widespread in Africa and are propagated to control sexual behaviour, especially that of unmarried people, particularly women
Åsander, A., A. Björkman., E. Belfrage., and E. Faxelid. 2009. [7] HIV-infected African parents living in Stockholm, Sweden: Disclosure and planning for their children’s future In Sweden, the majority of HIV-infected parents are of African origin and despite the introduction of ARV medication, there has been no tendency for disclosures to children to increase. The fear of a double stigma—that of being both an immigrant and HIV infected—is likely the main barrier to the disclosure of HIV infection. HIV-infected immigrants’ custody arrangements for their children remain critical because of their lack of immediate access to family members
Stark, L., K. Asghar., G. Yu., C. Bora., A. A. Baysa., and K. L. Falb. 2017. [8] Prevalence and associated risk factors of violence against conflict–affected female adolescents: a multi–country, cross–sectional study (1) Approximately half of the adolescent girls in the sample (54.4% in DRC, 50.5% in Ethiopia) reported experiencing at least one form of violence victimization in the previous 12 months. (2) The prevalence of physical, emotional, and/or sexual violence victimization among adolescent girls (51.62%) is similar to the regional prevalence of the past year’s violence estimated from census data of girls and boys aged 2–14 (50%) and 15–17 (51%) in Africa. Females are at the highest risk for violence during adolescence and persistent gaps in knowledge of violence victimization have, to date, limited the humanitarian community’s ability to appropriately respond to and prevent violence against adolescent girls in these contexts
Bermudez, L., L. Parks., S. R. Meyer., L. Muhorakeye., and L. Stark. 2018. [9] Safety, trust, and disclosure: A qualitative examination of violence against refugee adolescents in Kiziba Camp, Rwanda (1) Adolescent respondents noted food insecurity and unemployment as factors that hindered their sense of safety and security. (2) Lack of sufficient housing (overcrowding) were routine protection risks faced in the camp, which could lead to sexual abuse. (3) The fear of punishment or a general feeling that caregivers dismiss adolescent claims of abuse made adolescents less willing to disclose violence or abuse to their caregivers and seek support. (4) The social consequences of disclosing abuse using the formal reporting and referral process are the reason for low utilization of SRH services in refugee camps
Busza, J., S. Mtetwa., P. Chirawu., and F. Cowan. 2014. [10] Triple jeopardy: Adolescent experiences of sex work and migration in Zimbabwe Mobility was routine throughout childhood due to family instability and economic hardship. The determinants of mobility, e.g. inability to pay school fees or a desire for independence from difficult circumstances, also catalyzed entry into sex work, which then led to further migration to maximize income. Respondents described their adolescence as a time of both vulnerability and opportunity during which they developed survival skills
Gaspar de Matos, M., T. Gaspar., B. Simons-Morton., B. Reis., and L. Ramiro. 2008. [11] Communication and information about “safer sex”: intervention issues within communities of African migrants living in poorer neighborhoods in Portugal (1) African adolescents tend to begin sexual life early, use condoms infrequently, and have more difficulties in talking with parents about sex. (2) There are cultural-specific educational needs of African migrant adolescents. Boys and girls agreed that condom use decision making is the preserve of the male, and girls viewed even unprotected sex better than not being cared for. Some girls indicated that getting pregnant young was normative. (3) Both parents and adolescents expressed inhibition and lack of interest in talking to each other about sex and related issues. Both adolescents and parents think parents were poorly informed about sex-related issues to allow open discussion. Sexuality and HIV were considered taboo themes for parents and adolescents
Iyakaremye, I., and C. Mukagatare. 2016. [12] Forced migration and sexual abuse: experience of Congolese adolescent girls in Kigeme refugee camp, Rwanda Rape, unwanted physical touching, sexual exploitation, commercial sex, early marriage, and girl trafficking are the main forms of sexual abuse and exploitation. These are facilitated by the miserable life in the camp, shortcomings in the camp layout and security system, and adolescent developmental stage. They negatively impact girls’ reproductive health, social integration, and mental health
Kunnuji, M., S. Adejoh., U. Esiet., and A. A. Esiet. 2013. [13] Migration status, reproductive health knowledge and sexual behaviour among female out-of-school adolescents in Iwaya community, Lagos, Nigeria (1) Migrants are less knowledgeable about HIV and AIDS. Reasons for the observed differentials in knowledge of HIV/AIDS are found in the social exclusion theory which recognizes migrant status as a basis for social exclusion. Migrants may be disadvantaged because they cannot speak local languages well. It is not uncommon, for example, to find situations where information about HIV and AIDS is made available to people in local languages to ensure that most comprehend the messages. (2) Generally, awareness of contraceptive methods was very low among the participants. The methods most known by the participants were male condom and pills which were known to 29 and 10% of the participants respectively
Lay, M., and I. Papadopoulos. 2009. [14] Sexual maltreatment of unaccompanied asylum-seeking minors from the Horn of Africa: A mixed method study focusing on vulnerability and prevention A range of sexual maltreatment, including sexual harassment and rape was reported. Three-quarters of the participants experienced more than one incident. Most initial incidents happened in the first 12 months of their arrival in the UK. Two perpetrators were female carers. Many participants reported being groomed and sexually maltreated by people from their own country. Many described being seriously sexually maltreated, particularly by groups of young males living in the same accommodation or nearby, some reportedly also asylum seekers. Participants that had been warned of the dangers of sexual maltreatment were more likely to both disclose and to seek professional help
Macipe-Costa, R., N. García-Sanchez., L. A. Gimeno-Feliu., B. Navarra-Vicente., J. M. Jiménez-Hereza., I. Moneo-Hernández and P. Lobera-Navaz. 2014. [15] Non-therapeutic male circumcision performed on immigrant children from Africa in Spain There is non-therapeutic male circumcision among the African immigrant population in Spain. Half (49.1%) of the families who had the circumcision performed in Europe did so at home. The individuals who performed these circumcisions were not health professionals in 84.6% of the cases. Almost all the parents of uncircumcised children had the intention of circumcising them in the future, mostly in their countries of origin
Mberu, B., and M. J. White. 2011. [16] Internal migration and health: Premarital sexual initiation in Nigeria (1) Urban–rural migration is a route of transmission as urban migrants returning to rural areas infect their partners with HIV/AIDS. (2) Migrants with previous exposure to urban environments have an increased likelihood of high-risk sexual behaviour in rural areas. (3) Living arrangements and livelihood opportunities that give young people the most physical and financial independence from their parents and relatives expose them to a significant risk of premarital sexual initiation
Mitike, G., and W. Deressa. 2009. [17] Prevalence and associated factors of female genital mutilation among Somali refugees in eastern Ethiopia: a cross-sectional study The practice of Female Genital Cutting (FGC) in many societies is considered an obligatory social and traditional norm mainly to maintain virginity and sexual chastity and to reduce and control female sexuality
Odger, A., S. Frohlick, and R. Lorway. 2019. [18] Re-assembling “risky” subjects: African migrant youth in Winnipeg, Canada The study identified three trajectories of sexual health messaging in which African immigrant and refugee young women encountered different formations of messaging while living in Winnipeg and travelling between home, school, and university: trajectories of ubiquity, of events and incidents, and of racialized bodies. (1) The first trajectory traced how multiple factors—particularly immigration— shaped how and where interlocutors understood the concept of sexual health, and the visibility of specific issues (i.e., HIV/AIDS, pregnancy, STIs) was largely dependent on the context, emphasizing the everyday nature of sexual health messaging. (2) The second builds upon this ubiquity of sexual health messages by focusing on key moments in their lives that illustrate how risk is actively made in concrete events and incidents along trajectories. (3) The last examines how sexual health messages targeting particular bodies are negotiated and reworked through the experiences and perspectives of young newcomers seeking belonging in places of settlement always against the way they are racialized in the city of Winnipeg
Ortiz-Echevarria, L., M. Greeley., T. Bawoke., L. Zimmerman., C. Robinson., and J. Schlecht. 2017. [19] Understanding the unique experiences, perspectives and sexual and reproductive health needs of very young adolescents: Somali refugees in Ethiopia (1) Adolescents demonstrated relatively high comfort with body change during puberty. Both male and female very young adolescents (VYA) identified menstruation, hair growth, breast development, and voice change as signs of becoming an adult. Participants shared that they learned sexual reproductive health information primarily from parents, but also from siblings, peers, and religious leaders. (2) Early marriage was a widely expressed concern among VYAs, particularly among young girls. In general, boys have more opportunities to pursue their education and personal development than girls of similar ages due to community expectations around marriage. (3) While there is wide recognition that male and female roles have been changing since displacement, cultural patterns persist that reinforce inequitable relations between boys and girls in early adolescence
Patel, S., H. Muyinda., N. K. Sewankambo., G. Oyat., S. Atim., and P. M. Spittal, 2012. [20] In the face of war: examining sexual vulnerabilities of Acholi adolescent girls living in displacement camps in conflict-affected Northern Uganda (1) The erosion of traditional mentoring systems and cultural norms that previously governed girls’ sexual behaviour and provided cultural cohesion and guidance in supporting and protecting young girls from risky behaviours; these systems and norms have largely been eroded by war-induced displacement. (2) Combined with the collapse of livelihoods, being left in camps unsupervised and idle during the day, commuting within camp perimeters at night away from the family hut to sleep in more central locations due to decreased privacy, and heightened security issues have a direct influence on the girls’ vulnerability in refugee camps
Schlecht, J., E. Rowley., and J. Babirye. 2013. [21] Early relationships and marriage in conflict and post-conflict settings: vulnerability of youth in Uganda Marriage was defined as any union accepted by the community to be “marriage”, excluding courtship and dating. Participants distinguished between formalized marriage (which included traditional or religious ceremonies and the exchange of a bride price) and informal marriages acknowledged by the community over time. This research did not explicitly explore forced marriage. The increased practice of early relationships among adolescents, combined with the expansion of informal marriages, was a theme that was consistent throughout interviews in both focus group discussion and in-depth interview settings
Sommer, M., M. Muñoz-Laboy., A. Williams., Y. Mayevskaya., K. Falb, G. Abdella., and L. Stark. 2018. [22] How narratives of fear shape girls’ participation in community life in two conflict-affected populations It is difficult for caregivers to talk to their daughters about pubertal development and sex and to have practical discussions on preventing sexual violence. In the absence of having adequate communication tools for such topics, caregivers described obtaining cues about their daughter´s physical and social maturation-related experiences by observing changes in their bodies
Sommer, M., M. Munoz-Laboy., W. E. Salamea, J. Arp., K. L. Falb., N. Rudahindwa., and L. Stark. 2018. [23] How gender norms are reinforced through violence against adolescent girls in two conflict-affected populations The study findings provide insights into primarily female attitudes towards experiences of, rationales for, and approaches for risk reduction and response to gender-based violence occurring at the community and interpersonal levels. Overall, female perceptions of safety for adolescent girls were socially produced through girls’ everyday interpersonal interactions, including community and family perceptions of who is responsible for safety and local perceptions of appropriate (or socially inappropriate) responses to violence
Thommessen, S., P. Corcoran., and B. K. Todd. 2017. [24] Voices rarely heard: Personal construct assessments of Sub-Saharan unaccompanied asylum-seeking and refugee youth in England Social support, social connectedness, and meaningful social relationships, or sometimes the lack thereof, are important in enabling asylum seeking and refugee groups to resettle in their home countries
Vogt, S., C. Efferson., and E. Fehr. 2017. [25] The risk of female genital cutting in Europe: Comparing immigrant attitudes toward uncut girls with attitudes in a practicing country Sudanese immigrants in Switzerland have systematically more positive attitudes toward uncut girls than non-migrants and selective migration from Sudan likely contributes to this difference; migrants vary in their support for female genital cutting
Warria, A. 2018. [26] Challenges in assistance provision to child victims of transnational trafficking in South Africa In as much as it is necessary to acknowledge that trafficked children need to grow up in a safe and secure environment, it is also necessary to address the service provider’s concern that provision for total security might not be possible. At the same time, mechanisms put in place to achieve the children’s safety need not downplay the risks that the trafficker poses, nor take away the child’s carefree and fun experiences of childhood. Culturally responsive care becomes a highly important practise method for a child welfare practitioner when engaging with transnational trafficked children from diverse socio-cultural, linguistic, economic, and ethnic backgrounds. This is because trafficked children’s socio-cultural backgrounds will most likely influence the way they perceive the trafficking situation, their expectations for assistance provision, and how they respond to social work interventions. Thus, part of the practitioner’s role during needs assessment is to gain an understanding of the child’s background and cultural factors that could be affiliated to or that might have contributed to the child being trafficked and those that can be applied during therapy and integration processes
Williams, T. P., Chopra, V., and Chikanya, S. R. 2018. [27] “It isn’t that we’re prostitutes”: Child protection and sexual exploitation of adolescent girls within and beyond refugee camps in Rwanda (1) Stigma negatively played a role for girls who wished to receive services (as seen even when rape occurs). (2) Young people felt deterred from seeking support because they did not have confidence in the support systems that were available to them. There were concerns that accusations of rape would not be taken seriously and that there was a lack of justice. (3) Economic stressors threatened the viability of families. (4) Girls had material needs but few options to meet those needs within the camps. Their families expected them to do domestic work at home. (5) Children reportedly travelled to nearby towns to exchange sex for money or other goods leaving them exposed to HIV, unplanned pregnancies, and STDs