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"Human rights workers Interviews."
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Nothing to lose but our fear
\"Our 24/7 lives are saturated with round-the-clock fear. Scare-tactic headlines fill our homes and our public spaces. If it's not the war on terror, it's the new war on the middle class. Crisis is the new black, as catastrophe after casualty after crash shape the order of the day. We Have Nothing to Lose but our Fear delivers a counter blow to this rampant culture of fear fuelled by the likes of CNN, FOX and the Daily Mail. Exploring contemporary and historical manifestations of this controlling force, the conversations in this collection go beyond just scrutinizing what constitutes rational versus irrational fear, or identifying ways in which human fears are manipulated by political players. They reveal how fear antagonizes and changes our subjectivity and crucially, how the political use of fear has been resisted in different times and places, by different people across the globe\"--Back cover.
Experiences of gender-based violence among female sex workers, men who have sex with men, and transgender women in Latin America and the Caribbean: a qualitative study to inform HIV programming
by
Evens, Emily
,
Dayton, Robyn
,
Drago, Marta
in
Acquired immune deficiency syndrome
,
Adult
,
Aggression
2019
Background
Female sex workers, MSM, and transgender women—collectively referred to as key populations (KPs)—are disproportionately affected by gender-based violence (GBV) and HIV, yet little is known about the violence they face, its gender-based origins, and responses to GBV. The purpose of this study was to understand the nature and consequences of GBV experienced, to inform HIV policies and programming and to help protect KPs’ human rights.
Methods
Using a participatory approach, FSWs, MSM, and transgender women in Barbados, El Salvador, Trinidad and Tobago, and Haiti conducted 278 structured interviews with peers to understand their experiences of and responses to GBV. Responses to open-ended questions were coded in NVivo and analyzed using an applied thematic analysis.
Results
Nearly all participants experienced some form of GBV. Emotional and economic GBV were the most commonly reported but approximately three-quarters of participants reported sexual and physical GBV and other human rights violations. The most common settings for GBV were at home, locations where sex work took place such as brothels, bars and on the street; public spaces such as parks, streets and public transport, health care centers, police stations and—for transgender women and MSM—religious settings and schools. The most common perpetrators of violence included: family, friends, peers and neighbors, strangers, intimate partners, sex work clients and other sex workers, health care workers, police, religious leaders and teachers. Consequences included emotional, physical, and sexual trauma; lack of access to legal, health, and other social services; and loss of income, employment, housing, and educational opportunities. Though many participants disclosed experiences of GBV to friends, colleagues and family, they rarely sought services following violence. Furthermore, less than a quarter of participants believed that GBV put them at risk of HIV.
Conclusions
Our study found that across the four study countries, FSWs, MSM, and transgender women experienced GBV from state and non-state actors throughout their lives, and much of this violence was directly connected to rigid and harmful gender norms. Through coordinated interventions that address both HIV and GBV, this region has the opportunity to reduce the national burden of HIV while also promoting key populations’ human rights.
Journal Article
Dualist Land Regime, the Hukou System and the Welfare of Migrant Workers in Chinese Cities
2024
Why is China's household registration system so resilient, and why are migrant workers consistently excluded from equal urban welfare? By disaggregating the hukou and land components of the rural–urban dualist regime, this article argues that dualist land ownership, formalized in China's 1982 Constitution, perpetuates the hukou system and unequal welfare rights. On the one hand, dualist land ownership results in an abundance of low-cost, informal housing in urban villages. This reduces the cost of short-term labour reproduction and diminishes migrants’ demands for state-defined urban rights. On the other hand, dualist land ownership enables local governments to amass significant revenues from land sales. The prominence of land-based revenues prompts local governments to link urban welfare rights with formal property ownership and residency, obstructing substantive reforms to the hukou system. For comparison, this article highlights Vietnam, a communist country with a unitary land ownership system, which has made greater strides in reforming its household registration system.
Journal Article
Stigma, violence and HIV vulnerability among transgender persons in sex work in Maharashtra, India
2017
Among marginalised groups in India, HIV prevalence is highest among transgender persons; however, little is known about their HIV vulnerability. This study describes transgender sex workers' experiences of stigma and violence, a key driver of the HIV epidemic, and explores their coping responses. In-depth interviews were conducted with 68 respondents in Maharashtra state, India. Findings show that respondents face pervasive stigma and violence due to multiple marginalised social identities (transgender status, sex work, gender non-conformity), which reinforce and intersect with social inequities (economic and housing insecurity, employment discrimination, poverty), fuelling HIV vulnerability at the micro, meso and macro levels. Several factors, such as felt and internalised stigma associated with psycho-social distress and low self-efficacy to challenge abuse and negotiate condom use; clients' power in sexual transactions; establishing trust in regular partnerships through condomless sex; norms condoning violence against gender non-conforming persons; lack of community support; police harassment; health provider discrimination and the sex work environment create a context for HIV vulnerability. In the face of such adversity, respondents adopt coping strategies to shift power relations and mobilise against abuse. Community mobilisation interventions, as discussed in the paper, offer a promising vulnerability reduction strategy to safeguard transgender sex workers' rights and reduce HIV vulnerability.
Journal Article
Health and social impacts of California wildfires and the deficiencies in current recovery resources: An exploratory qualitative study of systems-level issues
2021
Wildfires in California have become more deadly and destructive in recent years, and four of the ten most destructive fires occurred in 2017 and 2018. Through interviews with service providers, this article explores how these recent wildfires have impacted surrounding communities and the role various recovery resources have played in responding to the short- and long-term health and social needs of survivors.
Using a purposive sampling methodology, we interviewed 21 health and social service personnel who assisted in wildfire recovery efforts in California in 2017 and 2018. The study participants worked or volunteered in medical facilities, social services agencies and philanthropy/nonprofit organizations located in communities affected by wildfires. Participants were asked about three common, overarching themes that fire-impacted communities navigate post-disaster: health issues, social issues, and response and recovery resources. Inductive coding was used to identify common subthemes.
The two most frequently discussed social issues during interviews were housing and employment access. Mental and emotional well-being and access to health resources were identified as being the most challenging health concerns that survivors face post-disaster. Participants also identified the following private and public recovery resources that survivors use to attempt to restabilize following the fire: community support, county agencies, the Federal Emergency Management Agency (FEMA,) insurance companies and philanthropic organizations. However, participants noted that the cumulative impacts of these efforts still leave many of their patients and clients without the resources needed to restabilize emotionally, financially and physically. Finally, participants spoke about the community-wide, downstream impacts of wildfires, noting that \"survivors\" are not only those whose health is immediately compromised by the disaster.
Given the worsening wildfire seasons in California, we must increase our understanding of both the scope of the health and social issues that survivors navigate following a disaster, as well as the effectiveness and sustainability of recovery resources available to survivors. We must also understand the \"ripple effect\" that wildfires have on surrounding communalities, impacting housing access, social services, and health care access. More research and support, especially during the current COVID-19 pandemic, is urgently needed to improve our ability to support the health and social needs of wildfire survivors in the future.
Journal Article
Patient‐centred care is a way of doing things: How healthcare employees conceptualize patient‐centred care
by
Hill, Jennifer N.
,
Fix, Gemmae M.
,
VanDeusen Lukas, Carol
in
Analysis
,
Biopsychosocial aspects
,
Concept formation
2018
Background Patient‐centred care is now ubiquitous in health services research, and healthcare systems are moving ahead with patient‐centred care implementation. Yet, little is known about how healthcare employees, charged with implementing patient‐centred care, conceptualize what they are implementing. Objective To examine how hospital employees conceptualize patient‐centred care. Research Design We conducted qualitative interviews about patient‐centred care during site four visits, from January to April 2013. Subjects We interviewed 107 employees, including leadership, middle managers, front line providers and staff at four US Veteran Health Administration (VHA) medical centres leading VHA's patient‐centred care transformation. Measures Data were analysed using grounded thematic analysis. Findings were then mapped to established patient‐centred care constructs identified in the literature: taking a biopsychosocial perspective; viewing the patient‐as‐person; sharing power and responsibility; establishing a therapeutic alliance; and viewing the doctor‐as‐person. Results We identified three distinct conceptualizations: (i) those that were well aligned with established patient‐centred care constructs surrounding the clinical encounter; (ii) others that extended conceptualizations of patient‐centred care into the organizational culture, encompassing the entire patient‐experience; and (iii) still others that were poorly aligned with patient‐centred care constructs, reflecting more traditional patient care practices. Conclusions Patient‐centred care ideals have permeated into healthcare systems. Additionally, patient‐centred care has been expanded to encompass a cultural shift in care delivery, beginning with patients' experiences entering a facility. However, some healthcare employees, namely leadership, see patient‐centred care so broadly, it encompasses on‐going hospital initiatives, while others consider patient‐centred care as inherent to specific positions. These latter conceptualizations risk undermining patient‐centred care implementation by limiting transformational initiatives to specific providers or simply repackaging existing programmes.
Journal Article
Essential elements of a community empowerment approach to HIV prevention among female sex workers engaged in project Shikamana in Iringa, Tanzania
by
Likindikoki, Samuel
,
Muraleetharan, Ohvia
,
Shembilu, Catherine
in
Capacity building approach
,
combination HIV prevention
,
Community
2020
Globally, female sex workers bear a disproportionate burden of HIV, with those in sub-Saharan Africa being among the most affected. Community empowerment approaches have proven successful at preventing HIV among this population. These approaches facilitate a process whereby sex workers take collective ownership over programmes to address the barriers they face in accessing their health and human rights. Limited applications of such approaches have been documented in Africa. We describe the community empowerment process among female sex workers in Iringa, Tanzania, in the context of a randomised controlled trial of a community empowerment-based model of combination HIV prevention. We conducted 24 in-depth interviews with participants from the intervention community and 12 key informant interviews with HIV care providers, police, venue managers, community advisory board members and research staff. Content analysis was employed, and salient themes were extracted. Findings reveal that the community empowerment process was facilitated by the meaningful engagement of sex workers in programme development, encouraging sex worker ownership over the programme, providing opportunities for solidarity and capacity building, and forming partnerships with key stakeholders. Through this process, sex workers mobilised their collective agency to access their health and human rights including HIV prevention, care and treatment.
Journal Article
Discrimination and violence against women migrant workers in Thailand during the COVID-19 pandemic: A mixed-methods study
2024
Women migrant workers are vulnerable to discrimination and violence, which are significant public health problems. These situations may have been intensified during the COVID-19 pandemic. This study aimed to investigate discrimination against women migrant workers in Thailand during the COVID-19 pandemic and its intersection with their experiences of violence and associated factors.
A mixed-methods study design was employed to collect data from 572 women migrant workers from Myanmar, Lao People's Democratic Republic, and Cambodia. Face-to-face interviews were conducted with 494 participants using a structured questionnaire for quantitative data, whereas qualitative data was collected through 24 in-depth interviews and focus group discussions with 54 migrant women. Simple and multiple logistic regression and content analysis were employed.
This study found that about one in five women migrant workers experienced discrimination during the COVID-19 pandemic. Among those who experienced discrimination, 63.2% had experienced intimate partner violence and 76.4% had experienced non-intimate partner violence in their lifetime. The multivariable analysis revealed that women migrant workers who had experienced any violence (AOR = 2.76, 95% CI = 1.49, 5.12), lost their jobs or income during the pandemic (AOR = 3.99, 95% CI = 2.09, 7.62), and were from Myanmar (AOR = 4.68, 95% CI = 1.79, 12.21) were more likely to have experienced discrimination.
The results suggest that the intersection of discrimination and violence against women migrant workers in Thailand demands special interest to understand and address the problem. It is recommended that policymakers provide interventions and programs that are inclusive and responsive to the unique needs of women migrants depending on their country of origin and job profile.
Journal Article
A qualitative study into female sex workers’ experience of stigma in the health care setting in Hong Kong
2019
Background
Hong Kong has gained a good reputation for its quality public health care services. However, there is a growing recognition that social stigma is a potential obstacle when female sex workers (FSWs) access health care services. There are a lack of studies focusing on how FSWs experience and cope with stigma when accessing health care services in Hong Kong.
Objective
This study aims to explore how FSWs experience stigma and develop coping strategies when accessing health care services in Hong Kong.
Methods
This is a qualitative interview study. Staff of non-governmental organizations (NGOs) that serve sex workers in Hong Kong facilitated the process of recruiting the participants. In-depth individual interviews were conducted with 22 FSWs, focusing on their experiences of stigma and coping strategies when accessing health care services. A directed content analysis approach was adopted to analyze the data.
Results
The interview data can be grouped into three themes: experience of stigma in the health care setting; coping with the stigma of sex work; and the call for non-judgmental holistic health care.
Conclusion
This study contributes to an understanding of the experience of stigma and stigma coping strategies of FSWs when accessing health care services in Hong Kon
g. stigma
remains an important issue for a large proportion of FSWs when they seek timely professional help, openly disclose their sex work identity, and receive comprehensive health care services. The study also highlights the need to address multiple healthcare needs of FSWs beyond STDs. Moreover, the study contributes to increasing awareness of, and respect for, the human right of FSWs to receive non-discriminatory health services.
Journal Article
Impaired health in working children: a critical ethnography
by
Jafari, Haleh
,
Nayeri, Nahid Dehghan
,
Nasrabadi, Alireza Nikbakht
in
Abused children
,
Adolescent
,
Anthropology, Cultural
2024
Child labor is one of the important social issues that deprive children of many fundamental rights, and make them face many problems and consequences, including health problems. Thus, this study was conducted with the aim of examining the health of working children in Tehran. This is an ethnographic study that was conducted using Carspecken’s approach and was completed in 2022. The main participants of this study included working children aged 10–18 years living in Tehran. In order to collect information, the researcher was present at the workplace, school, and living places of working children for more than two years, observing their lives and activities. Formal and informal interviews were also conducted with the working children and informed people. In total, hundreds of working children were assessed and observed in this research. A friendly conversation was formed between the researcher and more than 50 children, and official interviews were conducted with six of the working children. Also, more than 10 official interviews were conducted with informed people and parents of working children. In addition to observations and interviews, documents such as medical records and drawings of working children were also examined and interpreted. The information obtained from observations, interviews, and documents was entered into MAXQDA software, and its raw codes were extracted. The high-level codes as well as sub and main categories were formed from the aggregation of low-level codes. Impaired health was formed from three subcategories of tormented body (work and environmental trauma, sexual abuse, malnutrition, fatigue, sleep disorder and inadequate hygiene), disquieted mind (anxious children, depression and isolation, reduced self-esteem and unfocused mind) and disrupted sociability (negative social role modeling, aggression and violence, stubbornness and vindictiveness, harassment and nuisance, reprehensible social behaviors, neglecting others’ ownership, disturbed relationships and out-group self-censorship). The results of the present study showed that the health of working children is compromised in various physical, psychological, and social ways. Therefore, some measures should be taken at the national and international levels to improve their health, such as revising the existing laws regarding children and informing children of their rights.
Journal Article