To connect between worlds, to bridge over gaps: learning about the complex role of cultural mediators in perinatal health promotion from a case in Israel

Peres, Hagit; Sharaby, Rachel

doi:10.1186/s12939-020-01161-z

Cited by 5 publications

(4 citation statements)

References 36 publications

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“…In situations where pregnancy termination is initiated for a medical reason, compliance with Western medicine which apparently helps women create freedom and control leads them to acute conflicts with their moral values and the Muslim-Bedouin belief and tradition. This is also true for questions regarding the continued tradition of consanguineous marriages and support pervious research finding [ 46 , 47 , 64 , 65 ]. The mediators find themselves in the middle, due to their role in the health services, where they encourage women to comply with medical recommendations, but understand that by this they cause the women to face a whole new set of dilemmas.…”

Section: Discussionsupporting

confidence: 82%

Between a woman and her fetus: Bedouin women mediators advance the health of pregnant women and babies in their society

Sharaby

Peres

2021

BMC Pregnancy Childbirth

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Introduction Bedouin women in Israel confront a challenging circumstance between their traditional patriarchal society and transition to modernity. In terms of reproductive health, they face grave disparities as women, pregnant women and mothers. In this article we aim to understand the challenges of Bedouin women who work as mediators in the promotion of Bedouin women’s perinatal health. We explore their challenges with the dual and often conflictual role as health peer-instructors-mediators in mother-and-child clinics, and also as members of a Bedouin community, embodying a status as women, mothers, and family caretakers. Drawn upon a feminist interpretative framework, the article describes their challenges in matters of perinatal health. Our research question is: how do women who traditionally suffer from blatant gender inequality utilize health-promotion work to navigate and empower themselves and other Bedouin women. Methods Based on an interpretive feminist framework, we performed narrative analysis on eleven in-depth interviews with health mediators who worked in a project in the Negev area of Israel. The article qualitatively analyses the ways in which Bedouin women mediators narrate their challenging situations. Results This article shows how difficult health mediators’ task may be for women with restricted education who struggle for autonomy and better social and maternal status. Through their praxis, women mediators develop a critical perspective without risking their commitments as women who are committed to their work as well as their society, communities, and families. These health mediators navigate their ways between the demands of their employer (the Israeli national mother and child health services) and their patriarchal Bedouin society. While avoiding open conflictual confrontations with both hegemonic powers, they also develop self-confidence and a critical and active approach. Conclusions The article shows the ways by which the mediator’s activity involved in perinatal health-promotion may utilize modern perinatal medical knowledge to increase women’s awareness and autonomy over their pregnant bodies and their role as caregivers. We hope our results will be applicable for other women as well, especially for women who belong to other traditional and patriarchal societies.

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Section: Discussionsupporting

confidence: 82%

Between a woman and her fetus: Bedouin women mediators advance the health of pregnant women and babies in their society

Sharaby

Peres

2021

BMC Pregnancy Childbirth

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“…First, it is possible to assume that these high vaccination rates derive from the fact that a significant portion of Northern Bedouin mothers are illiterate (more than 60%) [ 85 ]. Consequently, their health literacy is low and their ability to search for, read and analyze health information in general and information about vaccinations in particular is limited [ 86 – 88 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, a substantial portion of the Druse population identifies itself with the dominant Jewish national group rather than the minority Arab population. Over the years, a picture has emerged of Druse solidarity with the Zionist ethos, while the Druse simultaneously distance themselves from the Arab and Islamic themes resonant among the Israeli-Arab sector of society [ 86 , 93 ]. Their desire to be part of the dominant Jewish population may lead to their similar or even higher vaccination uptake.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with seasonal influenza and HPV vaccination uptake among different ethnic groups in Arab and Jewish society in Israel

Shahbari

Gesser‐Edelsburg

Davidovitch

et al. 2021

Int J Equity Health

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Background Parents in the Arab population of Israel are known to be “pro-vaccination” and vaccinate their children at higher rates than the Jewish population, specifically against human papilloma virus (HPV) and seasonal influenza. Objectives This study seeks to identify and compare variables associated with mothers’ uptake of two vaccinations, influenza and HPV, among different subgroups in Arab and Jewish society in Israel. Methods A cross-sectional study of the entire spectrum of the Israeli population was conducted using a stratified sample of Jewish mothers (n = 159) and Arab mothers (n = 534) from different subgroups: Muslim, Christian, Druse and Northern Bedouins. From March 30, 2019 through October 20, 2019, questionnaires were distributed manually to eighth grade pupils (13–14 years old) who had younger siblings in second (7–8 years old) or third (8–9 years old) grades. Results Arab mothers exhibited a higher rate of uptake for both vaccinations (p < .0001, HPV – 90%; influenza – 62%) than Jewish mothers (p = 0.0014, HPV – 46%; influenza – 34%). Furthermore, results showed that HPV vaccination uptake is significantly higher than seasonal influenza vaccination uptake in both populations. Examination of the different ethnic subgroups revealed differences in vaccination uptake. For both vaccinations, the Northern Bedouins exhibited the highest uptake rate of all the Arab subgroups (74%), followed by the Druse (74%) and Muslim groups (60%). The Christian Arab group exhibited the lowest uptake rate (46%). Moreover, the uptake rate among secular Jewish mothers was lower than in any of the Arab groups (38%), though higher than among religious/traditional Jewish mothers, who exhibited the lowest uptake rate (26%). A comparison of the variables associated with mothers’ vaccination uptake revealed differences between the ethnic subgroups. Moreover, the findings of the multiple logistic regression revealed the following to be the most significant factors in Arab mothers’ intake of both vaccinations: school-located vaccination and mothers’ perceived risk and perceived trust in the system and in the family physician. These variables are manifested differently in the different ethnic groups. Conclusions This research shows that all Arabs cannot be lumped together as one monolithic group in that they exhibit major differences according to religion, education and access to information. Ranking of variables associated with uptake of the two vaccines can provide decision-makers an empirical basis for tailoring appropriate and specific interventions to each subgroup to achieve the highest vaccine uptake rate possible. Media campaigns targeting the Arab population should be segmented to appeal to the various sub-groups according to their viewpoints, needs and health literacy.

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“…An expanding body of literature has reported significant influence of culture and religion on health beliefs, health choices and treatment decisions [9][10][11][12][13]. The literature on cultural competency has stressed the practical challenges in understanding and effectively addressing ethnic, cultural and religious differences by healthcare systems and professionals in order to improve services and reduce health inequalities [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Workforce diversity in specialist physicians: Implications of findings for religious affiliation in Anaesthesia & Intensive Care

Alim-Marvasti,

Jawad,

Ogbonnaya

et al. 2023

PLoS ONE

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Background Minority ethnic identification between physician and patient can reduce communication and access barriers, improve physician-patient relationship, trust, and health outcomes. Religion influences health beliefs, behaviours, treatment decisions, and outcomes. Ethically contentious dilemmas in treatment decisions are often entangled with religious beliefs. They feature more in medical specialties such as Anaesthesia & Intensive Care, with issues including informed consent for surgery, organ donation, transplant, transfusion, and end-of-life decisions. Methods We investigate diversity in religious affiliation in the UK medical workforce, using data from the General Medical Council (GMC) specialist register and Health Education England (HEE) trainee applications to medical specialties. We performed conservative Bonferroni corrections for multiple comparisons using Chi-squared tests, as well as normalised mutual-information scores. Robust associations that persisted on all sensitivity analyses are reported, investigating whether ethnicity or foreign primary medical qualification could explain the underlying association. Findings The only significant and robust association in both GMC and HEE datasets affecting the same religious group and specialty was disproportionately fewer Anaesthesia & Intensive Care physicians with a religious affiliation of “Muslim”, both as consultants (RR 0.57[0.47,0.7]) and trainee applicants (RR 0.27[0.19,0.38]. Associations were not explained by ethnicity or foreign training. We discuss the myriad of implications of the findings for multi-cultural societies. Conclusions Lack of physician workforce diversity has far-reaching consequences, especially for specialties such as Anaesthesia and Intensive Care, where ethically contentious decisions could have a big impact. Religious beliefs and practices, or lack thereof, may have unmeasured influences on clinical decisions and on whether patients identify with physicians, which in turn can affect health outcomes. Examining an influencing variable such as religion in healthcare decisions should be prioritised, especially considering findings from the clinician-patient concordance literature. It is important to further explore potential historical and socio-cultural barriers to entry of training medics into under-represented specialties, such as Anaesthesia and Intensive Care.

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To connect between worlds, to bridge over gaps: learning about the complex role of cultural mediators in perinatal health promotion from a case in Israel

Cited by 5 publications

References 36 publications

Between a woman and her fetus: Bedouin women mediators advance the health of pregnant women and babies in their society

Between a woman and her fetus: Bedouin women mediators advance the health of pregnant women and babies in their society

Factors associated with seasonal influenza and HPV vaccination uptake among different ethnic groups in Arab and Jewish society in Israel

Workforce diversity in specialist physicians: Implications of findings for religious affiliation in Anaesthesia & Intensive Care

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