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      The social and structural determinants of sexual and reproductive health and rights in migrants and refugees: a systematic review of reviews Translated title: Déterminants sociaux et structurels de la santé sexuelle et reproductive et droits associés chez les migrants et les réfugiés : examen systématique d’analyses Translated title: ضارعتسا :ابه ةقلعتلما قوقلحاو ينئجلالاو نيرجاهملل ةيباجنلإاو ةيسنلجا ةحصلل ةيلكيلهاو ةيعماتجلاا تاددحلماتاضارعتسلال يجهنم
      مياهرانوأ ينتسيرك ،ول لاوكين ،نيابر هيزوف ،سوب تنيك ،دادر وبأ ثيل ،سكوه ةراس ،باتفأ ءافو ،ينيج-لييجإ نايد

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          Abstract

          Background

          The sexual and reproductive health and rights (SRHR) of migrants and refugees present important public health challenges. Social and structural determinants affect both the general health and SRHR of migrants, but the drivers of SRHR among migrant and refugee populations remain understudied.

          Aims

          To identify upstream social and structural determinants of SRHR health of migrants and refugees reported in systematic reviews.

          Methods

          We conducted a systematic review of reviews. We studied 3 aspects of SRHR: sexually transmitted infections, sexual violence and unintended pregnancy in migrants and refugees. We used an inductive approach to synthesize emerging themes, summarized them in a narrative format and made an adapted version of Dahlgren and Whitehead’s social determinants of health (SDH) model.

          Results

          We included 12 systematic reviews, of which 10 were related to sexually transmitted infections, 4 to sexual violence and 2 to unintended pregnancy. We identified 6 themes that operate at 4 different levels in an adapted version of the Dahlgren and Whitehead SDH model: economic crisis and hostile discourse on migration; limited legal entitlements, rights and administrative barriers; inadequate resources and financial constraints; poor living and working conditions; cultural and linguistic barriers; and stigma and discrimination based on migration status, gender, sex and ethnicity.

          Conclusion

          This review provides evidence of how upstream social and structural determinants undermine the SRHR of refugees and migrants. Unless these are addressed in policy-making and planning, the health of migrants and refugees is at risk.

          Résumé

          Contexte

          La santé sexuelle et reproductive et les droits associés des migrants et des réfugiés présentent d’importants défis en matière de santé publique. Les déterminants sociaux et structurels ont une incidence à la fois sur la santé générale et sur la santé sexuelle et reproductive et les droits associés des populations de migrants et de réfugiés, mais les facteurs qui influencent ces derniers demeurent sous-étudiés.

          Objectifs

          Identifier les déterminants sociaux et structurels intervenant en amont de la santé sexuelle et reproductive et des droits associés des migrants et des réfugiés, tels que décrits dans les examens systématiques.

          Méthodes

          Nous avons procédé à un examen systématique d’analyses. Nous avons étudié trois aspects de la santé sexuelle et reproductive et des droits associés : les infections sexuellement transmissibles, les violences sexuelles et les grossesses non désirées chez les migrants et les réfugiés. Nous avons utilisé une approche inductive pour synthétiser les thèmes émergents, puis les avons résumés dans un format narratif et avons réalisé une version adaptée du modèle de Dahlgren et Whitehead sur les déterminants sociaux de la santé.

          Résultats

          Nous avons inclus 12 examens systématiques, dont 10 étaient liés aux infections sexuellement transmissibles, quatre aux violences sexuelles et deux aux grossesses non désirées. Nous avons identifié six thèmes qui interviennent à quatre niveaux différents dans une version adaptée du modèle sur les déterminants sociaux de la santé de Dahlgren et Whitehead : la crise économique et les discours hostiles à la migration ; les droits légaux limités, les obstacles juridiques et administratifs ; les ressources insuffisantes et les contraintes financières ; les mauvaises conditions de vie et de travail ; les barrières culturelles et linguistiques ; et la stigmatisation et la discrimination basées sur le statut migratoire, le genre, le sexe et l’ethnicité.

          Conclusion

          La présente analyse montre comment les déterminants sociaux et structurels intervenant en amont nuisent à la santé sexuelle et reproductive et aux droits associés des réfugiés et des migrants. Tant que ces éléments ne sont pas pris en compte dans l’élaboration des politiques et la planification, la santé des migrants et des réfugiés est en danger.

          ةصلالخا

          تاددحلما رثؤتو .ةماعلا ةحصلا لامج في ةمهم تايدتح ابه ةقلعتلما قوقلحاو ينئجلالاو نيرجاهملل ةيباجنلإاو ةيسنلجا ةحصلا لثُت :ةيفللخا لىع ةرثؤلما لماوعلا لازت لا نكلو ،ابه ةقلعتلما قوقلحاو نيرجاهملل ةيباجنلإاو ةيسنلجا ةحصلاو ةماعلا ةحصلا نم ٍلك لىع ةيلكيلهاو ةيعماتجلاا.ةيفاو ًةسارد ةسوردم يرغ ينئجلالاو نيرجاهلما فوفص في ابه ةقلعتلما قوقلحاو ةيباجنلإاو ةيسنلجا ةحصلا

          ةقلعتلما قوقلحاو ينئجلالاو نيرجاهملل ةيباجنلإاو ةيسنلجا ةحصلل ةيلولأا ةيلكيلهاو ةيعماتجلاا تاددحلما ديدتح لىإ ةساردلا هذه تفده :فادهلأا.ةيجهنلما تاضارعتسلاا ابه تدافأ يتلا ابه

          :ابه ةقلعتلما قوقلحاو ةيباجنلإاو ةيسنلجا ةحصلا بناوج نم بناوج ةثلاث انسردو .تاضارعتسلال اًيجهنم اًضارعتسا انيرجأ :ثحبلا قرُط ،ةدجتسلما عيضاولما فيلوتل اًيئارقتسا اًجنه انعبتاو .ينئجلالاو نيرجاهلما ىدل دوصقلما يرغ لملحاو ،سينلجا فنعلاو ،اًيسنج ةلوقنلما ضارملأا.ةحصلل ةيعماتجلاا تاددحملل ديهتياوو نيرلجاد جذومن نم ةلَّدعم ةخسن انددعأو ،يدسر لكش في اهانصلخو

          ،سينلجا فنعلاب قلعتت تاضارعتسا 4و ،اًيسنج ةلوقنلما ضارملأاب قلعتت تاضارعتسا 10 اهنم ،اًيجهنم اًضارعتسا 12 انضرعتسا :جئاتنلا تاددحملل ديهتياوو نيرلجاد جذومن نم ةلَّدعم ةخسن في ةفلتمخ تايوتسم 4 في عيضاوم 6 انددحو .دوصقلما يرغ لملحاب ناقلعتي ناضارعتساو ةيافك مدعو ؛ةيرادلإا قئاوعلاو قوقلحاو ةينوناقلا تاقاقحتسلاا ةيدودمحو ؛ةرجلها نأشب يئادعلا باطلخاو ةيداصتقلاا ةمزلأا :ةحصلل ةيعماتجلاا يعماتجلاا عونلاو ةرجلها عضو ساسأ لىع زييمتلاو مصولاو ؛ةيوغللاو ةيفاقثلا زجاولحاو ؛لمعلاو ةشيعلما فورظ ءوسو ؛ةيلالما دويقلاو دراولما.قرعلاو سنلجا عونو

          نيرجاهملل ةيباجنلإاو ةيسنلجا ةحصلا ضيوقت في ةيلولأا ةيلكيلهاو ةيعماتجلاا تاددحلما رثأ لىع لئلاد ضارعتسلاا اذه مِّدقي :تاجاتنتسلاا نوكتس ينئجلالاو نيرجاهلما ةحص نإف ،طيطختلاو تاسايسلا مسر ةيلمع راطإ في روملأا هذه جَلاعُت لم امو .ابه ةقلعتلما قوقلحاو ينئجلالاو.رطخلل ةضرُع

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          Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach.

          With the increase in the number of systematic reviews available, a logical next step to provide decision makers in healthcare with the evidence they require has been the conduct of reviews of existing systematic reviews. Syntheses of existing systematic reviews are referred to by many different names, one of which is an umbrella review. An umbrella review allows the findings of reviews relevant to a review question to be compared and contrasted. An umbrella review's most characteristic feature is that this type of evidence synthesis only considers for inclusion the highest level of evidence, namely other systematic reviews and meta-analyses. A methodology working group was formed by the Joanna Briggs Institute to develop methodological guidance for the conduct of an umbrella review, including diverse types of evidence, both quantitative and qualitative. The aim of this study is to describe the development and guidance for the conduct of an umbrella review.
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            Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016

            Abstract Objective To generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, trichomoniasis and syphilis in women and men, aged 15–49 years, in 2016. Methods For chlamydia, gonorrhoea and trichomoniasis, we systematically searched for studies conducted between 2009 and 2016 reporting prevalence. We also consulted regional experts. To generate estimates, we used Bayesian meta-analysis. For syphilis, we aggregated the national estimates generated by using Spectrum-STI. Findings For chlamydia, gonorrhoea and/or trichomoniasis, 130 studies were eligible. For syphilis, the Spectrum-STI database contained 978 data points for the same period. The 2016 global prevalence estimates in women were: chlamydia 3.8% (95% uncertainty interval, UI: 3.3–4.5); gonorrhoea 0.9% (95% UI: 0.7–1.1); trichomoniasis 5.3% (95% UI:4.0–7.2); and syphilis 0.5% (95% UI: 0.4–0.6). In men prevalence estimates were: chlamydia 2.7% (95% UI: 1.9–3.7); gonorrhoea 0.7% (95% UI: 0.5–1.1); trichomoniasis 0.6% (95% UI: 0.4–0.9); and syphilis 0.5% (95% UI: 0.4–0.6). Total estimated incident cases were 376.4 million: 127.2 million (95% UI: 95.1–165.9 million) chlamydia cases; 86.9 million (95% UI: 58.6–123.4 million) gonorrhoea cases; 156.0 million (95% UI: 103.4–231.2 million) trichomoniasis cases; and 6.3 million (95% UI: 5.5–7.1 million) syphilis cases. Conclusion Global estimates of prevalence and incidence of these four curable sexually transmitted infections remain high. The study highlights the need to expand data collection efforts at country level and provides an initial baseline for monitoring progress of the World Health Organization global health sector strategy on sexually transmitted infections 2016–2021.
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              Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher– Lancet Commission

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                Author and article information

                Journal
                9608387
                East Mediterr Health J
                East Mediterr Health J
                Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit
                1020-3397
                1687-1634
                31 March 2022
                28 December 2021
                28 December 2021
                08 December 2024
                : 27
                : 12
                : 1203-1213
                Affiliations
                [1 ]Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
                [2 ]Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
                [3 ]Centre for Gender and Global Health, Institute for Global Health, University College London, London, United Kingdom
                [4 ]Kent Buse, Director, Healthier Societies Program, The George Institute for Global Health, Imperial College London, United Kingdom
                Author notes
                Correspondence to: Dianne Egli-Gany: degli-gany@ 123456bluewin.ch
                Article
                EMS144067
                10.26719/emhj.20.101
                7616978
                35137389
                a19af1a0-5eef-4437-a7c7-a339d14a6876

                This work is available under the CC BY-NC-SA 3.0 IGO license ( https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

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                migrants,refugees,sexual and reproductive health,social and structural determinants of health

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