Sexual and reproductive health and rights, HIV and migration in southern Africa: A rapid review
DOI:
https://doi.org/10.7196/SAMJ.2024.v114i8.2011Keywords:
migrants , Zimbabwe, South Africa, sexual & reproductive health, HIVAbstract
Migration, a prevalent global phenomenon, significantly impacts health, particularly in low- to middle-income countries. This article presents a rapid review aimed at mapping projects, lessons and policies concerning sexual and reproductive health (SRH), HIV and migration in southern Africa. Utilising a population-concept-context framework, the review focuses on understanding the scope, nature and extent of interventions, identifying lessons learnt, and assessing existing policies and strategies. A comprehensive search strategy and screening process resulted in 19 studies and reports for inclusion. The review highlighted diverse projects across southern Africa, addressing SRH and HIV among migrants, refugees and asylum seekers. Projects ranged from peer-education interventions to community-based referral systems, aiming to improve knowledge, access and outcomes related to SRH and HIV. The lessons learnt emphasised the importance of community involvement, healthcare worker (HCW) training and inclusive policies to address migrants’ diverse needs effectively. Additionally, projects facilitated cross-border collaborations and policy integration, enhancing access to SRH-HIV services and migrant health rights. Despite these efforts, challenges persist, including gender-based violence, financial barriers and xenophobic attitudes among HCWs. Limited access to comprehensive sexuality education and social protection for migrants underscores the need for further policy development and implementation. Nevertheless, existing policies, such as Botswana’s inclusive HIV treatment policy and South Africa’s National Strategic Plan for HIV, TB and STIs, demonstrate steps towards ensuring migrants’ rights to healthcare.
References
Nicholas PK, Mfono N, Corless IB, et al. HIV vulnerability in migrant populations in southern Africa: Sociological, cultural, health-related, and human-rights perspectives. Int J Africa Nurs Sci 2016;5:1-8. https://doi.org/10.1016/j.ijans.2016.09.003
InternationalOrganisationforMigration.WorldMigrationReport2022.IOM,2022.https://publications. iom.int/system/files/pdf/WMR-2022.pdf (accessed 13 March 2024).
Wickramage K, Vearey J, Zwi AB, et al. Migration and health: A global public health research priority. BMC Public Health 2018;18(987). https://doi.org/10.1186/s12889-018-5932-5
VeareyJ,OrcuttM,GostinL,etal.Buildingalliancesfortheglobalgovernanceofmigrationandhealth. BMJ 2019;366:14143. https://doi.org/10.1136/bmj.l4143
Ginsburg C, Collinson MA, Gómez-Olivé FX, et al. Internal migration and health in South Africa: Determinants of healthcare utilisation in a young adult cohort. BMC Public Health 2021;21(554):1-15. https://doi.org/10.1186/s12889-021-10590-6
African Union. Migration and health: Addressing current health challenges of migrants and refugees in Africa – from policy to practice. African Union, 2022. https://au.int/en/documents/20220504/migration-and-health (accessed 13 March 2024).
Alfaro-Velcamp T. ‘Don’t send your sick here to be treated, our own people need it more’: Immigrants’ access to healthcare in South Africa. Int J Migr Health Soc 2017;13(1):53-68. https://doi.org/10.1108/ IJMHSC-04-2015-0012
Brandon Chen Y. International migrants’ right to sexual and reproductive health care. Int J Gynaecol Obstet 2022;157(1):210-215. https://doi.org/10.1002/ijgo.14149
Coast E, Norris A, Moore A, Freeman E. Trajectories of women’s abortion-related care: A conceptual framework. Soc Sci Med 2018;200:199-210. https://doi.org/10.1016/j.socscimed.2018.01.035
Metusela C, Ussher J, Perz J, et al. ‘In my culture, we don’t know anything about that’: Sexual and reproductive health of migrant and refugee women. Int J Behav Med 2017;24(6):836-845. https://doi. org/10.1007/s12529-017-9662-3
Raben L, van den Muijsenbergh METC. Inequity in contraceptive care between refugees and other migrant women? A retrospective study in Dutch general practice. Fam Pract 2018;35(4):468-474. https:// doi.org/10.1093/fampra/cmx133
International Organisation for Migration. Flow Monitoring Report IOM Zimbabwe. IOM, July 2022. https://reliefweb.int/report/zimbabwe/flow-monitoring-report-iom-zimbabwe-july-2022 (accessed 13 March 2024).
Bornman J. Migrant mothers vs the state. New Frame, 2022. https://www.newframe.com/migrant- mothers-vs-the-state/#:~:text=Migrant%20mothers%20are%20asked%20to,as%20much%20as%20 R25%20000 (accessed 13 March 2024).
Kwankye SO, Richter S, Okeke-Ihejirika P, et al. A review of the literature on sexual and reproductive health of African migrant and refugee children. Reprod Health 2021;18(81):1-13. https://doi.org/10.1186/ s12978-021-01138-3
Chawhanda C, Levin J, Ibisomi L. Factors associated with sexual and reproductive health service utilisation in high migration communities in six southern African countries. BMC Public Health 2022;22(876):1-15. https://doi.org/10.1186/s12889-022-13308-4
Anglewicz P, van Landingham M, Manda-Taylor L, Kohler H. Migration and HIV infection in Malawi. AIDS 2016;30(13):2099-2105.
ShamseerL,MoherD,ClarkeM,etal.Preferredreportingitemsforsystematicreviewandmeta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ 2015;349:g7647. https://doi.org/10.1136/ bmj.g7647
AkersJ,Aguiar-IbáñezR,Baba-AkbariA.Systematicreviews:CRD’sguidanceforundertakingreviewsin health care. York: Centre for Reviews and Dissemination, 2009.
Dos Santos WM, Secoli SR, de Araujo Püschel VA. The Joanna Briggs Institute approach for systematic reviews. Revista latino-americana de enfermagem. 2018;26:e3074. https://doi.org/10.1590/1518- 8345.2885.3074
Popay JRH, Sowden A, Petticrew M, et al. Guidance on the conduct of narrative synthesis in systematic reviews. A product from the ESRC methods programme. Lancaster: Lancaster University, 2006.
Correa-Agudelo E, Kim HY, Musuka GN, Mukandavire Z, Akullian A, Cuadros DF. Associated health and social determinants of mobile populations across HIV epidemic gradients in Southern Africa. J Migr Health 2021;3:100038. https://doi.org/10.1016%2Fj.jmh.2021.100038
KhanlouN,HaqueN,SkinnerA,MantiniA,KurtzLandyC.Scopingreviewonmaternalhealthamong immigrant and refugee women in Canada: Prenatal, intrapartum, and postnatal care. J Pregnancy 2017;2017:8783294. https://doi.org/10.1155/2017/8783294
Spitzer DL, Torres S, Zwi AB, Khalema EN, Palaganas E. Towards inclusive migrant healthcare. BMJ 2019;366:14256. https://doi.org/10.1136/bmj.l4256
Madiba S, Ngwenya N. Cultural practices, gender inequality and inconsistent condom use increase vulnerability to HIV infection: Narratives from married and cohabiting women in rural communities in Mpumalanga province, South Africa. Glob Health Action 2017;10(Suppl 2):1341597. https://doi.org/10.1 080/16549716.2017.1341597
Luiking M, Heckemann B, Ali P, et al. Migrants’ healthcare experience: A meta-ethnography review of the literature. J Nurs Scholarship 2019;51(1):58-67.
LabysC,DreyerC,BurnsJ.Atzeroandturningincircles:RefugeeexperiencesandcopinginDurban,South Africa. Transcult Psychiatry 2017;54(5-6):696-714.
Adedeji A. Accessing sub-Saharan African migrant group for public health interventions, promotion, and research: The 5-wave-approach. CMS 2019;7(30):1-13 https://doi.org/10.1186/s40878-019-0134-6
Majid Z, Welch C, Davies J, Jackson T. Global frailty: The role of ethnicity, migration and socioeconomic factors. Maturitas 2020;139:33-41.https://doi.org/10.1016/j.maturitas.2020.05.010
Mukumbang F. Pervasive systemic drivers underpin COVID-19 vulnerabilities in migrants. Int J Equity Health 2021;20(146):1-7. https://doi.org/10.1186/s12939-021-01487-2
MutambaraV,CrankshawT,FreedmanJ.AssessingtheimpactsofCOVID-19onwomenrefugeesinSouth Africa. J Refug Stud 2022;35(1):704-721.
Skarstein T. Women-friendly spaces offer safe haven for Congolese refugees in Angola. Friends of Angola, 2018. https://friendsofangola.org/archives/tag/women-friendlyspaces#:~:text=Women%2Dfriendly%20 spaces%20offer%20safe,find%20safe%20haven%20and%20support (accessed 13 March 2024).
Sisonke-Botswana, BONELA. Botswana CEDAW Shadow Report. Global Network of Sex Work Projects (NSWP), 2019. https://www.nswp.org/resource/member-publications/botswana-cedaw-shadow-report (accessed 13 March 2024).
United Nations Namibia. 2021 UN Country Annual Results Report Namibia. Geneva: UN, 2022. https://namibia.un.org/en/download/115482/197937 (accessed 13 March 2024).
ChekeroT,RossF.‘Onpaper’and‘havingpapers’:Zimbabweanmigrantwomen’sexperiencesinaccessing healthcare in Giyani, Limpopo province, South Africa. Anthropol South Afr 2018;41(1):41-54.
Freedman J, Crankshaw T, Mutambara V. Sexual and reproductive health of asylum seeking and refugee women in South Africa: Understanding the determinants of vulnerability. Sex Reprod Health Matters 2020;28(1):1758440. https://doi.org/10.1080/26410397.2020.1758440
Makandwa T, Vearey J. Giving birth in a foreign land: Exploring the maternal healthcare experiences of Zimbabwean migrant women living in Johannesburg, South Africa. Urban Forum 2017;28(75-90):1-16. https://doi.org/10.1007/s12132-017-9304-5
Scorgie F, Vearey J, Oliff M, et al. ‘Leaving no one behind’: Reflections on the design of community-based HIV prevention for migrants in Johannesburg’s inner-city hostels and informal settlements. BMC Public Health 2017;17(Suppl 3):S482. https://doi.org/10.1186/s12889-017-4351-3
Sonke Gender Justice. Sonke Gender Justice launches its #undertheblankets campaign: Refugees’ and migrants’ access to sexual health in South Africa. Sonke Gender Justice, 2022. https://genderjustice.org.za/ news-item/sonke-gender-justice-launches-its-undertheblankets-campaignrefugees-and-migrants-access- to-sexual-health-in-south-africa/ (accessed 13 March 2024).
Temin M, Milford C, Beksinska M, van Zyl D, Cockburn J. Inclusive HIV prevention in South Africa: Reaching foreign migrant adolescent girls. Front Reprod Health 2021;3:629246. https://doi.org/10.3389/ frph.2021.629246
WalkerR,VeareyJ,NencelL.Negotiatingthecity:Exploringtheintersectingvulnerabilitiesofnon-national migrant mothers who sell sex in Johannesburg, South Africa. Agenda 2017;31(1):91-103.
August 2024, Vol. 114, No. 8
Médecins Sans Frontières. Our activities in https://www.msf.org/zimbabwe (accessed 13 March 2024).
in Zimbabwe. MSF, 2021.
PopulationServicesInternational.PSIensuringSRHRforallinZimbabwe2022-25.Openaid,2022.https:// openaid.se/en/activities/SE-0-SE-6-14481A0101-ZWE-12220 (accessed 13 March 2024).
International Organization for Migration. Sexual and reproductive health and rights remain a priority to IOM’s work in southern Africa. IOM, 2021. https://southafrica.un.org/en/124582-sexual-and-reproductive- health-and-rights-remain-priority-ioms-work-southern-africa (accessed 13 March 2024).
International Organization for Migration. SRHR-HIV Knows No Borders (KNB) project: A synthesis report of the regional, national, and community dialogues. Migration Health Research Portal, 2020. https:// migrationhealthresearch.iom.int/srhr-hiv-knows-no-borders-project-synthesis-report-regional-national- and-community-dialogues (accessed 13 March 2024).
Kingdom of Lesotho. Lesotho HIV Strategic Plan: 2018 - 2023. National AIDS Council, 2018. http://nac. org.ls/wp-content/uploads/2019/06/Lesotho-HIV-Strategic-Plan-2018-2023.pdf (accessed 13 March 2024). 46. Joint United Nations Programme on HIV and AIDS. Botswana extends free HIV treatment to non- citizens. UNAIDS, 2019. https://www.unaids.org/en/resources/presscentre/featurestories/2019/
september/20190924_Botswana_treatment_non-nationals (accessed 13 March 2024).
South African National AIDS Council. South Africa’s National Strategic Plan for HIV, TB, and STIs 2017 - 2022. Pretoria: Republic of South Africa, 2017. https://www.gov.za/sites/default/files/gcis_
document/201705/nsp-hiv-tb-stia.pdf (accessed 13 March 2024).
International Organization for Migration. Migrants right to health in southern Africa. IOM, 2017. https://
www.migration.org.za/wp-content/uploads/2017/08/Migrants-Right-to-Health-in-Southern-Africa.pdf
(accessed 13 March 2024).
Kingdom of Eswatini. Voluntary review report on the status of implementation of
the global compact for migration in Eswatini – 2022. Migration Network, 2022.
https://migrationnetwork.un.org/system/files/docs/Eswatini%20-%20Voluntary%20GCM%20Review.pdf
(accessed 13 March 2024).
Multicultural Centre for Women’s Health. Sexual and reproductive health. MCWH, 2019. https://www.
mcwh.com.au/project/sexual-and-reproductive-health/ (accessed 13 March 2024).
InstituteofSocialandPreventiveMedicine.ISPMBern’sSexualandReproductiveHealthgroupcollaborates on newly awarded grant to improve the sexual health of migrants and refugees. ISPM, 2017. https://www. ispm.unibe.ch/about_us/news/collaborate_to_improve_the_sexual_health_of_migrants_and_refugees/
index_eng.html (accessed 13 March 2024).
ArnottG,OtemaC,ObalimG,OdalloB,NakubulwaT,OkelloSB.Humanrights-basedaccountabilityfor
sexual and reproductive health and rights in humanitarian settings: Findings from a pilot study in northern
Uganda. PLoS Glob Public Health 2022;2(8):e0000836. https://doi.org/10.1371/journal.pgph.0000836
Ivanova O, Rai M, Kemigisha E. A systematic review of sexual and reproductive health knowledge, experiences and access to services among refugee, migrant and displaced girls and young women in Africa.
Int J Environ Res Public Health 2018;15(8):1583. https://doi.org/10.3390/ijerph15081583
Mengesha Z, Hawkey AJ, Baroudi M, Ussher JM, Perz J. Men of refugee and migrant backgrounds in Australia: A scoping review of sexual and reproductive health research. Sex Health 2022;20 (1):20-34. https://
doi.org/10.1071/sh22073
BaroudiM,Nkulu-KalengayiF,GoicoleaI,JonzonR,SanSebastianM,HurtigA.Accessofmigrantyouths in Sweden to sexual and reproductive healthcare: A cross-sectional survey. Int J Health Policy Manag 2022;11(3):287-298.
Faturiyele I, Karletsos D, Ntene-Sealiete K, et al. Access to HIV care and treatment for migrants between Lesotho and South Africa: A mixed methods study. BMC Public Health 2018;18(1):668. https://doi. org/10.1186/s12889-018-5594-3
DavidsonN,HammarbergK,RomeroL,FisherJ.Accesstopreventivesexualandreproductivehealthcare for women from refugee-like backgrounds: A systematic review. BMC Public Health 2022;22(1):403 https:// doi.org/10.1186/s12889-022-12576-4
Downloads
Published
Issue
Section
License
Copyright (c) 2024 G Musuka, I Chingombe, E Moyo, T Chikava, B Moyo, M Mapingure, H Musuka, T Dzinamarira
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Licensing Information
The SAMJ is published under an Attribution-Non Commercial International Creative Commons Attribution (CC-BY-NC 4.0) License. Under this license, authors agree to make articles available to users, without permission or fees, for any lawful, non-commercial purpose. Users may read, copy, or re-use published content as long as the author and original place of publication are properly cited.
Exceptions to this license model is allowed for UKRI and research funded by organisations requiring that research be published open-access without embargo, under a CC-BY licence. As per the journals archiving policy, authors are permitted to self-archive the author-accepted manuscript (AAM) in a repository.
Publishing Rights
Authors grant the Publisher the exclusive right to publish, display, reproduce and/or distribute the Work in print and electronic format and in any medium known or hereafter developed, including for commercial use. The Author also agrees that the Publisher may retain in print or electronic format more than one copy of the Work for the purpose of preservation, security and back-up.
