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  • 1.
    Nanyanzi, Salima
    et al.
    Karolinska Institute.
    Emegwa, Leah
    The Swedish Red Cross University College, Department of Health Sciences. University of Gävle,.
    Lawoko, Stephen
    Karolinska Institute; Victoria University, Kampala, Uganda.
    HIV Testing Among Women of Reproductive Age Exposed to Intimate Partner Violence in Uganda2018In: Open Public Health Journal, ISSN 1874-9445, Vol. 11, p. 275-287Article in journal (Refereed)
    Abstract [en]

    Background:

    Intimate Partner Violence (IPV) and Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) occur as dual epidemics with gender dimensions. IPV sometimes result in lack of decision making autonomy over one’s own health and this may negatively affect uptake HIV testing services.

    Objective:

    The study aimed to examine the association between exposure to IPV and HIV testing among women of reproductive age in Uganda.

    Method:

    The study is based on cross-sectional data from 2011 Uganda Demographic and Health Survey (UDHS). A sub-sample of 1705 ever-partnered women aged 15-49 who responded to the domestic violence module was examined in the study. Bivariate and multivariable (logistic regression) analyses were used to determine the association between exposure to IPV and HIV testing.

    Results:

    Up to 82.3% and 61.5% of the respondents were tested for HIV ever and in the past year, respectively. The prevalence of physical IPV and IPV of any form in the past year was 25.6% and 44% respectively. Exposure to physical IPV and emotional IPV in the past year was associated with HIV testing within the past year. In the multivariate analysis, exposure to physical IPV remained significantly associated with HIV testing within the past year (OR: 1.34; 95% CI: 1.03-1.73). Frequent access to newspapers remained a significant predictor of HIV testing uptake.

    Conclusion:

    HIV testing in the past year is associated with exposure to IPV among women of reproductive age in Uganda. There is a need to include IPV as a part of global strategy to address HIV/AIDS.

  • 2.
    Okenwa Emegwa, Leah
    University of Gävle.
    Economic Burden of occupational Injuries on Primary Healthcare2015In: Proceeding 22nd International Conference on Safe Communities 2015: Involvement of Grassroots: The First Step to a Global Vision on Commuity Safety Promotion : November 22-25, 2015 Nan Province Thailand, 2015, p. 223-Conference paper (Refereed)
  • 3.
    Okenwa Emegwa, Leah
    University of Gävle.
    Profiling bodily trauma by demographic and occupational characteristics among workers injuried in the county of Gävleborg between 2007-20122015In: Proceeding 22nd International Conference on Safe Communities 2015: Involvement of Grassroots: The First Step to a Global Vision on Commuity Safety Promotion : November 22-25, 2015 Nan Province Thailand, 2015, p. 116-Conference paper (Refereed)
  • 4.
    Okenwa Emegwa, Leah
    Högskolan i Gävle.
    Trends in Work Place Injury and Consequent Absence from Work in the County of Gävleborg, Sweden2014In: / [ed] Massimo Cecaro, 2014Conference paper (Refereed)
    Abstract [en]

    Work related injuries continue to contribute to the global burden of disease and injuries. According to recent global estimates, about a million workers are injured and a thousand die per day due to work injuries. In Sweden, trends in reporting work place injuries have varied over time with various peaks and troughs.Differences have been observed between the reporting ofinjuries requiring sick leaves and those requiring no sick leaves, the so called ‘zero’ accidents.There are however few studies exploring the specific trends and patterns of occupational injuries in Sweden. Even problematic is the fact that available studies are very industry specific. Aim: To explore trends in workplace injuries and associated socio-demographic risk factors in the county of Gävleborg, Sweden.The study also aims to look at sick leave patterns in terms of total number of days absent from week and their determinants. Method: The study is based on retrospective longitudinal data comprising of all cases of work place accidents between 1992 and 2012 which were reported to the Swedish social insurance agency. A total of 24129 cases were reported across different industries. Data was analyzed using SPSS. Results: Preliminary results show that work place injuries vary by social demographic factors (such as age, sex, type of employment status) and industry.Results also show that age and sex are major determinants of total number of sick leave days. Conclusion: The implication for interventions and further research are discussed.

  • 5.
    Okenwa, Leah
    Karolinska institutet.
    Intimate Partner Violence Among Women of Reproductive Age in Nigeria: Magnitude, Nature and Consequences For Reproductive Health2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Intimate Partner Violence (IPV) against women is now recognised as a problem of global magnitude, owing to its detrimental consequences on the health, social and economic welfare of women and their children. This scenario has prompted increased research to understand its risk factors and data has indicated contextual variation in this regard, warranting an assessment in each unique setting. A major constraint, however, on the detection and potential management of IPV lies in the poor disclosure of abuse by many women and their submission to abuse, particularly in Sub- Saharan Africa.

    Objective: We studied the magnitude and risk factors for IPV exposure among women in a community of Nigeria (paper 1), extent of and factors associated with the disclosure of IPV in the community sample (paper 2), the association between IPV and reproductive health outcomes in a nationally representative sample of Nigerian women (paper 3) and women and men‟s attitudes towards IPV in a nationally representative sample (paper 4).

    Methods: Structured interviews were conducted in a sample of over 900 women selected systematically from among visitors to a community health facility (papers 1 and 2). Women were probed on exposure to and disclosure of IPV, as well as demographic, social and empowerment measures. Secondary data was retrieved from the demographic and health surveys of Nigeria 2008, which utilised multi-stage sampling to gather demographic and health data on over 45,000 men and women, which was used to study the reproductive health outcomes in relation to IPV (paper 3) as well as model attitudes towards IPV using demographic, social and empowerment indicators (paper 4). Statistical analyses used included Chi-square tests and Logistic regressions.

    Results: The 1 year prevalence of IPV was 29%, with significant proportions reporting psychological (23%), physical (9%) and sexual (8%) abuse. Independent predictors of IPV included in-access to information, women‟s autonomy in decision making and contribution to household expenses (paper 1). Fifty four percent of the participating women would not disclose IPV on the hypothetical situation of exposure. Among those willing to disclose, 37% (n=103) would disclose to some form of institutions (i.e. religious leaders, law enforcement officers (only 1% would actually disclose to the police). This institutional disclosure is in contrast to 68% who opted to disclose to close family and relatives. Ethnicity, woman‟s own use of alcohol and autonomy in household decision (e.g. having a say on household purchases), increased the likelihood of disclose IPV (paper 2). Exposure to IPV was associated with using modern forms of contraception; have a history of miscarriages, induced abortions, stillbirths, or infant mortality; and having many children. These associations remained even after adjustment for potential confounders including demographic and socioeconomic factors (paper 3). Although justification of IPV was common among men and women, a higher proportion of women justified IPV compared to men. For both men and women, justification of wife beating was associated with low education, rural residency and ethnicity. Access to information was associated with justification of abuse, sometimes in the unexpected manner. While in-access to newspaper was associated with an increased likelihood of justifying abuse among women, in-access to radio/tv decreased the likelihood of endorsing wife abuse among the women. The direct opposite was observed among men. Finally, having a shared autonomy in household decisions was associated with a reduced likelihood of justifying wife abuse among both women and men (paper 4).

    Conclusion: IPV is rampant and is associated with detrimental reproductive health outcomes and contraception use among Nigerian women. Nigerian women justify IPV to a higher degree than men, with variations in gender regarding the determinants of such justification. Though many of the predictors of IPV exposure, disclosure and attitudes tend to corroborate previous work and theories, the association between empowerment indicator and these outcomes are sometimes contradictory to previous work, suggesting possible contextual differences. The thesis has important implications for prevention of IPV in Nigeria and further research.

  • 6.
    Okenwa, Leah E.
    et al.
    Karolinska Institutet.
    Lawoko, Stephen
    Karolinska Institutet.
    Jansson, Bjarne
    Karolinska Institutet.
    Exposure to Intimate Partner Violence Amongst Women of Reproductive Age in Lagos, Nigeria: Prevalence and Predictors2009In: Journal of family Violence, ISSN 0885-7482, E-ISSN 1573-2851, Vol. 24, no 7, p. 517-530Article in journal (Refereed)
    Abstract [en]

    Research on predictors of Intimate Partner Violence (IPV) in Sub-Saharan Africa is contradictory, necessitating further investigation. This study sought the prevalence and predictors of IPV among women in Lagos, Nigeria. Questionnaire data from 934 women visiting an obstetrics and gynecology clinic in Lagos were analyzed using multivariable methods. The 1 year prevalence of IPV was 29%, with significant proportions reporting psychological (23%), physical (9%) and sexual (8%) abuse. In-access to information, women's autonomy and contribution to household expenses independently predicted IPV. The findings provide new incites for IPV prevention in Lagos with implications for further research.

  • 7.
    Okenwa, Leah
    et al.
    Karolinska Institutet.
    Lawoko, S.
    Karolinska Institutet.
    Jansson, B.
    Karolinska Institutet.
    Factors associated with disclosure of intimate partner violence among women in Lagos, Nigeria2009In: Journal of Injury and Violence Research, ISSN 2008-2053, E-ISSN 2008-4072, Vol. 1, no 1, p. 37-47Article in journal (Refereed)
    Abstract [en]

    Though the prevalence of Intimate Partner Violence (IPV) remains high in less developed countries, data suggest that these figures may represent an underestimation considering that many women are unwilling to disclose abuse. This paper aims to determine women's willingness to report abuse, factors determining willingness to disclose IPV, and to whom such disclosure is made. A total of 911 women visiting reproductive health facility responded to the questionnaire, and the collected data was analyzed using multivariate analysis. About 54% (n=443) of the participating women reported that would not disclose IPV. Among those willing to disclose abuse, 68% (n=221) would opt to disclose to close relatives in contrast to 32% (n=103) who would disclose to some form of institutions (i.e. religious leaders, law enforcement officers). Ethnicity, woman's own use of alcohol and autonomy in decision making such as having a say on household purchases, money use and visitation, independently predicted willingness to disclose IPV. The role of family is still important in the Nigeria context and the implications for research and intervention are discussed.

  • 8.
    Okenwa, Leah
    et al.
    Karolinska Institutet.
    Lawoko, Stephen
    Karolinska Institutet.
    Social Indicators and Physical Abuse of Women by Intimate Partners: A Study of Women in Zambia2010In: Violence and Victims, ISSN 0886-6708, E-ISSN 1945-7073, Vol. 25, no 2, p. 278-288Article in journal (Refereed)
    Abstract [en]

    Intimate partner physical abuse (IPPA) of women is a societal problem with sinister implications on health. IPPA has been integrally linked to social status though the direction of association remains elusive, not the least in sub-Saharan Africa. This article investigated the association between IPPA and social status of women in Zambia. Data comprising 3,969 currently partnered women were retrieved from the 2001 Zambian Demographic and Health Survey and analyzed using chi-square test and logistic regression. IPPA augmented with low education, income-generating activity, access to information, autonomy over household health issues, and having tolerant attitudes toward IPPA. Tolerant attitude toward IPPA and illiteracy were independent risk factors for IPPA. Educational interventions are recommended to prevent IPPA in Zambia.

  • 9.
    Okenwa, Leah
    et al.
    Karolinska Institutet.
    Lawoko, Stephen
    Karolinska Institute.
    Jansson, Bjarne
    Karolinska Institute.
    Contraception, reproductive health and pregnancy outcomes among women exposed to intimate partner violence in Nigeria2011In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, no 1, p. 18-25Article in journal (Refereed)
    Abstract [en]

    Objectives To examine the association between reproductive health practices/outcomes and exposure to intimate partner violence (IPV) among women in Nigeria. More specifically, the association between IPV and use of contraception; miscarriages, induced abortions, stillbirths, and infant mortality; and having many children, was assessed. Methods Data on studied variables were retrieved from the Demographic and Health Surveys of Nigeria 2008, a nationally representative sample of 33,385 women of reproductive age. IPV was defined as exposure to physical, sexual or emotional abuse. The association between contraception use, pregnancy outcomes and infant mortality, and exposure to IPV was assessed using the chi-square test for unadjusted analyses. To control for potential confounding, socio-demographic variables were adjusted for using multiple logistic regression. Results Compared with women not exposed to IPV, those who were, exhibited a higher likelihood of using modern forms of contraception; having a history of miscarriages, induced abortions, stillbirths, or infant mortality; and having many children. The aforementioned observations still stood after adjustment for potential confounders (e.g., demographic and socioeconomic factors). Conclusion Though causal inference cannot be drawn due to the cross-sectional design, the study has important implications for incorporation of IPV detection and management in initiatives aimed at improving women's reproductive health.

  • 10.
    Okenwa-Emegwa, Leah
    Högskolan i Gävle.
    Determinants of sick leave duration following occupational injuries among workers in the county of Gävleborg, Sweden2014In: Ocean and Atmospheric Data Management, ISSN 1463-502X, Vol. 2, no 4, article id 176Article in journal (Refereed)
    Abstract [en]

    Background: Occupational injuries continue to add to the global burden of injuries. Recent global estimates show that up 317 million workers were injured in accidents at work that resulted in absence from work of four days or more. Whereas sick leave is important for rehabilitation and recovery, the duration of sick leave and consequent return to work is of concern in order to prevent negative outcomes. There is therefore a need to examine factors associated with sick leave duration among injured workers for effective rehabilitation. This study aimed to investigate the determinants of leave sick duration following occupational injuries. Method: The Swedish National Working Environment Agency keeps a record of all cases of occupational injuries requiring at least one day sick leave day and reported to Swedish Social Welfare Security Agency. The present study is register based using data from a total of 5291 cases of occupational injuries that occurred in the county of Gävleborg, Sweden between 2007 and 2012. Result: Sick leave longer than two weeks was highest for the self-employed and temporary workers although injury frequency was low for both groups. Fall injuries and injuries involving slip, trip and snapping or breaking of an object were more likely to lead to sick leave longer than two weeks. Shorter sick duration was observed among injured workers in the health and manufacturing sectors. Conclusions: Possible reasons for the observed results and the need for individual based rehabilitation process for effective and more meaningful return to work are discussed.

  • 11.
    Okenwa-Emegwa, Leah
    The Swedish Red Cross University College, Department of Health Sciences. Högskolan i Gävle.
    Doctoral Theses as a Source of Knowledge Production for IPV Prevention: A Literature Review of Doctoral Theses at a Swedish University2019In: The Open Public Health Journal, ISSN 1874-9445, Vol. 12, p. 145-154Article in journal (Refereed)
    Abstract [en]

    Background:

    Intimate Partner Violence (IPV) is a pervasive form of Violence Against Women (VAW). IPV has been acknowledged as a human rights violation and a public health problem. Years of research and advocacy have led to a better understanding of the problem including the development of the ecological model for explaining IPV. Although diverse international policies and global advances in women’s rights have contributed to addressing IPV, the problem still persists. IPV is associated with adverse health outcomes, therefore, its prevention is an important aspect of population health promotion.

    Objective:

    Considering that doctoral research and theses form an integral aspect of knowledge production, the present study aims to provide a review of doctoral theses on IPV at a Swedish university in order to identify areas of unmet need for future IPV prevention studies.

    Methods:

    A search was conducted to identify IPV related thesis stored in the Karolinska Institutet (KI), which is a database where all publications produced at KI are stored. A total of thirteen PhD theses (the earliest published in 2004 and the latest in 2017) met the inclusion criteria and were reviewed.

    Results:

    Through their wide range of contexts and contents, these theses provide a global insight into IPV. Findings show that prevalence estimates and risk factors at the individual and relationship levels are well researched. Potential areas of unmet needs include the under-researched nature of risk factors and interventions at the community and societal level as well as underlying issues preventing the healthcare sector from actively playing its role in addressing IPV.

    Conclusion:

    Capacity building for the health sector and addressing community and societal level risk factors of IPV are modifiable factors to address IPV and improve population health.

  • 12.
    Okenwa-Emegwa, Leah
    University of Gävle.
    Risk Factors of Occupational Injuries Due to Loss of Control, Falls and Overexertion2017In: Journal of Epidemiology and Public Health Reviews, ISSN 2471-8211, Vol. 2, no 2Article in journal (Refereed)
    Abstract [en]

    Occupational injuries are a major concern globally due to its growing prevalence and its consequences on health. While many of the risks are related to daily routines others are as a result of individual characteristics and environmental conditions at work. Studies show that certain demographic groups and work categories appear to have higher prevalence of specific types of injury causes especially those resulting in hospital care. Most studies of risk factors for occupational injuries traditionally attempt to understand factors that distinguish persons who get injured at work from those who do not. In this study, the probability of specific occupational injury causes is modeled using injury data accrued between 2007 and 2012. In this approach, the contrast group comprises those who attained other injuries during the same time frame. All statistical analysis was performed using SPSS version 22. Results show that Injuries due to falls, loss of control and overexertion were the top three leading causes of occupational injury for the period under study. The risk for falls and overexertion were highest in the healthcare sector compared to loss of control in the manufacturing industry. Foreign born workers had increased risk for overexertion. Gender and age differences as well as other risk factors are discussed.

    Knowledge of specific risk factors for individual occupational injury cause may be relevant for primary and secondary interventions.

  • 13.
    Okenwa-Emegwa, Leah
    et al.
    The Swedish Red Cross University College. University of Gavle.
    Dalal, Koustuv
    University of Orebro.
    Length of Stay in Hospital Following Occupational Injury2018In: Journal of Epidemiology and Public Health Reviews, ISSN ISSN 2471-8211, Vol. 3, no 1, p. 1-6Article in journal (Refereed)
    Abstract [en]

    Background: Length of stay in hospital (LOS) is regarded as a useful indicator of morbidity and an important determinant of medical care cost. LOS has been shown to have implications for post injury functionality, return to work, sickness absence and some psychosocial health outcomes such as quality of life. However, not much is known about LOS following occupational injury. The present study examined LOS and its predictors in a population of Swedish workers injured at work, and admitted for hospital care between 2007 and 2012.

    Methods: The study is based on data from the Swedish Working Environment Agency and hospital records of injured workers in the county of Gävleborg, Sweden. Specifically those admitted and discharged alive during the period under review.

    Results: A total of 1608 cases were identified, 34.4% were from the manufacturing sector, 32.2% had injuries of the upper extremities, mean LOS was 2.78 days. Individual level independent predictors of LOS were employment and injury location. Factors such as referrals, admitting ward and diagnose related groups (DGRs) were hospital level predictors of LOS. Injured workers admitted to the orthopedic ward and those referred from other clinics had approximately four fold likelihood of LOS greater than 3days.

    Discussion: The findings show individual and hospital level factors were identified as predictors of LOS in hospital following an occupational injury. The likely implications of these findings are discussed.

  • 14.
    Okenwa-Emegwa, Leah
    et al.
    University of Gävle.
    Lawoko, Stephen
    Karolinska Institutet.
    Jansson, Bjarne
    Karolinska Institutet.
    Attitudes Toward Physical Intimate Partner Violence Against Women in Nigeria2016In: SAGE Open, ISSN 2158-2440, E-ISSN 2158-2440, Vol. 6, no 4, article id 2158244016667993Article in journal (Refereed)
    Abstract [en]

    Attitudes toward intimate partner violence (IPV) are known predictors of IPV victimization and perpetration with more women generally believed to justify IPV than men. An understanding of the determinants of justification of IPV may provide information necessary for holistic interventions. This study sought to examine the magnitude, extent, and predictors of justification of physical IPV against women among men and women in Nigeria. Data from 33,385 women and 15,486 men from the 2008 Nigerian demographic and health surveys were analyzed using chi-square test and multiple logistic regressions. Results show that although larger proportions of women justified physical IPV, certain categories of men such as poor, illiterate men, and men with secondary education justified abuse more than women. Contrary to expectations, access to radio/TV increased the odds of justifying abuse among women thus casting doubts on program content. The gender differences observed for predictors of attitudes to physical IPV suggest a need for gender-tailored interventions to change attitudes toward partner violence in Nigeria.

  • 15.
    Okenwa-Emegwa, Leah
    et al.
    The Swedish Red Cross University College, Department of Public Health and Medicine.
    Paillard-Borg, Stéphanie
    The Swedish Red Cross University College, Department of Public Health and Medicine.
    Tinghög, Petter
    The Swedish Red Cross University College, Department of Public Health and Medicine.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Public Health and Medicine.
    von Strauss, Eva
    The Swedish Red Cross University College, Department of Public Health and Medicine. Swedish Red Cross University College.
    A global workspace is the emerging reality for future public health workforce2017In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 94, no 3, p. 132-140Article in journal (Refereed)
    Abstract [en]

    There is an urgent need to train public health professionals at undergraduate level who can face global challenges that are due to longstanding conflicts, increasing number of displaced people, natural disasters, and growing inequalities between and within countries. Future public health professionals will lead activities ranging from national and international community planning, strategic work geared towards integration of migrants and crisis management of refugees, and humanitarian services. Consequently, the need for public health professionals with deep and wide theoretical and practical competencies in global contexts has become most relevant. In response to this need, The Swedish Red Cross University College has created such a programme leading to a Bachelor degree in Public Health Science, specialization Global Health.

  • 16.
    Okenwa-Emegwa, Leah
    et al.
    The Swedish Red Cross University College, Department of Public Health and Medicine.
    Paillard-Borg, Stéphanie
    The Swedish Red Cross University College, Department of Public Health and Medicine.
    Tinghög, Petter
    The Swedish Red Cross University College, Department of Public Health and Medicine.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Public Health and Medicine.
    von Strauss, Eva
    The Swedish Red Cross University College, Department of Public Health and Medicine.
    Framtidens hälsovetare verkar på en global arena.2017In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 94, no 3, p. 318-326Article in journal (Refereed)
    Abstract [sv]

    Det föreligger ett akut behov att utbilda folkhälsovetare på grundnivå och som kan möta de globala utmaningarna. Hälsoutmaningarna förändras i takt med långvariga konflikter, människor på flykt, stora katastrofer och en ökande ojämlikhet mellan och inom länder, i en omvärld som är i ständig rörelse. Dagens och morgondagens folkhälsovetare ska kunna arbeta med olika aktörer på skilda arenor; med hälso- och sjukdomsprevention kommunalt, regionalt, nationellt (regering, myndigheter) och internationellt (europeiskt och globalt). Det innefattar även integrationsarbete, internationellt biståndsarbete och humanitärt arbete. Behovet av professionella folkhälsovetare med breda och djupa teoretiska och praktiska kompetenser i globala sammanhang har därför blivit högst relevant. Därför agerar nu Röda Korsets Högskola och startar ett folkhälsovetenskapligt program på kandidatnivå med global inriktning.

  • 17.
    Okenwa-Emegwa, Leah
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Högskolan i Gävle.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Health Sciences. Högskolan i Gävle.
    Tinghög, Petter
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska institutet.
    Depression and Low Labour Market and Social Expectations among Resettled Syrian Refugees in Sweden: Leah Okenwa Emegwa2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no 3Article in journal (Other academic)
    Abstract [en]

    Background

    Large numbers of refugees have come to Europe in search of safety. For non-refugee migrants, expectations and the extent to which they are met are shown to be integral components of adaptation and wellbeing. This study aims to explore the prevalence of low expectations for labour market, economic and social integration among Syrian refugees recently resettled in Sweden and whether depression is associated with these expectations.

    Methods

    A random sample of 1215 Syrian refuges of working age recently resettled in Sweden responded to a questionnaire in Arabic. Expectations were assessed by three items developed for this study. Average item score of >1.80 on the depressive symptoms in Hopkins Symptom Checklist indicated depression. Logistic regressions adjusted for demographic factors and social support were conducted. Weighted data was used to produce socio-demographically representative prevalence rates and odds ratios (ORs). Robust standard errors were used to obtain 95% confidence intervals for all estimates.

    Results

    Prevalence of low economic, social and labour market expectations were 14.1% (95% CI 12.0-16.1), 13.4% (11.3-15.4) and 10.9% (9.1-12.6) respectively. Approximately 40.2% (36.9-43.3) of the participants had depression. Those with depression were about four times more likely to have low economic expectations (OR 3.89, 95% CI 2.66-5.92), three times more likely to have low social (OR 3.1, 2.30-5.24), and labour market (OR 2.83, 1.90-4.47) expectations.

    Conclusions

    Low expectations, while not widespread, exist among Syrian refugees in Sweden. Notable proportions had depression which was also significantly associated with low expectations. The association between depression and low expectations in keys areas necessary for adaptation and wellbeing in a new land, indicates the need to address mental health issues in current societal level efforts aimed at boosting labour market participation and social inclusion.

    Key messages:

    • Notable proportions of Syrian refugees in Sweden have low expectations in domains vital for adaptation and wellbeing in a new land. Depression is significantly associated with low expectations.

    • Low expectation among Syrian refugees in domains vital for adaptation and wellbeing and the association with depression indicate need to address mental health in social and labour market interventions.

  • 18.
    Okenwa-Emegwa, Leah
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Department of occupational and public health, faculty of health and occupational studies, University of Gävle, Sweden..
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Health Sciences.
    Tinghög, Petter
    The Swedish Red Cross University College, Department of Health Sciences.
    Prevalence and predictors of violence among Syrian refugee women resettled in Sweden2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl. 4, p. 156-Article in journal (Other academic)
    Abstract [en]

    Background Refugee women are at more risk of a continuum of violence, pre, during and post flight. After resettlement, increased family conflicts are likely, due to shifts in gender roles and changing family structures. Prevalence estimates, however, remain scarce especially for Syrian refugee women in Europe. Given that exposure to violence is a substantial risk factor for ill health and poor adaptation, this study aims to estimate the prevalence of violence in different phases of flight and associated sociodemographic factors. Methods The study is based on a random sample of 452 Syrian refugee women resettled in Sweden. Exposure to violence was operationalised as having been a victim of torture, physical or sexual violence, pre and during flight; witnessing violence was operationalised as experiencing war at close quarters, witnessing physical violence, or forced separation from loved ones, pre and during flight; family conflicts was operationalised as experiencing distressing conflicts in the family since resettlement. Descriptive analysis were conducted to estimate prevalence and logistic regression to assess associations. Weighted data produced socio-demographically representative estimates. Robust standard errors were used to obtain 95% confidence intervals for all estimates. Results About 25.1% (95% 20.9 – 29.4) of the women were exposed to violence preflight, 7.8% (95% 5.2 – 10.4) were victims during flight. Up to 93.3% (95% 90.7 – 95.9) witnessed violence preflight, 67.2% (95% 62.6 – 71.8) during flight. About 34.2% (95% 29.7 – 38.7) are experiencing distressing family conflicts.Logistic regressions showed no significant difference after controlling for age, education and marital status. Conclusions The magnitude of violence and ongoing family conflicts calls for a closer look at the plight of refugee women.Violence is widespread and not specific to any sociodemographic group, an important finding for healthcare and public health workforce to take note of. 

  • 19.
    Okenwa-Emegwa, Leah
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. University of Gävle, Gävle, Sweden.
    von Strauss, Eva
    The Swedish Red Cross University College, Department of Health Sciences.
    Higher education as a platform for capacity building to address violence against women and promote gender equality: the Swedish example2018In: Public Health Reviews, ISSN 0301-0422, E-ISSN 2107-6952, Vol. 39, no 31Article in journal (Refereed)
    Abstract [en]

    Violence against women is an acknowledged public and global health problem which has adverse consequences for women’s health. Education, especially higher education, has long been identified as an important arena for addressing the problem and promoting gender equality. Two measures recently put in place in the Swedish higher education have brought the role of the sector into focus. The first is the inclusion of gender equality as a measurable outcome in quality assurance in higher education. The second measure is the amendment of the Swedish Higher Education Ordinance to include mandatory knowledge of VAW in the degree programme of seven selected relevant professional groups. The potentials of both measures to positively contribute to the gender equality discourse, as well as improving capacity building for the public health workforce who encounter VAW, are discussed.

  • 20.
    Sigblad, Fanny
    et al.
    Uppsala University / The Swedish Work Environment Authority.
    Fredriksson, M
    Uppsala University.
    Wilmer, Mikaela
    University of Gävle.
    Okenwa-Emegwa, Leah
    The Swedish Red Cross University College, Department of Health Sciences. University of Gävle.
    Savela, Maria
    University of Gävle.
    Barriers and Facilitators of Employees’ Utilisation of Wellness Subventions: Managers Perspectives2018In: Implementing Health Promotion in the Life Course - User Involvement in Practice and Research: September 24 – 26, 2018, Trondheim, Norway : Programme and Abstracts / [ed] Siw Tone Innstrand, Geir Arild Espnes and Bjarne Bruun Jensen, Norway, 2018, p. 155-156Conference paper (Refereed)
    Abstract [en]

    The workplace has an important influence on the health trajectories of individuals due to the amount of time spent in this sphere daily and over the life course. Work related factors such as injury, poor ergonomics, exposure to hazards etc. all have health implications during the course of life. The workplace is thus an important arena for population level health promotion. Recent times have seen much emphasis on ensuring healthy working lives. Examples inlude creation of many international and national policies, employers’ growing interest in work place health promotion (WPH) and large resources invested in WPH. Research however shows that utilisation of some WPH packages is relatively low. One such package is the provision of wellness subventions for employees in many Swedish workplaces. Managers are often charged with the responsibilities of WPH and have direct contact with employees. The aim of this study therefore is to investigate managers’ perspectives on barriers and facilitators of WHP package uptake among employees.

    Method: A qualitative method based on semistructured interview questions was used. Participants include managers at medium to large scale private companies in central Sweden. State owned companies were excluded in order to ensure homogeneity in terms of structure and policy. Not more than one manager per company was interviewed, giving rise to a total of nineteen respondents. Data was analyzed using content analysis. Results: A total of three themes and nine sub themes emerged. The first theme deals with factors at the individual level, sub themes include work-life balance, individual resources and individual attitude. In the second theme which relates to the Structure of WHP packages, sub themes including design and delivery of WHP, information flow and type of external collaborators/partners involved were identified. Company culture and leadership is the third theme, sub themes are leadership style and health perspective of management; existence of enabling environmet and support for management.

    Conclusion: Modifiable factors at organisational level can lead to improved design and delivery of WPH packages. These modifications may be crucial in addressing barriers at individual level with lots of potential to improve utilisation.

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