RESUMEN
UNLABELLED: The sexual and reproductive behaviors of Ethiopians immigrating to Israel have changed drastically as they transition to a new culture. With the postponement of age of marriage and an increase in sexual activity prior to marriage, there is an increased risk of unplanned pregnancy among young people in this group. The increasing rates of unplanned pregnancy among immigrants in developed countries have become a formidable public health challenge. OBJECTIVE: To examine abortion request rates and trends among young women of Ethiopian origin aged 16-24 years during the period 1995-2005 in order to characterize the relative extent of abortions and the time trends, and also to provide development and intervention recommendations. FINDINGS: During the years 1995-2005 the rate of abortion requests among young women of Ethiopian origin was 3-6 times that of other Israelis. Young women of Ethiopian origin born in Israel requested abortions at 1.3-3 times the rate of Israelis of non-Ethiopian origin. However, the adolescents of Ethiopian origin born in Israel had abortion request rates that were more comparable to other Israelis than to women born in Ethiopia who subsequently immigrated to Israel. However those who have been in Israel 5-9 years, compared to those living in the country for 1-4 years, have lower rates of requests for abortion, most notable in the 20-24 year old age group. CONCLUSIONS: Israeli women of Ethiopian origin have a considerably higher risk of requesting an abortion than other Israeli women of the same age. Although women of Ethiopian origin born in Israel had a lower rate of requests for abortions compared to those born in Ethiopia, this rate is still higher in comparison to other Israelis. Females born in Ethiopia have even higher rates. It is evident that these youth need exposure to appropriate preventive interventions and that this group cannot be considered homogenous. We recommend that appropriate interventions should be based on the specific needs of sub-groups within them and on appropriate analytical and development research.
Asunto(s)
Aborto Inducido/estadística & datos numéricos , Emigrantes e Inmigrantes/estadística & datos numéricos , Embarazo no Planeado/etnología , Adolescente , Factores de Edad , Etiopía/etnología , Femenino , Humanos , Israel , Embarazo , Adulto JovenRESUMEN
OBJECTIVE: Despite receiving full medical care and many social services, many Ethiopian immigrants in Israel feel frustrated, and even alienated, by the care they receive. This study uses a qualitative approach to explore the obstacles Ethiopian immigrants face regarding effective health seeking behavior and optimal interactions with healthcare providers in Israel. DESIGN: We gained a three-cornered perspective by conducting semi-structured interviews with healthcare providers, immigrants, and interpreters who mediate between the two. An ecological system or socio-ecological model guided the data analysis. It allowed organizing the varied and complex relationship between the factors that influence healthcare delivery and receipt among this population. RESULTS: The advanced analysis of our results delineated four themes which we grouped into two domains: the cultural divide and the interpreters. Within each of these themes, we explored influences on health or healthcare at each level of the socio-ecological model. We demonstrated that the problems surrounding health seeking behaviors and receiving treatment stem mainly from a cultural divide. This cultural incongruity and its effects are apparent at multiple levels of the ecological model and must be recognized and addressed programmatically at these levels. CONCLUSIONS: Necessary program and service modifications include that cultural mediation become an integral part of health personnel's training for healthcare delivery and a necessary criterion for good practices. We recommend that professionals from within the health system be trained to act as interpreters. Lastly, the integration of traditional healers into the allopathic health system should be considered. These modifications require a system-wide change in policy, structure of services, and practices.