81:oral Equity for all? A policy analysis of priority to refugees and asylum seekers’ sexual and reproductive health in Norway (2010–2019)

Objective

Migrants’ health is conditioned by individual, social and structural determinants of health that are shaped by policies. Refugees and asylum seekers are of particular risk of sexual and reproductive health (SRH) issues, but few have studied whether and how their health is prioritized in policies. This study aims to assess how the SRH of refugees and asylum seekers is addressed in Norwegian health policies. Acknowledging that migration health is impacted by social determinants of health, this was given particular attention.

Methods

A document review of relevant policies (2010-2019) on SRH and refugees and asylum seekers in Norway was conducted. Documents were analysed systematically in four steps, informed by the READ approach (Read, Extract, Analyse, Distil).

Results

14 policy documents were included. While migrants’ health receives increased policy attention, this attention remains general in character. The national migrant health strategy (2013) was not followed by a specific policies or action plans. SRH issues of refugees and asylum seekers is not policy priority. This contrasts the decade long distinct policy priority and financial support to female genital mutilation (FGM) and forced marriage among migrants. FGM is seen as an area of concern across different policies on health alongside specific attention within violence polices. While social determinants of health and equality underpins general health policies in Norway, this was less prominent when polices discuss migrants and refugees’ health, including their SRH. Addressing migrant health, including SRH and in particular FGM, was often presented as a matter of language problems, cultural barriers and harmful norms and practices. Other higher-level determinants, such as poverty and low education were rarely a focus in policies and in actions suggested for change.

Conclusion

The SRH of refugees and asylum seekers is not a policy priority in migrant health policies nor in general health policies in Norway.