Background: While a large body of research has focused on the challenges experienced by healthcare staff when providing sexual and reproductive health services, little attention has been paid to the ways healthcare providers navigate these challenges. This study examined healthcare providers' accounts of encounters when providing sexual and reproductive health SRH services to migrants in Southern Sweden. It sought to examine challenges and dilemmas experienced by healthcare providers, strategies used to navigate these challenges and dilemmas, and assumptions underlying participants' accounts.
Methods: The data collection was conducted between September and March Qualitative thematic analysis was used to analyze thirty-one interviews with healthcare providers working in youth clinics and women healthcare clinics. Results: Three themes were identified in the analysis: 1 Between person centeredness and cultural considerations; 2 Knowledge positions and patient involvement; and 3 beyond the dyadic interaction healthcare provider-patient.
Some participants understood person-centered care as individualized care where the influence of culture on the encounter should be de-emphasized, whereas others tended to highlight this influence. Many participants viewed the influence of culture as primarily driven by migrants' cultural backgrounds, and as a source of challenges and dilemmas. Participants' strategies to navigate these perceived challenges and dilemmas included practicing cultural humility and seeking cultural competency. Knowledge positions also emerged as an important aspect of participants' accounts of encounters with migrants.
Many participants experienced that migrant patients were lacking knowledge about the body and sexuality. This disadvantaged knowledge position affected migrant involvement in care. Additionally, the study shows how participants placed their experiences in a broader organizational and social context. Participants highlighted several organizational challenges to encountering migrants and discussed dilemmas stemming from the interplay between migrants' structural and individual disadvantages.
Conclusions: The study findings illuminate the complex links between person-centered care and two important dimensions of the encounters with migrants: culture and knowledge positions. They also shed the light on the organizational and structural challenges surrounding these encounters.
