Exposure to culturally sensitive sexual health information and impact on health literacy: a qualitative study among newly arrived refugee women in Sweden

In Sweden, migrants have poorer sexual and reproductive health compared to the general population. Health literacy, in the form of the cognitive and social skills enabling access to health promoting activities, is often poorer among migrants, partly due to language and cultural barriers. Culturally sensitive health education provides a strategy for enhancing health literacy. Since 2012, specially trained civic and health communicators have provided sexual and reproductive health and rights information to newly arrived refugees in Skåne, Sweden. The aim of this study was to explore how information on sexual and reproductive health and rights was perceived by female recipients and whether being exposed to such information contributed to enhanced sexual and reproductive health and rights literacy. Semi-structured in-depth interviews were conducted with nine women and analysed using qualitative content analysis. Two themes emerged: (1) opening the doors to new understandings of sexual and reproductive health and rights and (2) planting the seed for engagement in sexual and reproductive health and rights issues, illustrating how cultural norms influenced perceptions, but also how information opened up opportunities for challenging these norms. Gender-separate groups may facilitate information uptake, while discussion concerning sexual health norms may benefit from taking place in mixed groups.