Evaluating a sexual and reproductive health and rights program ”Sexual health and rights for all” implemented in Swedish for immigrants education

Plain English summary of protocol

Background and study aims
Sexual and reproductive health and rights (SRHR) are essential for everyone’s overall health, equality, and well-being. In Sweden, most people have good access to SRHR information and care, but many migrants face barriers. These include language difficulties, cultural differences, limited health knowledge, and a lack of trust in the healthcare system. Such barriers can lead to poorer health and greater inequality.

To help address this, a midwifery clinic in the Bergsjön area of Gothenburg has developed a program called “Sexual Health and Rights for All”. The program is designed to give adult migrants clear, culturally sensitive education about sexual and reproductive health as part of their Swedish for Immigrants (SFI) language studies. The educational program covers sex, gender, and sexual health; human rights and Swedish laws about SRHR; reproductive health, family planning, and access to care.

Our hypothesis is that integrating a culturally tailored SRHR education program into the SFI curriculum will be both feasible and acceptable to educators and migrant participants. We further hypothesize that participation in the program will lead to measurable improvements in SRHR knowledge, attitudes, communication skills, and use of healthcare services. In the longer perspective, the program has the potential to reduce inequities in access to SRHR information and services, and to serve as a scalable model for promoting sexual and reproductive health and rights in diverse adult education contexts.
The overall aim of this project is to evaluate the implementation and impact of a sexual and reproductive health, and rights program integrated into Swedish for Immigrants education in Gothenburg . The specific aims are as follows:
• To determine factors influencing the implementation of the SRHR program (Study I)
• To identify key determinants of acceptability, and perceived relevance of the SRHR program among adult migrants enrolled in SFI education (Study II).
• To identify factors that may promote or hinder the learning of SRHR in SFI education (Study III).
• To explore the outcomes and effectiveness of the SRHR program in SFI education (Study IV).

Who can participate?
The study involves adult migrants (both men and women) who are enrolled in Swedish for Immigrants (SFI) education in northeastern Gothenburg. They take part as learners in SFI courses at study path 2 (levels B, C, and D).
Additional participants include midwives, SFI teachers, managers, and local policymakers who are involved in organizing or delivering the program.

What does the study involve?
The project is made up of four sub-studies, using interviews and classroom observations to understand different parts of the program.
Sub-study 1 – Implementation:
Researchers will interview midwives, SFI staff, and local managers to learn what helps or hinders the delivery of the SRHR program.
Sub-study 2 – Acceptability:
Researchers will interview about 30–40 adult migrants (both men and women) who have attended the program to learn what they think about it — whether it felt relevant, understandable, and respectful of their cultures. Interviews will be conducted at a time and place convenient to participants, either in person or online, and interpreters will be available when needed.
Sub-study 3 – Learning process:
Researchers will observe classroom sessions for both men’s and women’s groups to see how SRHR topics are taught, discussed, and understood. These observations will help identify what teaching methods work best and what challenges arise.
Sub-study 4 – Program outcomes:
About one year after completing the program, participants will be interviewed again to see if the program changed their knowledge, attitudes, or health behaviors, such as seeking healthcare or using contraception.

What are the possible benefits and risks of participating?
Benefits:
Participants will have an opportunity to share their experiences and contribute to improving SRHR education for other migrants. Taking part in interviews may also help participants reflect on their learning and feel more confident discussing health topics. In the long term, the program aims to improve access to SRHR information, strengthen health knowledge, and promote gender equality.

Risks:
The risks are minimal. Some topics may feel sensitive or personal, but participants will only answer questions they are comfortable with. All information will be kept confidential, and participants can withdraw at any time without giving a reason.

Where is the study run from?
The study is conducted by a research team at the Sahlgrenska Academy, University of Gothenburg, in collaboration with Regionhälsan Västra Götaland, Sweden.

When is the study starting and how long is it expected to run for?
December 2025 to May 2028.

Who is funding the study?
The Region Västra Götaland (Regionhälsan) and supported by the University of Gothenburg, Sweden.

Who is the main contact?
Dr Malin Bogren, malin.bogren@gu.se

Contact information

Dr Malin Bogren
Public, Scientific, Principal investigator

Arwid Wallgrens backe, House 1
Gothenburg
413 46
Sweden

ORCID ID	0000-0003-2432-8097
Phone	+46 738099508
Email	malin.bogren@gu.se

Study information

Eligibility

Locations

Countries of recruitment

• Sweden

Study participating centres

Results and Publications

Editorial Notes

25/11/2025: Study’s existence confirmed by the Swedish Ethical Review Authority.