Healthcare providers balancing norms and practice : challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study

BACKGROUND: Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. OBJECTIVE: This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. DESIGN: We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. RESULTS: The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. CONCLUSIONS: Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in-service training including value clarification and attitude transformation to equip providers to be able to better cater to young people seeking sexual and reproductive health advice.

Managing Seasonality in Tourism : Challenges and Opportunities for the Tourism Industry in Húsavík, Iceland

Seasonality is a common phenomenon in the tourism industry around the world. Húsavík, a town on the northern coast of Iceland, has experienced tremendous growth in tourism in recent years and is sometimes recognised as the „Whale Watching Capital of Europe‟. However, Húsavík faces extreme seasonality with high demand mainly during the summer months and limited or no demand at other times of the year. As is emphasised in the tourism literature and widely in practice, seasonality is frequently seen as a problem for the tourism industry which has to be tackled. Academic research has never before been done on seasonality in Húsavík and the aim of this thesis is to understand the nature of seasonality within the tourism industry in Húsavík and discover potential ways to reduce seasonality in Húsavík tourism. In order to fulfil the aim, qualitative semi-structured interviews were undertaken with six tourism managers in Húsavík to investigate their perceptions of seasonality and if and how it could be managed. The results confirmed that the peripheral location of the destination stimulates seasonality and it poses major economic challenges for tourism businesses in Húsavík. Managers would prefer a longer tourism season. Several recommendations were provided for how to reduce seasonality such as develop other attractions than whale watching, improve accessibility, focus marketing on seasons outside the summer, and offer winter packages for foreign and domestic tourists.

English-medium instruction in Sweden : Perspectives and practices in two upper secondary schools

This thesis presents English-medium instruction (EMI) in the Swedish context, focusing on perspectives and practices in two schools. The research question is as follows: How and why is EMI offered, chosen, and practiced in the Swedish upper secondary school today? The aim is to explore the status of the educational option, the reasons for offering EMI to stakeholders, the stakeholders’ beliefs about and goals of EMI, and the implementation of EMI in the classroom. A survey of all upper secondary schools in Sweden was conducted to ascertain the spread of content teaching through a foreign language. The educational context was studied from an ecological perspective using methods based in linguistic ethnography. Language alternation, academic language, and language hierarchy were all considered. Interviews were analysed for content; and classroom language use was analysed for language choice and function. The concepts of affordance and scaffolding together with translanguaging were key. The de facto policies of the micro contexts of the schools were examined in light of the declared national policy of the macro context of Sweden. The results indicate that the option in Swedish schools has not increased, and also tends to only be EMI—not Content and Language Integrated Learning (CLIL) or instruction through other languages. EMI is offered for prestige, an international profile, marketing potential and personal interest. EMI students are academically motivated and confident, and see the option as “fun”. 100% EMI in the lessons is not the goal or the practice. Translanguaging is abundant, but how language alternation is perceived as an affordance or not differs in the two schools. One focuses on how the languages are used while the other focuses on how much each language is used. In conclusion, the analysis suggests that a development of definitions and practices of EMI in Sweden is needed, especially in relation to language policy and language hierarchy.