Evaluating a sexual and reproductive health and rights programme within Swedish for Immigrants education: a study...

Sexual and reproductive health and rights (SRHR) are central to health equity, yet migrants in Sweden, especially from low-income countries, experience linguistic, cultural, and structural barriers to SRHR information and services. Although migrants are prioritised in Sweden's national strategy for SRHR, no evaluation has examined SRHR education embedded within language programmes, limiting culturally responsive and scalable interventions. This protocol describes a study evaluating an SRHR programme integrated into Swedish for Immigrants (SFI), the national language programme for newly arrived adults.The study explores implementation processes, experiences of participants and implementers, and changes in SRHR knowledge, attitudes, behaviours, and healthcare navigation. Guided by implementation research principles and the UK Medical Research Council process evaluation framework, four qualitative sub-studies will be conducted across participating SFI sites. Semi-structured interviews and ethnographic fieldwork will involve midwives, SFI teachers, municipal stakeholders, and adult migrant learners. Data will be analysed using a combination of deductive and inductive qualitative content analysis and an ethnographic - hermeneutic approach, with process evaluation examining fidelity, adaptations, mechanisms of impact, and contextual determinants.The study is expected to identify key facilitators and barriers influencing programme delivery, acceptability, and relevance. Findings will inform evidence-based recommendations to strengthen cultural adaptation, implementation strategies, and learner engagement. Anticipated impacts include improved individual SRHR knowledge and health literacy, enhanced institutional capacity for inclusive SRHR promotion, and more equitable public service delivery at the societal level.Trial registration: ISRCTN 63,513,002 (registered 27 November 2025).