Somali Refugee Women’s Experiences and Perceptions of Western Health Care

Njenga, Angela

doi:10.1177/10436596221125893

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…This is consistent with other quantitative literature that suggests preventive health visits are generally lower among foreign-born MENA compared to US-born White women (Dallo & Kindratt, 2015). Consistent with this, qualitative (focus group) studies demonstrate there are language and nancial barriers to receiving appropriate care among foreign-born MENA populations (Njenga, 2023;Ross Perfetti et al, 2019). Another barrier identi ed by MENA women in the US is the avoidance of well-woman visits when the health care provider is not of the same culture or religion (Harper et al, 2022).…”

Section: Discussionsupporting

confidence: 88%

Maternal and Perinatal Health Disparities Among Middle Eastern and North African Women and Children in the United States

Kindratt,

Dallo,

Brown

2024

Matern Child Health J

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Introduction: Few studies have evaluated the health of Middle Eastern and North African (MENA) women and children in the United States. Objectives were to determine the odds of well-visits, preventive behaviors during pregnancy, and low birthweight among foreign-born non-Hispanic MENA women and children compared to their US-and foreign-born non-Hispanic White counterparts after adjusting for covariates (hereafter, reported as MENA and White).Methods: We analyzed 2000. Outcomes included well-woman visits (past 12 months); dentist visits (past 6 months) and current smoking among pregnant women; and low, moderately low, and very low birthweight among children. Covariates included age, family income, and health insurance for children. Education and marital status were also evaluated among women.Results: Over half (53.4%) of foreign-born MENA women were of childbearing age (ages 18-45) compared to 47.7% US-born and 43.2% foreign-born White women. The odds of completing a well-women visit were 0.73 times lower (95% CI=0.38-0.89) among foreign-born MENA women compared to US-born White women after adjusting for age, education, and marital status. There was no statistically signi cant difference in dental visits between groups. No foreign-born MENA pregnant women reported current smoking. Foreign-born MENA children had higher odds of low (OR=1.65; 95% CI=1.16-2.35) and moderately low birthweight (OR=1.78; 95% CI=1.19-2.66) compared to US-born White children in adjusted models.Discussion: MENA women and children are classi ed as White by the federal government. Our results highlight that the health of foreign-born MENA women and children differ from their White counterparts. Signi canceWhat is already known on this subject? National studies have evaluated maternal and perinatal health among racial and ethnic minority groups; however, none have presented results among Middle Eastern and North African (MENA) women and children. The few studies that have evaluated MENA maternal and child health (MCH) outcomes have provided only state and local estimates. What this study adds?This study provides nationally representative baseline data on the maternal and perinatal health of foreign-born MENA women and children. This is the rst study to examine oral health among pregnant MENA women compared to US-and foreign-born pregnant White women.

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Section: Discussionsupporting

confidence: 88%

Maternal and Perinatal Health Disparities Among Middle Eastern and North African Women and Children in the United States

Kindratt,

Dallo,

Brown

2024

Matern Child Health J

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“…Somali refugee women expressed fear and mistrust toward Western health care, health care providers, and diagnostic tests but also acknowledged positive encounters with health care providers who were polite, attentive, and expressed interest in their lives and were perceived to be engaging in skilled caring practices [ 37 ]. Positive perceptions of health care providers were an influential factor in traumatized Yazidi refugees’ utilization and perception of health care [ 38 ]. This underscores not only how important it is for refugees to have a positive experience with health care [ 39 ] but also for FHBs whose perceptions may influence the extent of health care utilization by their family members with chronic health conditions.…”

Section: Discussionmentioning

confidence: 99%

Refugee Family Health Brokers’ (FHBs’) Experiences with Health Care Providers: A Thematic Analysis

Sar

2023

IJERPH

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Background. The resettlement and post-resettlement quality of life of refugees is often marred by chronic health/mental health conditions. To adequately care for refugees suffering these conditions, a promising strategy is the use of refugee Family Health Brokers (FHBs). FHBs are safe and trusted family members functioning as intermediaries between one’s family and health care providers. Although FHBs are known to positively influence health care utilization in their families, little is known about them and this aspect of their family caregiving role and experiences, particularly with health care providers, necessitating further research. Methods. Fourteen Bhutanese and three Bosnian refugee FHBs participated in a 2-hr focus group discussing their experiences with health care providers after being surveyed about their FHB role. Results. Thematic analysis yielded five themes centered around perceptions, knowledge, communication, behavior, and responsibilities reflective of FHBs’ experiences, which can be understood as symptoms of existing structural inequalities. Conclusions. FHBs primarily conveyed problems, struggles, and dilemmas they experienced more so than rewarding aspects of being an FHB. Suggestions are provided on how to avert these negative experiences from occurring and becoming barriers to developing allyship with FHBs in the context of existing structural inequalities.

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“…Even when provided with access to health services, refugees report difficulties navigating healthcare systems in host countries due to lack of knowledge about these organizations, transportation problems, or communication difficulties (Matlin et al, 2018; Taylor & Haintz, 2018; Winn et al, 2018). Furthermore, refugees, especially those with histories of discrimination or mistreatment, may mistrust healthcare providers in host countries, or be uncomfortable with certain medical practices or procedures (Njenga, 2023). Disconnected from their communities and familiar health practices, refugees might prefer using remedies familiar from home rather than seeking treatment or ignore personal health needs in favor of meeting those of their family members (Bellamy et al, 2015; Henry et al, 2020; Johnsen et al, 2020; Taylor & Haintz, 2018; Winn et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Refugees and their healthcare providers both report struggling with differences in expectations of care and means of communication (Winn et al, 2018). Refugees explain that they might hesitate to ask providers questions because their questions might be misunderstood or unwelcome; they also explain that providers often do not understand refugees’ cultural norms and the importance of traditional gender roles—for example, the need to see a provider of the same gender as the patient (Griffin et al, 2022; Njenga, 2023; Winn et al, 2018). Healthcare providers may also find it difficult to understand how refugees describe their bodily symptoms and might misunderstand refugees’ healthcare expectations (Ahmed et al, 2017; Johnsen et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Understanding Refugees Health Experiences in Host Countries: Three Theoretical Perspectives

Gepshtein,

Lee,

Bounds

et al. 2024

Clin Nurs Res

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Healthcare providers working with forcefully displaced populations often have limited knowledge and skills regarding the care of this population. The reasons are twofold. First, most of the research on refugee health does not consider refugees’ adaptive skills, diversity of experiences, and daily life context. Second, healthcare providers’ knowledge of how the sociopolitical environment shapes health research and practice in the context of refugee care is often limited. This work aims to specify gaps in refugee healthcare and research by applying a relational approach to three theoretical frameworks. The relational approach supports a pragmatic, in-depth understanding of healthcare practices by shifting the focus of the inquiry from description of social structures toward exploration of processes and relations that propagate and sustain such structures. The focus is on the threefold interaction between refugees, healthcare providers, and healthcare institutions. The three theoretical frameworks are as follows: First, using concepts from the Theory of Practice by Bourdieu, we examine how gaps in care can result from a mismatch between the dispositions and skills that refugees develop through life experience and the cultural–professional practices of healthcare providers in host countries. Second, the Cultural Determinants of Help Seeking by Saint Arnault is applied to posit that gaps in care can result from differences in the meanings that healthcare providers and refugees assign to their interactions. Finally, we use the concept of Othering as described in nursing by Canales to explain how power dynamics inherent in the interaction between refugees and healthcare systems can affect refugee healthcare and research. This relational approach helps to elucidate some of the culture-bound mechanisms of health maintenance and help-seeking and brings attention to the sociopolitical context that shapes the way we care to refugees.

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Somali Refugee Women’s Experiences and Perceptions of Western Health Care

Cited by 5 publications

References 15 publications

Maternal and Perinatal Health Disparities Among Middle Eastern and North African Women and Children in the United States

Maternal and Perinatal Health Disparities Among Middle Eastern and North African Women and Children in the United States

Refugee Family Health Brokers’ (FHBs’) Experiences with Health Care Providers: A Thematic Analysis

Understanding Refugees Health Experiences in Host Countries: Three Theoretical Perspectives

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