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J Immigr Minor Health. 2018 Apr;20(2):380-387. doi: 10.1007/s10903-017-0659-4.

Learning from UJAMBO: Perspectives on Gynecologic Care in African Immigrant and Refugee Women in Boston, Massachusetts.

Author information

1
Department of Obstetrics and Gynecology, Boston University Medical Center & Boston University School of Medicine, 85 East Concord Street, Boston, MA, 02118, USA. p.k.mehta@gmail.com.
2
Department of Obstetrics & Gynecology, School of Medicine, Program in Health Policy and Systems Management, School of Public Health, Maternal & Womens Health Policy, LSU Consortium for Health Transformation, Louisiana State University Health Sciences Center, New Orleans, LA, USA. p.k.mehta@gmail.com.
3
Department of Obstetrics and Gynecology, Boston University Medical Center & Boston University School of Medicine, 85 East Concord Street, Boston, MA, 02118, USA.
4
Boston University School of Medicine, Boston, MA, USA.
5
Department of Internal Medicine/Immigrant and Refugee Health Program, Boston University Medical Center, Boston University School of Public Health & Boston University School of Medicine, Boston, MA, USA.
6
Center on Gender Equity and Health/Division of Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, USA.
7
Department of Psychiatry/Boston Center for Refugee Health and Human Rights, Boston University Medical Center & Boston University School of Medicine, Boston, MA, USA.

Abstract

African-born immigrant women, and particularly refugees and asylum seekers, are at risk for reproductive health disparities but inadequately use relevant gynecologic services. We sought to elucidate perspectives on gynecologic care in a population of Congolese and Somali immigrants. We conducted a secondary qualitative analysis of focus group data using a grounded theory approach and the Integrated Behavioral Model as our theoretical framework. Thirty one women participated in six focus groups. Participant beliefs included the states of pregnancy and/or pain as triggers for care, preferences included having female providers and those with familiarity with female genital cutting. Barriers included stigma, lack of partner support, and lack of resources to access care. Experiential attitudes, normative beliefs, and environmental constraints significantly mediated care preferences for/barriers to gynecologic health service utilization in this population. Centering of patient perspectives to adapt delivery of gynecologic care to immigrants and refugees may improve utilization and reduce disparities.

KEYWORDS:

African immigrants; Gynecology; Health services; Qualitative; Refugees; Reproductive health

PMID:
29032521
DOI:
10.1007/s10903-017-0659-4

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