Learning from UJAMBO: Perspectives on Gynecologic Care in African Immigrant and Refugee Women in Boston, Massachusetts
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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.
KeywordsAfrican immigrants Refugees Health services Reproductive health Gynecology Qualitative
This project was funded by the Office of Minority Health (Grant Number: BBCMP1002A).
Compliance with Ethical Standards
Conflict of interest
Pooja Mehta receives research funding from the American College of Obstetricians and Gynecologists and the Maternal Child Health Bureau of the Health Resources and Services Administration. Kelley Saia has no conflicts of interest to disclose. Devi Mody has no conflicts of interest to disclose. Sondra Crosby has no conflicts of interest to disclose. Anita Raj receives funding from the National Institutes of Health, the Bill and Melinda Gates Foundation, the David and Lucile Packard Foundation, Kaiser Permanente, and the California Coalition Against Sexual Assault. Sheela Maru has no conflicts of interest to disclose. Lin Piwowarczyk has received funding from the United Nations and the Office of Refugee Resettlement.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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