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Factors Associated with Access to Maternal and Reproductive Health Care among Somali Refugee Women Resettled in Ohio, United States: A Cross-Sectional Survey


This study examined maternal and reproductive health (MRH) access of Somali refugees in the U.S. across four access dimensions (willingness to seek care, gaining entry to the health system, seeing a primary provider and seeing a specialist). We conducted a cross-sectional survey of 427 Somali refugee reproductive-age women in Franklin County, Ohio. Following descriptive statistics of demographics, we conducted multivariate analyses to test associations between demographics and the four access dimensions. Most Somali refugee women were married (68%), attained primary education (92%), employed (64%) and were circumcised (82%). Young (OR 2.61, 95% CI 1.25–5.60), single (OR 1.78, 95% CI 1.15–2.78), and minors upon arrival (OR 2.36, 95% CI 1.44–3.90) were more willing to seek care. Lack of insurance, limited language fluency and being circumcised limited access to care across all dimensions. Barriers to access need to be systematically addressed. Deconstructing beliefs regarding health systems may improve access, especially among older Somali women.

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This study was funded by the Robert Wood Johnson Foundation Clinical Scholars Program and the University of Michigan, Department of Obstetrics & Gynecology. Data analysis and manuscript development was supported by the Research Education and Training Core (RETC) of the Southwest Interdisciplinary Research Center (SIRC) at Arizona State University and the Early Career Faculty Fellowship from the National Institute on Minority Health and Health Disparities of the National Institutes of Health (NIMHD/NIH), award P20 MD002316 (F. Marsiglia, P.I.). We would like to thank Dr. Lubayna Fawcett for providing technical support, data entry error checking and data cleaning. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMHD or the NIH.

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Correspondence to Crista Johnson-Agbakwu.

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Ethical Approval

Ethics approval for this study was obtained from the ethics committee of the University of Michigan Institutional Review Board (IRB) (HUM00009502).

Informed Consent

Participants’ written informed consent was obtained using an informed consent form, which had been reviewed and approved by the IRB. For those participants who could not read and write, the enumerators read out the research information sheet and the informed consent form, and their thumbprint was taken as proof of consent. All participation was voluntary, and participants were allowed to exit the survey if they desired.

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Banke-Thomas, A., Agbemenu, K. & Johnson-Agbakwu, C. Factors Associated with Access to Maternal and Reproductive Health Care among Somali Refugee Women Resettled in Ohio, United States: A Cross-Sectional Survey. J Immigrant Minority Health 21, 946–953 (2019).

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  • Refugee
  • Access
  • Somali
  • Maternal health
  • Reproductive health