East African Somali Speaking Women of Childbearing Age: Access to Early Prenatal Healthcare

Saturday, 29 October 2011

Shukri Adam, MHCA, BSN, RN, PHN
Health and Human Services Agency, Central Region Public Health Center, The County of San Diego, San Diego, CA
Bonnie J. Copland, RN, MSN
San Diego County Health and Human Services, San Diego, CA
Julia Snethen, PhD, RN
College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI

Learning Objective 1: The learner will be able to understand the experiences of East African Somali Speaking Women (EASSWs) of childbearing age regarding accessing prenatal healthcare services.

Learning Objective 2: The learner will be able to gain an in depth understanding about East African culture, perceptions, and beliefs on prenatal healthcare health services.

Background: When East African Somali Speaking Women (EASSWs) of Childbearing age migrate from Africa to the USA, they resist the Western perception that medicine has the power to prevent, control, and cure diseases. The EASSWs perceive health matters to be out of their control because physical and mental disorders are controlled by God. One concern is that because of their belief system and cultural practices, EASSWs of childbearing age are not obtaining prenatal healthcare services, preferring to only visit a doctor when they are sick.

Purpose: The purpose of this project is to explore the experiences of EASSWs regarding accessing prenatal healthcare services. The aim is to gain an in depth understanding about East African culture, perceptions, and beliefs on preconception and prenatal healthcare health services.

Methodology: This quality improvement project was conducted, using a naturalistic inquiry approach. Participants were 13 EASSW who met the inclusion criteria of: 18 to 44 years of age, East African Somali speaking women, willing to discuss their perceptions of prenatal care, and residents of a large West Coast community. Interviews were manually recorded and thematically analyzed for recurring themes and patterns.

Findings: Themes that emerged from the data included: Strong cultural beliefs that are inconsistent with Western medical beliefs, mistrust and lack of knowledge about the Western healthcare system, communication barriers related to limited and inadequate interpreter services, limited access to health services due to coverage (Medicaid), and lack of resources.

Conclusion: Increased education and awareness about cultural differences are needed for EASSWs and their healthcare providers. Interpreters must receive training on HIPPA guidelines and the significance of not sharing information about the patients; and they must be held accountable. It is important to provide education to the EASSWs to help them understand not only the Western healthcare system, but their current cultural environment.