Caring for Somali women: Implications for clinician–patient communication

Abstract

Objective-We sought to identify characteristics associated with favorable treatment in receipt of preventive healthcare services, from the perspective of resettled African refugee women.Methods-Individual, in-depth interviews with 34 Somali women in Rochester, NY, USA. Questions explored positive and negative experiences with primary health care services, beliefs about respectful vs. disrespectful treatment, experiences of racism, prejudice or bias, and ideas about removing access barriers and improving health care services. Analysis was guided by grounded theory.Results-Qualities associated with a favorable healthcare experience included effective verbal and nonverbal communication, feeling valued and understood, availability of female interpreters and clinicians and sensitivity to privacy for gynecologic concerns. Participants stated that adequate transportation, access to healthcare services and investment in community-based programs to improve health literacy about women's preventive health services were prerequisite to any respectful health care system. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access

Refugee experiences of general practice in countries of resettlement: a literature review

“…The studies were conducted in the US, [17][18][19][20][21][22][23] Canada, 24 England, [25][26][27] Scotland, 28,29 Ireland, 30 Netherlands, 31,32 Norway, 33 Sweden, 34 Finland, 35 Switzerland, 36 New Zealand, 37,38 and Australia. 39 Thirteen papers focused on refugees, three on asylum seekers, and seven combined both.…”

“…Most studies combined multiple ethnic groups, while four studies focused exclusively on people from Somalia, 17,19,21,38 and one each focused only on people from Bosnia, Ethiopia, Iran, Afghanistan, and Sri Lanka. 22,24,27,31,33 All selected studies used qualitative methods and collected data through interviews with individuals, families, or focus groups.…”

“…knowledge about the health system 26 and described systems as complicated and difficult to understand. 21 Knowledge gaps included the role of the GP, 27 where to find a GP, 25 how to make an appointment, 19 and how to access out-of-hours primary care: 28,29 'I hadn't even heard the word GP before you know!' 28 Refugees found it difficult to register at practices and to make appointments because of limited knowledge of processes and language barriers.…”

“…22,25,28 Registration and appointment making were facilitated with assistance from friends, family, support workers, and the NHS Health Board in the UK: 25,27,28 'If I don't have anybody to make the appointment for me I can't do it [myself].' 19 Refugees described difficulties with transport to and from services. 17,19,20,38 They struggled with the costs of medical care, [17][18][19][20][21][22]39 especially medicines: 21,28,29 'I just find it very hard when I am sick, I can't afford to pay for a doctor.'…”

“…19 Refugees described difficulties with transport to and from services. 17,19,20,38 They struggled with the costs of medical care, [17][18][19][20][21][22]39 especially medicines: 21,28,29 'I just find it very hard when I am sick, I can't afford to pay for a doctor.' 39 Sometimes access was limited by visa entitlements or insurance programmes.…”