Communication and Cultural Issues in Providing Reproductive Health Care to Immigrant Women: Health Care Providers’ Experiences in Meeting Somali Women Living in Finland

Abstract

Communication problems due to language and cultural differences between health care professionals and patients are widely recognized. Finns are described as more silent whereas one concurrent large immigrant group, the Somalis, are described as more open in their communication. The aim of the study was to explore physicians-nurses/midwives' communication when providing reproductive and maternity health care to Somali women in Finland. Four individual and three focus group interviews were carried out with 10 gynecologists/obstetricians and 15 nurses/midwives from five selected clinics. The health care providers considered communication (including linguistic difficulties), cultural traditions, and religious beliefs to be problems when working with Somali women. Male and female physicians were generally more similar in communication style, interpersonal contacts, and cultural awareness than the nurses/midwives who were engaged in more partnership-building with the Somali women in the clinics. Despite the communication and cultural problems, there was a tentative mutual understanding between the Finnish reproductive health care professionals and the Somali women in the clinics.

Reproductive and maternity health care services in Finland: perceptions and experiences of Somali-born immigrant women

“…Nevertheless, the practice is still a long-standing common cultural tradition in Somalia, where more than 90% of females are circumcised. However, not all Somali women living in Finland are comfortable with such practice (Degni 2004). A third point is that although, the scope of this study was not women's interpretation of faith; however, our observation was that our participants did not share a radical view on the use of contraception and practice of abortion.…”

“…Somalis are visible because their different culture and religion sets them apart from other Africans, and also from mainstream Finns. Degni (2004) highlighted that Somalis are a unique minority ethnic group that is vulnerable to health and social challenges because many Somalis (particularly women) had experienced considerable stress due to the social instabilities and violent circumstances they encountered in their homeland. Nevertheless, Somalis in Finland cannot be considered a homogenous group with uniform sets of belief practices, customs and needs because beliefs might find different expressions in practice among individuals of the same culture, religion and language (Alitolppa-Niitamo 1994).…”

Factors influencing intercultural doctor–patient communication: A realist review

“…[47,52] In four studies, ICC was facilitated when the doctor was aware of his own culture. [31,43,110,111] For doctors, another main objective in ICC was to manage patients' expectations of the health care system. For example, it was often reported that patients with different ethnic backgrounds did not know how to enter the healthcare system, how to make an appointment with the doctor or which person with a high social status and regarded it as disrespectful to contradict the doctor (paternalism).…”

“…For example, it was often reported that patients with different ethnic backgrounds did not know how to enter the healthcare system, how to make an appointment with the doctor or which person with a high social status and regarded it as disrespectful to contradict the doctor (paternalism). [43,72,79,88,90,97,[122][123][124]127,[130][131][132][133][134][135][136][137][138][139][140] In these cases, patient-centered communication might be a effective approach for ICC.…”

“…When the doctor knew the situation and context of the patient, he adapted his Page 10 of 66 A c c e p t e d M a n u s c r i p t 10 behavior to expectations of the patient, which improved the communication outcome. [39,40,43,57,113] …”