'You want to treat all patients the same. . . But it's important to know where someone is coming from': a qualitative study of U.S. healthcare providers' perspectives on culturally relevant sexual and reproductive healthcare for refugee women.

Abstract

Refugee women have poor outcomes and low utilization of sexual and reproductive health services, which may partly arise from a lack of culturally relevant sexual and reproductive healthcare. Little research has explored strategies to provide culturally relevant sexual and reproductive healthcare to this population. Our study seeks to fill this literature gap. We conducted in-depth, semi-structured interviews with 17 providers (e.g. physicians, nurse practitioners, registered nurses) serving refugee women in Metropolitan Atlanta, Georgia. Two coders analysed the data using a qualitative thematic approach. According to providers, perceived cultural barriers to receiving sexual and reproductive healthcare included hesitancy to voice concerns or needs, delayed care seeking, a low emphasis on preventive care, and decision-making that is influenced by gender norms. Many providers reported a lack of or inadequate formal training in providing sexual and reproductive healthcare for refugee women. Regarding strategies to deliver culturally relevant care, providers emphasized: applying principles of patient-centered care, tailoring care to patients' characteristics and cultural backgrounds, recognizing implicit bias and structural racism, accommodating autonomous, informed decision-making while building trust, and partnering with community members. In conclusion, our study identified multiple important strategies that can facilitate the provision of culturally relevant sexual and reproductive healthcare for this population.