Learning from UJAMBO: Perspectives on Gynecologic Care in African Immigrant and Refugee Women in Boston, Massachusetts

J Immigr Minor Health. 2018 Apr;20(2):380-387. doi: 10.1007/s10903-017-0659-4.


African-born immigrant women, and particularly refugees and asylum seekers, are at risk for reproductive health disparities but inadequately use relevant gynecologic services. We sought to elucidate perspectives on gynecologic care in a population of Congolese and Somali immigrants. We conducted a secondary qualitative analysis of focus group data using a grounded theory approach and the Integrated Behavioral Model as our theoretical framework. Thirty one women participated in six focus groups. Participant beliefs included the states of pregnancy and/or pain as triggers for care, preferences included having female providers and those with familiarity with female genital cutting. Barriers included stigma, lack of partner support, and lack of resources to access care. Experiential attitudes, normative beliefs, and environmental constraints significantly mediated care preferences for/barriers to gynecologic health service utilization in this population. Centering of patient perspectives to adapt delivery of gynecologic care to immigrants and refugees may improve utilization and reduce disparities.

Keywords: African immigrants; Gynecology; Health services; Qualitative; Refugees; Reproductive health.

MeSH terms

  • Adolescent
  • Adult
  • Black or African American / statistics & numerical data
  • Boston / epidemiology
  • Congo / ethnology
  • Emigrants and Immigrants / psychology*
  • Female
  • Focus Groups
  • Grounded Theory
  • Health Knowledge, Attitudes, Practice / ethnology*
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Middle Aged
  • Patient Acceptance of Health Care / ethnology*
  • Qualitative Research
  • Refugees / psychology*
  • Reproductive Health Services / statistics & numerical data*
  • Social Stigma
  • Somalia / ethnology
  • Young Adult