Using cultural humility to build maternal health literacy among diverse refugee women: A community-based, multi-institutional partnership

In addition to the stress of resettlement and adjustment, refugee women who are pregnant face the challenge of navigating pregnancy and delivery in an unfamiliar culture and healthcare system. A group of Chicago-area resettlement agencies, noting that fear and misconceptions prevented many of their pregnant refugee clients from accessing prenatal care and caused apprehension about the childbirth process, created a multicultural pregnancy and post-partum support group providing culturally-sensitive educational workshops and social support for refugee women. The purpose of this effort is to improve maternal health literacy, build capacity to navigate the healthcare system and decrease social isolation among pregnant and post-partum refugee women. A true community-based collaboration, two agencies provided funding and oversight; six agencies participated in the project planning committee. Planning committee members developed the six-month curriculum with attention to the context in which these women live, presuming some basic knowledge was needed but allowing flexibility to adjust to unanticipated needs. Sessions were structured around participant questions, feedback and sharing of cultural maternity practices. Language interpretation, transportation, childcare and food were provided as attendance incentives. Local experts facilitated workshops on topics including childbirth options, accessing the healthcare system, breastfeeding, positive parenting and the science of play. These external partnerships further enriched the collaborative nature of the project by providing linkages to outside resources locally available but typically inaccessible to participants. A mixed-methods, multi-level evaluation examined content, process, lessons learned and the value of “connecting the dots” at the community level. Preliminary findings reveal broad diversity across participant demographics, including ethnicity (Burmese, Bhutanese, Iraqi and Burundi), age, marital/partnered status and parity. Growth in attendance indicates that the sessions were accessible and that informal peer recruitment occurred within communities. Partnering agencies responded positively about their involvement in the project. Project challenges included funding and multi-level, multi-directional communication.