264804 Prenatal Care Utilization in a Dedicated Refugee Clinic

Tuesday, October 30, 2012 : 10:45 AM - 11:00 AM

Luwam Semere, MD , Robert Wood Johnson Foundation Clinical Scholars Program, Department of Medicine and Obstetrics and Gynecology, University of California Los Angeles School of Medicine, Los Angeles, CA
Crista Johnson-Agbakwu, MD, MSc , Department of Obstetrics and Gynecology, Refugee Women's Health Clinic, Maricopa Integrated Health System, Phoenix, AZ
Jeanne Nizigiyimana, MS, MSW , Department of Obstetrics and Gynecology, Refugee Women's Health Clinic, Maricopa Integrated Health System, Phoenix, AZ
Kristina Cordasco, MD, MPH, MSHS , Division of General Internal Medicine, Department of Medicine, VA Greater Los Angeles HealthCare System, The University of California, Los Angeles, RAND Health, Los Angeles, CA
Gery Ryan, PhD , RAND Health, RAND Corporation, Santa Moncia, CA
PURPOSE: We partnered with the only U.S. clinic exclusively focusing on reproductive health needs of refugee women. To inform this clinic's outreach strategies, we examined patients' prenatal care utilization patterns and identified patient characteristics associated with inadequate utilization. BACKGROUND: Evidence suggests refugee women are at higher risk for inadequate prenatal care utilization and poor obstetric outcomes. The Refugee Women's Health Clinic (RWHC) was founded in 2008 to address disparities in reproductive health outcomes among the growing refugee population in Phoenix, Arizona. RWHC has identified their patients' inadequate prenatal care utilization as an area they would like to address. METHODS: We reviewed medical records of all adult RWHC patients seen since 2008. We assessed for associations between the Adequacy of Prenatal Care Utilization Index and patient characteristics using chi-squared tests and logistic regression. RESULTS: 132 refugee adult women presented to RWHC between 2008 and 2011. The majority of women were from Africa (61%), 25-29 years old (30%), married (83%), and multiparous (68%). 53% of women had inadequate utilization and 59% initiated care beyond the first trimester. No associations were observed between utilization and patient age, region of origin, marital status, or parity. CONCLUSIONS: Even in a clinic tailored to meet refugee women's needs, greater than 50% of refugee women had inadequate utilization and significantly less utilization compared to the general U.S. population (26%) as well as other immigrants (32%). This study constitutes a resource for women's health in refugee communities that will lead to further research and program development.

Learning Areas:
Diversity and culture

Learning Objectives:
Discuss significance of prenatal care utilization Discuss prenatal care utilization patterns among refugees

Keywords: Prenatal Care, Refugees

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working with the Refugee Women's Health Clinic at the Maricopa Integrated Health System, conducted the retrospective chart review, conducted the analyses, and written the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.