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Migrant Women's Experiences with Community Health Care: A Holistic Examination of Barriers to Reproductive Health Care for Chuukese Women in Guam, U.S
Objectives/Purpose: This paper explores the factors that contribute to low rates of reproductive healthcare utilization by Chuukese women.
Methods: Participant observation and in-depth semi-structured interviews with 29 community health center care workers and 20 Chuukese migrant women were conducted to explore factors impacting Chuukese women’s utilization of and access to quality, effective and culturally competent sexual and reproductive healthcare. This research explored both the clinic and the community in order to holistically understand the environment in which these health disparities emerge.
Results: Chuukese women described poor treatment by front-line healthcare workers coupled with a confusing system, difficulty making appointments and inability to pay clinic co-payments as the largest barriers to care. Yet, workers described different barriers, including language, lack of education and the culture of Chuukese patients. Further, women seeking reproductive healthcare not directly related to pregnancy were often turned away to make room for pregnant patients.
Discussion/Conclusion: Front-line workers directly contribute to patient experience and access. However, worker concerns with language, culture and education often perpetuate a ‘blame the victim’ ideology of health disparities, masking structural and clinical environment contributions to poor outcomes. Finally, primary attention to pregnant women exacerbates reproductive health disparities of all non-pregnant women.
Learning Areas:
Administer health education strategies, interventions and programsDiversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Social and behavioral sciences
Learning Objectives:
Describe the impact of migration, poverty and discrimination on women’s reproductive health in a U.S. Pacific Island territory.
Discuss the impact of structural factors, migration and the clinical environment which contribute to low health care utilization and increased health disparities.
Analyze the potential for interventions that address not only structural but clinical issues, specifically acknowledging the role of non-provider clinic employees in providing patient access and care.
Keyword(s): Immigrant Health, Asian and Pacific Islanders
Qualified on the content I am responsible for because: I have been researching Chuukese migrant women's health between Chuuk and Guam for the past two years. Among my scientific interests has been the study of the intersection of gender, migration and reproductive health, with a focus on Micronesian populations.
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.