Barriers to reproductive health care for migrant women in Geneva: a qualitative study.

BACKGROUND: Migrant mothers in developed countries often experience more complicated pregnancy outcomes and less fewer women access preventive gynecology services. To enlighten health care providers to potential barriers, the objective of this paper is to explore barriers to reproductive health services in Geneva described by migrant women from a qualitative perspective. METHODS: In this qualitative study, thirteen focus groups (FG) involving 78 women aged 18 to 66 years were conducted in seven languages. All the FG discussions were audio-recorded and later transcribed. The data was classified, after which the main themes and sub-themes were manually extracted and analyzed. RESULTS: Barriers were classified either into structural or personal barriers aiming to describe factors influencing the accessibility of reproductive health services vs. those influencing client satisfaction. The five main themes that emerged were financial accessibility, language barriers, real or perceived discrimination, lack of information and embarrassment. CONCLUSION: Structural improvements which might meet the needs of the emergent extremely diverse population are the (1) provision of informative material that is easy to understand and available in multiple languages, (2) provision of sensitive cultural training including competence skill for all health professionals, (3) provision of specifically trained nurses or social assistance to guide migrants through the health system and (4) inclusion of monitoring and evaluation programs for the prevention of personal and systemic discrimination.

[Reproductive health among migrant women in Geneva: what are the challenges for Community-based participatory research]. / Santé reproductive des femmes migrantes à Genève: quels défis pour une approche participative basée sur !a communauté?

Community-based participatory research (CBPR) focuses on inequalities in health by involving community members and researchers in all parts of the research process. The project COMIRES (COmmunity Migrant RESearch), based in the Department of Obstetrics and Gynecology at the University Hospitals of Geneva, engages academic researchers and migrant communities in Geneva in a co-learning process to understand barriers to reproductive health services and evaluate the role of the community. The article illustrates the methodological approach, but also advantages and challenges of CBPR.