"It's different here" Afghan refugee maternal health experiences in the United States.

BACKGROUND: The number of Afghan families in the US has grown over the past two decades, yet there is a paucity of research focused on their maternal healthcare experiences. Afghan families have one of the highest fertility rates in the world and typically have large families. As the US faces rising maternal mortality rates, it is crucial to understand factors that affect health outcomes for culturally distinct groups. We aimed to better understand Afghan women's maternal health experiences in South Texas as a step toward designing culturally sensitive care. METHODS: Using a qualitative descriptive design, twenty Afghan women who gave birth in the US within the past 2 years participated in audio-recorded interviews. The first and second authors conducted each interview using a semi-structured interview guide. The authors used an in vivo coding method and qualitative content analysis of the transcribed narrative data. RESULTS: We identified three broad categories with corresponding sub-categories: 1) Maternal Healthcare Experiences: pregnancy, birthing, and postpartum, 2) Communication: language barrier, relationship with husband, and health information seeking, 3) Access to Care: transportation and financing healthcare. The participants expressed perspectives of gratefulness and positive experiences, yet some described stories of poor birth outcomes that led to attitudes of mistrust and disappointment. Distinct cultural preferences were shared, providing invaluable insights for healthcare providers. CONCLUSIONS: The fact that the Afghan culture is strikingly different than the US mainstream culture can lead to stereotypical assumptions, poor communication, and poor health outcomes. The voices of Afghan women should guide healthcare providers in delivering patient-centered, culturally sensitive maternity care that promotes healthy families and communities.

A Life Course Theory Approach to Understanding Eritrean Refugees' Perceptions of Preventive Health Care in the United States.

Thousands of Eritreans flee their homes each month, embarking on dangerous journeys. With these extreme life experiences in mind, this qualitative study aimed to better understand Eritrean resettled refugees' perceptions of United States (US) preventive health care through the lens of the Life Course Theory. Through secondary thematic analysis of narrative data, two over-arching themes emerged: 1) a thirst for information, understanding and affordable health care and 2) attitudes of gratitude and hope despite lack of information and funding. Health promotion programs should focus on enhancing community engagement while nurturing protective factors of resiliency and hope to improve information dissemination and access to affordable health-care services.