Date of Award

2011-07-01

Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN; Cynthia D. Connelly, PhD, RN, FAAN; Andrea L. Hazen, PhD

Keywords

East Africans, Lived experience, nursing, Phenomenology, Prenatal care, Somali language, United States healthcare system, women

Abstract

Access to prenatal healthcare for East African Somali Speaking Women (EASSW) who are immigrants to the U.S. has been dependent on the availability of a systematic healthcare treatment model. The purpose of this study was to explore EASSW's lived experiences in accessing prenatal healthcare services in the U.S. A descriptive, qualitative phenomenological approach informed by the work of Husserl was used to explore EASSW's experiences, views, and problems encountered while attempting to access prenatal healthcare services in the U.S. Fifteen EASSW of childbearing age (ages 18–45) were recruited for this study. All participants interviewed privately, beginning with a semi-structured, open-ended question regarding access to prenatal health care services, followed by three more focused questions. Due to cultural restraints, no digital recorder was used in this study, instead the researcher took pencil, and paper notes during the interviews. The specific aims of this study were: 1) to describe EASSW's experiences while seeking prenatal healthcare services; 2) to understand EASSW's views towards the American prenatal healthcare services available to them; and 3) to identify any problems participants encountered while obtaining prenatal care, including, if applicable, the reasons for not seeking early prenatal care services. Examination of participants' narratives revealed four major themes, including cultural barriers, favorable and unfavorable prenatal healthcare experiences, systematic obstacles, and the target population's lack of knowledge of the U.S. healthcare system. The study provided additional sub-theme categories regarding prenatal healthcare services for the EASSW of childbearing age. Further analysis of themes and subthemes identified three major categories of factors limiting access to prenatal health care in this population, including internal, external, and systematic factors. These factors include health care providers' lack of cultural sensitivity, a lack of quality interpretation services, EASSW's lack of access to resources such as transportation and childcare, and the complexity of the U.S. healthcare system. This study indicates the need for future research to understand more regarding factors currently limiting access to prenatal care.

Document Type

Dissertation: Open Access

Department

Nursing

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