Women’s Health 2015, April 16-19. Washington DC
“A Somali girl is Muslim and does not have premarital sex. Is vaccination really necessary?” A qualitative study into the perceptions of Somali women in the Netherlands of the prevention of cervical cancer Authors Jihan Salad1, Petra Verdonk 2, Fijgje de Boer1, Tineke A Abma1 Email:
[email protected] /
[email protected] Affiliations 1Department of Medical Humanities, VU University Medical Centre, EMGO+ Institute of Health and Care Research, Amsterdam, the Netherlands 2Department of Medical Humanities, VU University Medical Centre, EMGO+ Institute of Health and Care Research, School of Medical Sciences
Background The participation in Human Papillomavirus (HPV) vaccination and Papanicolaou Screening (Pap smears) is low among ethnic minorities in the Netherlands and hardly any information is available about Somali women living in the diaspora. This qualitative study, based on the Health Belief Model (HBM) and an intersectionality framework, explores the perceptions of Somali women living in the Netherlands regarding the measures to prevent cervical cancer.
Methods Semi-structured interviews were conducted with young Somali women aged 17-21 years (n=14) and Somali mothers aged 30-46 years (n=6). Two natural group discussions were conducted with 12 and 14 Somali mothers aged 23-66 years. Data were analysed thematically for content.
Results Three themes were distinguished in which gender and culture play a role: (1) perceived barriers to uptake of preventive measures: distrust of the Dutch health care system and embarrassment to get Pap smears due to Female Genital Mutilation (FGM) and having a Dutch male practitioner; (2) other ways of information exchange and decision-making: the women used mainly peers in their communication about health and illness; (3) risk perception: perceived susceptibility to HPV and cancer is low because of the religious norms that prohibit sex before marriage. Susceptibility to HPV through (future) male partners was unknown.
Conclusions The current measures in the Netherlands to prevent women from cervical cancer hardly reach the Somali women, because these are perceived not to be relevant to them. Education about cervical cancer deviates from the ways of exchanging information within the Somali community. Teachers can provide culturally sensitive information to young Somali women at schools. For Somali mothers, oral education, e.g. poetry or theatre, about the Dutch health care system and men’s role in HPV transmission may be useful. An intersectionality approach, grounded in the HBM, is recommended to promote equal access to preventive health care for Somali women.
References Abdullahi A, Copping J, Kessel A, Luck M, Bonell C: Cervical screening: Perceptions and barriers to uptake among Somali women in Camden. Public Health 2009, 123(10):680–685 Hankivsky O, Reid C, Cormier R, Varcoe C, Clark N, Benoit C, Brotman S: Exploring the promises of intersectionality for advancing women’s health. International Journal for Equity in Health 2010, 9(5):1-15 Raymond NC, Osman W, O'Brien JM, Ali N, Kia F, Mohamed F, Mohamed A, Goldade KB, Pratt R, Okuyemi K: Culturally informed views on cancer screening: a qualitative research study of the differences between younger and older Somali immigrant women. BMC Public Health 2014, 14(1188) Rondy M, Van Lier A, Van de Kassteele J, Rust L, De Melker H: Determinants for HPV vaccine uptake in the Netherlands: A multilevel study. Vaccine 2010, 28(9):2070-2075
