'You want to treat all patients the same. . . But it's important to know where someone is coming from': a qualitative study of U.S. healthcare providers' perspectives on culturally relevant sexual and reproductive healthcare for refugee women.
Vu M, Enders M, et al. • Health education research • 2025
Providers identified multiple important strategies to facilitate culturally relevant sexual and reproductive healthcare for refugee women, including patient-centered care, tailoring care to cultural backgrounds, recognizing implicit bias and structural racism, and partnering with community members.
Key Findings
Results
Providers identified hesitancy to voice concerns or needs as a key cultural barrier to refugee women receiving sexual and reproductive healthcare.
Data collected through in-depth, semi-structured interviews with 17 providers in Metropolitan Atlanta, Georgia
Providers included physicians, nurse practitioners, and registered nurses
Hesitancy to voice concerns was described as a perceived cultural barrier specific to refugee women
Two coders analyzed data using a qualitative thematic approach
Results
Delayed care seeking was identified by providers as a cultural barrier to sexual and reproductive healthcare among refugee women.
Delayed care seeking was one of multiple perceived cultural barriers described by providers
This pattern was identified across provider interviews conducted in Metropolitan Atlanta
The barrier was identified through thematic analysis of semi-structured interviews with 17 healthcare providers
Results
A low emphasis on preventive care among refugee women was perceived by providers as a barrier to sexual and reproductive health service utilization.
Providers described refugee women as placing lower priority on preventive care
This finding emerged from thematic analysis of interviews with 17 providers serving refugee women
Low preventive care emphasis was framed as a culturally influenced pattern rather than an individual failing
Results
Gender norms were identified by providers as influencing healthcare decision-making among refugee women.
Decision-making influenced by gender norms was listed among perceived cultural barriers
Providers described gender norms as shaping whether and how refugee women sought or accepted sexual and reproductive healthcare
This finding was identified through qualitative thematic analysis of provider interviews
Results
Many providers reported a lack of or inadequate formal training in providing sexual and reproductive healthcare for refugee women.
Inadequate training was a widely reported issue among the 17 interviewed providers
The gap in training was specific to the intersection of refugee populations and sexual and reproductive health
This finding points to a systemic gap in healthcare provider education and preparation
Results
Providers emphasized applying principles of patient-centered care as a key strategy for delivering culturally relevant sexual and reproductive healthcare to refugee women.
Patient-centered care was one of five main strategies identified through thematic analysis
Providers described individualized approaches as essential given the diversity within refugee populations
This strategy was identified across interviews with physicians, nurse practitioners, and registered nurses
Results
Tailoring care to patients' individual characteristics and cultural backgrounds was identified as an important strategy for culturally relevant care.
Tailoring was described as distinct from applying uniform cultural assumptions
Providers noted the importance of understanding where individual patients 'are coming from'
This strategy was highlighted as part of a broader framework of culturally responsive practice
Results
Recognizing implicit bias and structural racism was identified by providers as a necessary strategy in delivering culturally relevant sexual and reproductive healthcare.
Providers explicitly named implicit bias and structural racism as factors affecting care delivery
This recognition was framed as a provider-level responsibility rather than solely a patient-level issue
It was one of five key strategies identified through thematic analysis of 17 provider interviews
Results
Accommodating autonomous, informed decision-making while building trust was identified as a strategy for culturally relevant care for refugee women.
Providers described trust-building as essential given historical and cultural factors affecting refugee patients
Supporting informed, autonomous decision-making was linked to respecting patients' agency within their cultural contexts
This strategy was identified through qualitative thematic analysis of semi-structured interviews
Results
Partnering with community members was identified as a strategy to facilitate culturally relevant sexual and reproductive healthcare for refugee women.
Community partnerships were described as a way to bridge cultural and linguistic gaps
This strategy was one of five key approaches identified by providers in Metropolitan Atlanta
Community engagement was framed as complementary to clinical strategies for improving care delivery
What This Means
This research examines how healthcare providers in the Atlanta, Georgia area think about delivering sexual and reproductive health services to refugee women. Seventeen providers — including doctors, nurse practitioners, and registered nurses — were interviewed about the challenges they face and the strategies they use. The study found that refugee women face several cultural barriers to accessing care, including reluctance to speak up about their health concerns, delays in seeking care, less familiarity with preventive health services, and the influence of gender roles on health decisions. Many providers also said they had not received adequate training specifically focused on caring for refugee women's sexual and reproductive health needs.
Despite these challenges, providers described a range of practical strategies they use to provide better, more culturally appropriate care. These included treating each patient as an individual rather than making assumptions based on cultural background, recognizing their own potential biases and the role of systemic racism in healthcare, helping patients make informed decisions on their own terms while building trust over time, and working closely with community members who can help bridge cultural and language gaps.
This research suggests that improving sexual and reproductive healthcare for refugee women requires both individual provider awareness and systemic changes, including better training programs and stronger ties between healthcare institutions and refugee communities. The findings highlight that culturally relevant care is not about applying one-size-fits-all cultural rules, but about understanding and respecting each patient's unique background and circumstances.
Vu M, Enders M, Evans D, Copeland H, Dogbe A, Zhao D, et al.. (2025). 'You want to treat all patients the same. . . But it's important to know where someone is coming from': a qualitative study of U.S. healthcare providers' perspectives on culturally relevant sexual and reproductive healthcare for refugee women.. Health education research. https://doi.org/10.1093/her/cyaf032