Refugee Health Technical Assistance Center
Our May issue highlights refugee women's health in honor of National Women's Health Week, May 13-19!

Patient-Centered Health Care for  Refugee Women

Written by Crista Johnson-Agbakwu, MD, MSc, FACOG, Founder and Director of the Refugee Women's Health Clinic.


Refugee women are a vulnerable group who have been involuntarily displaced, are survivors of human rights abuses, and need special attention and care. Pre- and post-resettlement experiences of forced migration can have profound effects on women's reproductive health as refugee women are more likely to experience delays in accessing health services and disparities in reproductive health outcomes. Areas that require culturally sensitive care include not only pregnancy and childbirth, but also education and counseling on family planning, inter-conception care, screening for gender-based violence, sexually transmitted infections, preventive health, chronic diseases, and traditional cultural practices that may influence reproductive health.


The Refugee Women's Health Clinic (RWHC) of Maricopa Integrated Health System in Phoenix, Arizona is a unique patient-centered medical home for more than 1,500 refugee women, predominantly from Burma, Somalia, Burundi, Iraq, and Bhutan. RWHC provides comprehensive reproductive health services for refugee women including specialized care for women with female genital cutting. The multilingual staff, including refugee women who serve as Cultural Health Navigators, facilitates an integrated, team-based approach to health care delivery with intensive care coordination and case management that engenders women's trust and enhances their health literacy.


RWHC has a community partnership, engagement, and shared leadership infrastructure. Coordination of culturally competent care is facilitated through an interdisciplinary team of ethnic organizations, refugee resettlement agencies, mental health and social services agencies, and academic partners. Community-Based Participatory Research partnerships are currently underway to assess prenatal care utilization, maternal and neonatal delivery outcomes, refugee women's care experiences, and health service needs to better serve the community. Read more about refugee women's health > 


In the Literature    

Perspectives on preventive health care and barriers to breast cancer screening among Iraqi women refugees. Saadi A, Bond B, Percac-Lima S. (2011). J Immigr Minor Health.


Physical activity and nutrition among immigrant and refugee women: a community-based participatory research approach. Wieland ML, Weis JA, Palmer T, Goodson M, Loth S, Omer F, Abbenyi A, Krucker K, Edens K, Sia IG. (2012). Womens Health Issues, 22(2):e225-32.


Lost in translation: reproductive health care experiences of Somali Bantu women in Hartford, Connecticut. Gurnah K, Khoshnood K, Bradley E, Yuan C. (2011). J Midwifery Womens Health, 56(4):340-6.


Sexually transmitted infections in newly arrived refugees: is routine screening for Neisseria gonorrhoae and Chlamydia trachomatis infection indicated? Stauffer WM, Painter J, Mamo B, Kaiser R, Weinberg M, Berman S. (2012). Am J Trop Med Hyg, 86(2):292-5.


"They get a C-section...they gonna die": Somali women's fears of obstetrical interventions in the United States. Brown E, Carroll J, Fogarty C, Holt C. (2010). J Transcult Nurs, 21(3):220-7.


Indicators of acculturation related to Somali refugee women's birth outcomes in Minnesota. Flynn PM, Foster EM, Brost BC. (2011). J Immigr Minor Health, 13(2):224-31.

Introducing the Refugee Suicide Prevention Training Toolkit

Looking for a suicide prevention training that incorporates the challenges and strengths of resettled refugees? RHTAC, in collaboration with Bhutanese community members, recently adapted a nationally recognized suicide prevention training model called Question, Persuade, Refer (QPR) and developed a toolkit that includes presentation slides, facilitator's guide, interactive training activities, and resource handouts. Download the free Toolkit and host a training > 

Update on Lead Poisoning among Refugee Children

Newly published research confirms the on-going risk of elevated blood lead levels among refugee children from various developing countries. Two articles have documented high prevalence of elevated blood lead among refugee children from Burma: as high as 7.1% in Indiana and 14.5% in Thai camps. Of particular concern is the association of daily use of thanakha, a traditional cosmetic, with elevated blood lead levels.  

Learn more >

Affordable Care Act & Refugee Health

Women have unique healthcare needs. The Affordable Care Act (ACA) recognizes this and protects women by providing insurance options, covering preventive services, and lowering costs:

  • The ACA ends the practice of health insurance companies denying coverage to women with pre-existing conditions, such as cancer.
  • Women who joined a new health plan after March 23, 2010 can now receive many preventive care services without co-pays. Read more >
  • Starting in 2014, insurance companies will not be allowed to charge women higher premiums than men, which controls the cost of healthcare for women. Read more > 
  • All eligible individuals residing in the U.S., including refugees and immigrants, joining new health insurance plans have the freedom to choose any primary care provider, obstetrician-gynecologist, or pediatrician in their health plan's network without a referral.

 ACA Resources

North American Refugee Healthcare Conference

June 28-30, 2012

The North American Refugee Healthcare Conference will feature lectures and poster presentations from experts covering contemporary issues in refugee health, mental health, women's health, pediatrics, and primary care. RHTAC will be available to provide scheduled consultations with interested conference attendees. Keynote speakers are Eskinder Negash, Director, U.S. Office of Refugee Resettlement and Martin Cetron, M.D., Director, Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention.  

Register now > 

Community Dialogue:
World Refugee Day 2012

World Refugee Day on June 20, 2012 is an occasion to raise awareness about the unique health needs and strengths of refugees. How are you highlighting refugee health in your community, family, or workplace this World Refugee Day? What refugee health events have you held in the past? Share your experiences and be inspired to hold an event.  

Join the conversation >  

Upcoming RHTAC Webinars
Refugee Mental Health Screening: Operationalizing the RHS-15
Wednesday, May 23, 2012
1:00 - 2:30 PM EDT
Presented by: Beth Farmer, MSW, Project Director for the Pathways to Wellness Project, and Sasha Verbillis-Kolp, MSW.
Details: This webinar is a follow-up to Tools and Strategies for Refugee Mental Health Screening: Introducing the RHS-15.
Register now >

Making Culturally and Linguistically Appropriate Services (CLAS) Happen - Save the date! 

Wednesday, June 20, 2012
12:00 - 1:30 PM EDT
Details: This training will introduce the Culturally and Linguistically Appropriate Services (CLAS) standards, issued in 2001 by the US Department of Health Human Services' Office of Minority Health. 
Upcoming Events    


Integrated Health and Mental Approach to Care of Torture Survivors Webinar  

May 23, 2012, 2-4PM ET

Presented by: Gulf Coast Jewish Family & Community Services


North American Refugee Healthcare Conference - Registration open!

June 28-30, 2012, Rochester, NY

Presented by: Rochester General Hospital 

View updated speaker schedule > 


September 19-20, 2012, Washington, DC

Presented by: U.S. Office of Refugee Resettlement


National Immigrant Integration Conference 

September 22-25, 2012, Baltimore, MD
Presented by: The National Partnership for New Americans 

2012 National Refugee and Immigrant Conference: Issues and Innovations

October 18-19, 2012, Chicago, IL. Abstracts due May 31, 2012.

Presented by: Adult Learning Resource Center

Funding Opportunities 

Refugee School Impact 

U.S. Office of Refugee Resettlement

Letter of Intent Due May 18, 2012.

Application Due June 18, 2012. Funding to support local school systems that are impacted by significant numbers of refugee children or are faced with challenges in providing education to refugee students. 


Discretionary Grants for Refugee Microenterprise Development 

U.S. Office of Refugee Resettlement
Due June 5, 2012.
Provides discretionary grants to public agencies, community economic development agencies, community action and other human service agencies, local mutual assistance associations, and/or voluntary agencies with a long-term commitment to refugee microenterprise development.

Community Economic Development (CED) Projects
U.S. Office of Community Services

Due June 6, 2012. Provides approximately $27 million in grants ($800,000 maximum per project) to Community Development Corporations (CDCs) for projects designed to address the economic needs of low-income individuals and families through the creation of employment and business opportunities. Up to $10 million of this funding will go to CED projects designed to improve access to healthy, affordable foods.


Discretionary Grant Funds for Projects to Establish Individual Development Account (IDA) Programs for Refugees
U.S. Office of Refugee Resettlement
Due June 18, 2012. Designed for projects to establish and manage IDAs for low-income refugee participants. Grantee organizations may use ORR funds to provide matches for the savings in the IDAs for individual refugees and refugee families.

Cuban/Haitian Discretionary Grant Program

U.S. Office of Refugee Resettlement

Due June 25, 2012. Designed for services in the program areas of employment, hospitals, and other health and mental health care programs, adult and vocational education, refugee crime or victimization, and citizenship/naturalization for those localities most heavily impacted by Cuban and Haitian entrants and refugees, particularly where arrival numbers in recent years have increased.


Services to Older Refugees

U.S. Office of Refugee Resettlement

Due June 25, 2012. Funding for programs that ensure the provision of social and supportive services to older refugees, defined as refugees and other ORR-eligible populations age 60 and above.

RHTAC is a project of the Refugee and Immigrant Health Program, Massachusetts Department of Public Health, in collaboration with the Center for Refugee Trauma and Resilience at Children's Hospital Boston, the Bellevue/NYU Program for Survivors of Torture, the Cultural Orientation Resource Center at Center for Applied Linguistics, and JSI Research and Training Institute, Inc. RHTAC is funded by the Office of Refugee Resettlement, Administration for Children and Families, U.S. Department of Health and Human Services. Grant #90RB0042.    


For more information, please email [email protected].

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Tips and Strategies to Promote Culturally-Sensitive Care around Refugee Women's Health


Includes tools to serve refugee women and identify their special needs.


Somali Health Education Materials and Videos

WellShare International 

Anatomy booklet, family planning pamphlet, and women's health fact sheets in English and Somali.


Pregnancy & Family Planning in the United States Video

Colorado Department of Public Health and Environment
Designed for newcomer refugees as a pregnancy and family planning orientation. Video is not available online. Visit and click on Contact Us to request a copy.


Clinical Topics: Mother, Child & Infant Care


Useful information on peripartum/perinatal care, clinically relevant articles, breastfeeding, and journal articles.

Our Bodies Ourselves: Women's Health Information Resource Center

Our Bodies Ourselves
Informative website on women's health, pregnancy, and birth. Some materials have been translated into 25+ languages including Nepali, Thai, and Arabic.


Healthy Refugee Toolkit: Women's Health


Contains health education materials in refugee languages on women's health, including routine health exams, breast cancer, female genital cutting, and female anatomy.


Sexual and Gender-based Violence against Refugees, Returnees and Internally Displaced Persons: Guidelines for Prevention and Response  


Guidelines offering practical advice on how to design strategies and carry out activities aimed at preventing and responding to sexual and gender-based violence perpetrated against refugee women.


Webinar Archive     

Infectious Disease Challenges in Refugees and Immigrants 

May 9, 2012  


Addressing the Language Access Barrier When Serving Refugee Patients

March 28, 2012  


Strong Roots and Bright Futures: Promoting Successful Adjustment for Refugee Youth 

February 8, 2012  


Adapting QPR Training to Incorporate Refugee Experiences 

January 31, 2012 


Tools and Strategies for Refugee Mental Health Screening: Introducing the RHS-15

January 25, 2012 


Clinical Care to Refugees with HIV Infection 

November 30, 2011


Domestic Refugee Health Screening Models and Clinical Guidelines

October 26, 2011


Addressing the Mental Health Needs of Refugees in Primary Care Settings

July 27, 2011


HIV and Refugee Resettlement  

June 23, 2011

Suicide Among Refugees: Understanding the Social and Cultural Context for Prevention Strategies

May 17, 2011   


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