Exploring disparities in prenatal care between refugees and local South African women

Abstract

Objective: To explore possible disparities in prenatal care between refugees and South African women attending public health facilities in an urban setting in South Africa.

Methods: A cross-sectional, mixed methods study was conducted at four public health clinics providing prenatal services in Durban between January 29, 2013, and June 15, 2013. Pretested client-satisfaction questionnaires were administered to 200 women attending immunization services at the clinics whose infants were aged 6 months or younger. An additional 16 refugees participated in in-depth interviews. Finally, a maternity chart audit was conducted to compare the quality of basic prenatal care.

Results: Among the women enrolled, 78 (39.0%) were refugees and 122 (61.0%) were South African citizens. Dissatisfaction was reported by 23 (19.3%) of 119 citizens and 32 (43.2%) of 74 refugees (P<0.001). However, the maternity chart audit of 68 participants (31 refugees, 37 citizens) did not reveal significant disparities in the quality of prenatal care. The most recurring categories arising in the in-depth interviews were linguistic barriers and the challenges faced when using informal interpreters.

Conclusion: There were no significant disparities in prenatal care; however, refugees unable to communicate in the local languages reported that they were not provided with relevant health information and occasionally faced restricted access to prenatal services.

Keywords: Disparities; Prenatal care; Refugees; South Africa.