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


CONCLUSIONS
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.
Department of Obstetrics and Gynaecology, University of KwaZulu-Natal, Durban, South Africa.
Edith T
ET
Kibiribiri
Department of Obstetrics and Gynaecology, University of KwaZulu-Natal, Durban, South Africa. Electronic address: moodleyd1@ukzn.ac.za.
Dhayendre
D
Moodley
Centre on Health, Risk and Society, American University, Washington, DC, USA.
Allison K
AK
Groves
Department of Obstetrics and Gynaecology, University of KwaZulu-Natal, Durban, South Africa.
Motshedisi H
MH
Sebitloane
D000328:Adult; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008485:Medical Audit; D017060:Patient Satisfaction; D011247:Pregnancy; D011295:Prenatal Care / Q000523:psychology*; D036301:Qualitative Research; D012036:Refugees / Q000523:psychology*; D013019:South Africa; D011795:Surveys and Questionnaires
Disparities; Prenatal care; Refugees; South Africa