The goal of this initiative is to improve overall maternal-child health outcomes among refugees in Wisconsin by increasing (i) health education on reproductive, perinatal and women’s health, (i) access to social services and health care, and (iii) encouraging usage of social and health care services. To accomplish this, we collaborate with refugee communities, resettlement agencies, state and local health departments, non-profit organizations, schools, hospitals/clinics, health care providers, and other stakeholders to co-design community-based interventions, programs, and evaluation research that are culturally appropriate and prioritizes communities’ needs.
More information about the different projects supported by the WI Refugee MCH Initiative can be found below.
Background
Worldwide, refugee women are more likely to experience pregnancy complications, poor birth outcomes, postpartum depression, and have unmet health needs after childbirth. Resettled refugees in the U.S., including those in Wisconsin, face many barriers to accessing health care, which can amplify their already poor maternal-child health outcomes, Refugees’ poor maternal and perinatal health profile is influenced by a combination of pre- and post-migration risk factors operating at individual, group and institutional/societal levels. Importantly, refugees are incredibly resilient–indeed many have survived unimaginably difficult and heartbreaking situations in their countries of origin and in refugee camps. Rather than mere survival, however, refugees want the opportunity to thrive as they reconstitute their lives in the United States. Our work with refugee women and their families at the MatCHES Lab is aimed at helping refugees to maintain or even strengthen their resilience through evidence-based interventions that support health and thriving.
Current Projects
The Perinatal Community Health Worker (PCHW) Pilot Project. Community health workers (CHWs) are trusted, typically co-ethnic members of a community who can serve as cultural brokers and help connect members to mainstream health and social services. CHWs have been shown to strengthen patient- provider relationships, reduce patients’ health risks, and improve proper health care usage among disadvantaged and underserved populations. But less is known about the effectiveness of CHWs for increasing refugee women’s health care access and improving maternal, infant and under 5 child outcomes.
The PCHW Pilot Project:
- Trained 3 co-ethnic members from the Afghan, Congolese and Rohingya communities in the Fox Valley, Madison and Milwaukee.
- Deploys the trained PCHW to provide one-on-one and group-based non-clinical services to pregnant and postpartum Afghan, Congolese and Rohingya women.
- Uses a pre/post-test design and mixed-methods to assess the feasibility, acceptability and limited effectiveness of the PCHW intervention.
Research team:
- Principal investigator: Zoua Vang, School of Human Ecology (SoHE), UW-Madison
- Co-investigators: Larissa Duncan, SoHE, UW-Madison; Beth Olson, Nutrition, UW-Madison; Natasha Hernandez, MD, Sinai Women’s Hospital
Community partners and collaborators:
- Aurora Walker’s Point Community Clinic
- World Relief Wisconsin
- Northport Apartments
Steering committee members:
- Eve Ropel – Educator
- Yusuf Abdullah – Physician, SSM Health, Sun Prairie Clinic
- Savitri Tsering – Refugee Health Coordinator, Wisconsin Department for Children and Families
- Kathryn Schlipmann – Program Manager, City of Milwaukee Health Department
The Pathways to Self-Sufficiency (PaSS) Project. Nationally, nearly 90,000 Afghan refugees arrived in the US since mid-2021, adding to the 132,000 Afghans already living in the country. Afghan refugees in WI concentrate in cities like Milwaukee, Appleton, Green Bay, and Madison. Afghans in WI are a diverse group, with individuals concentrated at the two extremes of the socioeconomic distribution. Research demonstrates that women’s support groups can significantly improve women’s lives by providing a safe and empowering space for sharing experiences, community building, and developing coping strategies. For refugee women, where experiences of isolation and trauma are common, support groups can offer an important lifeline, helping them to build connections with and learn from others with similar life experiences and circumstances. This kind of peer social support can help improve mental health. Research also shows that cash transfer programs can increase women’s empowerment, improve household well-being, and even reduce intimate partner violence. Unconditional cash transfers to women affect empowerment through giving them greater control over household finances and decision-making. Cash transfers can also bolster women’s health by increasing access to health care services and improved nutrition. By combining these two evidence-based programmatic features, the PaSS program has the potential to significantly improve the lives of low-income Afghan refugee women and their children.
This project aims to empower low-income, English-limited Afghan women from predominantly rural areas of Afghanistan and who have resettled in Wisconsin through a combination of a monthly women’s group, ESL, health education workshops, and a guaranteed monthly income transfer. Working with our established community partners, we will accomplish the following two objectives. Objective 1: Pilot the PaSS program. Objective 2: Evaluate the impact of the PaSS program on women’s decision-making, self-sufficiency, health knowledge, and maternal-child health outcomes using a combination of photovoice, in-depth interviews and questionnaires.