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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2015

Open Access 01-12-2015 | Research

“A Somali girl is Muslim and does not have premarital sex. Is vaccination really necessary?” A qualitative study into the perceptions of Somali women in the Netherlands about the prevention of cervical cancer

Authors: Jihan Salad, Petra Verdonk, Fijgje de Boer, Tineke A. Abma

Published in: International Journal for Equity in Health | Issue 1/2015

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Abstract

Introduction

Participation in Human Papillomavirus (HPV) vaccination and Papanicolaou Screening (Pap smears) is low among ethnic minorities in the Netherlands and hardly any information is available about the cervical cancer prevention methods of Somali women living in the diaspora. This qualitative study, based on the Health Belief Model (HBM) and an intersectionality-based framework, explores the perceptions of Somali women living in the Netherlands regarding measures to prevent cervical cancer.

Methods

Semi-structured interviews have been conducted with young Somali women aged 17–21 years (n = 14) and Somali mothers aged 30–46 years (n = 6). Two natural group discussions have been conducted with 12 and 14 Somali mothers aged 23–66 years. The collected data has been analyzed thematically for content.

Results

In this study, we have identified perceived barriers to the use of preventive measures across three major themes: (1) Somali women and preventive healthcare; (2) Language, knowledge, and negotiating decisions; and (3) Sexual standards, culture, and religion. Many issues have been identified across these themes, e.g., distrust of the Dutch health care system or being embarrassed to get Pap smears due to Female Genital Mutilation (FGM) and having a Dutch, male practitioner; or a perceived low susceptibility to HPV and cancer because of the religious norms that prohibit sex before marriage.

Conclusions

Current measures in the Netherlands to prevent women from developing cervical cancer hardly reach Somali women because these women perceive these kinds of preventative measures as not personally relevant. Dutch education strategies about cervical cancer deviate from ways of exchanging information within the Somali community.
Teachers can provide culturally sensitive information to young Somali women in schools. For Somali mothers, oral education (e.g., poetry or theater) about the Dutch health care system and men’s roles in HPV transmission may be useful.
An intersectional approach, grounded in the HBM, is recommended to promote equal access to preventive health care for Somali women.
Footnotes
1
This poem has been written for this study and is intended for distribution.
 
2
The RATS guidelines on qualitative research are reporting guidelines provided for qualitative research reviews. They review the following four aspects of a manuscript: Relevance of study question, Appropriateness of qualitative method, Transparency of procedures, and Soundness of interpretive approach (RATS).
 
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Metadata
Title
“A Somali girl is Muslim and does not have premarital sex. Is vaccination really necessary?” A qualitative study into the perceptions of Somali women in the Netherlands about the prevention of cervical cancer
Authors
Jihan Salad
Petra Verdonk
Fijgje de Boer
Tineke A. Abma
Publication date
01-12-2015
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2015
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-015-0198-3

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