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Reimagining Reproductive Health Care for Refugee Women: Integrating Cultural Health Navigators into a Clinical Model
Ehiremen Azugbene1, Kathryn Claypool2, Zoë Baker3
1College of Health Solutions, Arizona State University, Phoenix, Arizona, USA.
Health Equity
|July 31, 2026
Summary
Integrated cultural health navigators (CHNs) effectively address reproductive health barriers for refugee women in safety-net settings. This program improves access to care, enhancing health equity for this vulnerable population.
Area of Science:
- Public Health
- Reproductive Health
- Health Equity
Background:
- Refugee women encounter significant barriers to reproductive healthcare, including language, transportation, insurance, socioeconomic instability, and trauma-related mental health issues.
- The Refugee Women's Health Clinic (RWHC) at Valleywise Health (VH) provides care to this population in the southwestern United States.
- Cultural Health Navigator (CHN) programs are integrated to address these access and care barriers.
Purpose of the Study:
- To characterize the demographics, health diagnoses, and reproductive health care utilization of refugee women at the RWHC.
- To examine the scope and impact of the integrated CHN program in mitigating care barriers.
- To evaluate the effectiveness of a community-based, equity-focused model for refugee women's reproductive health.
Main Methods:
- Retrospective cohort study using electronic medical record data from 2009-2024 at VH.
- Focused descriptive analysis of 7,504 refugee women receiving care at the RWHC.
- Analysis of CHN service delivery among 1,581 patients with documented CHN interactions.
Main Results:
- Patients represented over 100 countries, highlighting significant diversity.
- High rates of prenatal care utilization (93.2%) were observed, with 55.3% initiating in the first trimester.
- Common diagnoses included anxiety (10.0%) and depression (9.8%); preventive services like STI screening (43.1%) and contraceptive counseling (32.2%) were utilized. CHNs supported ~5,000 encounters annually, focusing on adherence, interpretation, transportation, and linkage to services.
Conclusions:
- The RWHC and its CHN program offer a successful community-based, equity-focused model for refugee women's reproductive healthcare in safety-net settings.
- Embedding CHN programs within clinical settings can mitigate socioeconomic, linguistic, and mental health barriers by improving care coordination and access.
- This model provides a framework for advancing reproductive health equity among resettled refugee women.
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