Online Program

280104
Building capacity and partnership with bhutanese refugees to access well-women preventive & health services


Monday, November 4, 2013 : 1:00 p.m. - 1:15 p.m.

Karen A. Heckert, PhD, MPH, MSW, Health Promotion Sciences Division and Global Health Institute, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ
Deirdre Demers, MPH, Health Promotion Sciences Division, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ
Purna Budathoki, BA, Bhutanese Mutual Assistance Association of Tucson (BMAAT), Tucson, AZ
Ram Upreti, BS, Bhutanese Mutual Assistance Association of Tucson (BMAAT), Tucson International Alliance of Refugee Communities (TIARC), Tucson, AZ
Bishnu Tiwari, BA, Bhutanese Mutual Assistance Association of Tucson (BMAAT), Tucson, AZ
Damayanti Kathet, BA, Bhutanese Mutual Assistance Association of Tucson (BMAAT), International Rescue Committee Tucson, Tucson, AZ
Sita Adhikari, BA, Bhutanese Mutual Assistance Association of Tucson (BMAAT), International Rescue Committee Tucson, Tucson, AZ
Purna Adhikari, Bhutanese Mutual Assistance Association of Tucson (BMAAT), Tucson, AZ
Lachu Ghataney, Bhutanese Mutual Assistance Association of Tucson (BMAAT), Tucson, AZ
Erica Smith, BS, Family Planning & Women's Wellness Programs, North Office, Pima County Health Department, Tucson, AZ
Stephanie Smith, BS, Family Planning & Women's Wellness Programs, North Office, Pima County Health Department, Tucson, AZ
Significance: The Lhotshampa ethnic group migrated from Nepal to Bhutan in the 1800s. In the 1980s the Bhutanese monarchy implemented a “One Nation, One People” policy eliminating Nepali in schools and requiring documentation for citizenship. Over 85,000 Lhotshampa fled to Nepal in 1990 where they lived in refugee camps for 20 years before being resettled to the United States. The Bhutanese are the third largest refugee group in the US. Limited resettlement services in Arizona include financial assistance for up to 8 months; case management for 3 to 6 months; and health insurance by the Refugee Medical Assistance Program (RMAP) for 8 months. Significant challenges persist such as retaining health insurance, lack of transportation, unemployment, limited English proficiency, illiteracy in Nepali, health seeking practices, and difficulties understanding the US health system. Objective: The aim of this project is to increase access to well-women preventive and care services for the Bhutanese refugees. Methods: A small grant was obtained and a four-step strategy was implemented: orient mainstream service providers to Bhutanese community, train BMAAT community health educators, provide educational outreach in 3 Bhutanese neighborhoods, engage the local health department to bring the Mobile Van to the Bhutanese neighborhoods and offer a free clinic day. Results: Outcomes included; established a committed partnership, trained 6 BMAAT community health educators, carried out 6 community education sessions in the 3 Bhutanese neighborhoods reaching at least 200 community members, and provided preventive education, screening and clinical services to 45 women and their husbands.

Learning Areas:

Administration, management, leadership
Assessment of individual and community needs for health education
Chronic disease management and prevention
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe the social, political and cultural factors that forced the Bhutanese to become refugees in Nepal. Discuss the partnership’s 4-step strategy that has enabled the Bhutanese community in Tucson to build its competence and confidence to effectively promote and access well-women’s educational and clinical services, including breast and cervical cancer screening.

Keyword(s): Community-Based Partnership, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have more than 30 years international and domestic experience bridging theory and practice as a public health practitioner and academic, including 18 years in developing countries with the World Health Organization, the Public Health Institute, Johns Hopkins University and as tenured faculty at the University of Otago, Department of Public Health, Christchurch, New Zealand. While at Johns Hopkins University I traveled frequently to Nepal to provide technical assistance and operations research in reproductive health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.