PROVIDING CULTURALLY COMPETENT PRIMARY-CARE FOR IMMIGRANT AND REFUGEEWOMEN - A CAMBODIAN CASE-STUDY

Currently, one of every 13 U.S. residents is foreign born. A 1991 surv ey of certified nurse-midwives (CNMs) indicated that 51% of the respon dents serve immigrant women. Using a case study approach, this article illustrates barriers to health care experienced by foreign-born women and demonstrates how cultural competence increases provider effective ness in meeting the unique needs of this population. Effective primary care requires understanding the context of the refugee experience and its physical and emotional sequelae; addressing geographic, linguisti c, economic, and cultural barriers; and providing high-quality care th rough the efficient use of resources without unduly controlling women' s choices. Providing care within the context of the traditional family structure, gender roles, family support systems, and community servic es and resources further enhances health care services. Equally import ant is the establishment of a sustained partnership with clients, base d on the support of protective traditional health practices and the re cognition that a woman is expert in her own health. By respecting the complex cultural, political, economic, and personal backgrounds that c ontribute to immigrant women's perceptions of health, illness, and hea lth care needs, culturally competent primary care providers serve dive rse populations more effectively and help to enrich the communities in which they live and work. (C) 1997 by the American College of Nurse-M idwives.