Date of Award


Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)




Care during pregnancy is an important preventative health intervention for women and their unborn baby in all cultures. Healthcare inequities exist among some ethnic minority groups and contribute to racial disparities in birth outcomes. Pregnant Somali women, newly immigrated to the United States, ffie forced to seek prenatal care within a cultural context that can be very different from their own experiences and expectations. This refugee population is expected to fit into a medical system that is not only unfamiliar to them, but at times unable to meet their needs during pregnancy. As Somali women seek access to western healthcare systems, practitioners need to understand, facilitate, and integrate traditional cultural practices into prenatal care encounters. Somali Culturally Appropriate and Respectful Education and Support (CARES) Program for Pregnancy is a clinic-based, group prenatal care program for Somali refugees that advances healthcare delivery. A creative approach of providing prenatal care, the Somali CARES program was developed and implemented at Mayo Clinic, Rochester, MN in 2009 to support the cultural and social contexts of Somali women through the use of a cross-cultural pedagogy. Incorporating storytelling, role playing, and facilitative discussion created an atmosphere of respect for cultural differences and built trust between the Somali women and their healthcare practitioners. The use of learning through cultural ways of expression was a very effective method of bring traditional African education alive for the learners and enabled active participation as teachers involved the learners in uncovering the meaning of their stories. Through a both ways educational approach, an equal power status was created between the healthcare practitioners and the Somali women, because both learned from the other. When healthcare practitioners listened and partnered with the Somali women, a new paradigm for advancing participatory healthcare practice transformed. The Somali women indicated a high level of satisfaction with the program and recommended it to other Somali women. Entering into the world of the Somali culture, while listening to the voices of the women, while honoring their ways of knowing and doing, new insights unfolded for healthcare practitioners. Listening to the voices of the other help to dismantle barriers of providing culturally appropriate prenatal care for the Somali women created an atmosphere of a caring, teaching-learning environment that lead to improved health outcomes of the mother and baby.


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