The Development of a Reproductive Health Curriculum for Female Bhutanese Refugees in Atlanta, Georgia: A Special Studies Project Open Access

Avidano, Erica Dawn (2012)

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The Development of a Reproductive Health Curriculum for Female Bhutanese Refugees in Atlanta, Georgia:
A Special Studies Project
By: Erica Avidano, RN

Background: Resettled refugees are at high risk for poor health literacy and subsequent health outcomes. This is particularly true in regards to reproductive health, an area which is often taboo and given low priority in the lives of female refugees. Reproductive health is essential to a woman's overall health and livelihood and has a significant impact on her family, community, and society as a whole. Unfortunately, many refugees have limited access to reproductive information, services, and rights. This has been the case for the thousands of Bhutanese refugees who have been resettled from Nepali refugee camps to their new homes in Atlanta, Georgia.
Purpose: The purpose of this project was to develop a reproductive health curriculum specifically targeted towards female Bhutanese refugees. It will be incorporated into a broader refugee health literacy curriculum currently being developed by Georgia Refugee Health and Mental Health (GRHMH). It will provide a usable, comprehensive, medically accurate, and culturally sensitive tool for refugee organizations working in the Atlanta area.
Methods: The reproductive health curriculum was developed with input from refugee aid organizations, leaders in the Bhutanese community, and members of the target audience and was informed by a variety of reliable medical resources. The curriculum, consisting of five modules, was pilot tested in two local settings and was evaluated through the use of pre/post tests, feedback surveys, and verbal input.
Results: The reproductive health classes were attended by an average of 12 women per class, ranging in age from their late teens to early sixties. Pre/post test results showed a statistically significant improvement of knowledge during six out of eight class sessions, and the refugees reported positive feedback for both the curriculum content and classes. The curriculum was revised, and a final product was created based on input from the refugees, pre/post test results, classroom observations, and suggestions from GRHMH staff, as well as nursing and public health faculty.
Discussion: Further efforts should be made to expand the curriculum and address the needs of other target refugee populations. This should be accomplished through continued collaboration with the Bhutanese community and local refugee aid organizations.

Table of Contents

Table of Contents

Chapter 1: Introduction and Background...1

Introduction and Significance...1

Problem Statement...7

Purpose Statement...8

Definition of Terms and Abbreviations...10

Chapter 2: Review of Literature...11

Health Literacy...11

Reproductive Health and its Implications for Female Refugees...21


Chapter 3: Methods...28

Needs Assessment...28

Curriculum Development...30

IRB Approval...31

Pilot Testing...31

Curriculum Revisions...33

Chapter 4: Results...34


Pilot Testing...35

Evaluation Results...39

Chapter 5: Discussion...43

Strengths and Limitations...43




Appendix: Reproductive Health Curriculum for Bhutanese Refugees...57

An Introduction to Reproductive Health for Female Bhutanese Refugees: A Health Literacy Curriculum...58

Module 1: Anatomy and Menstruation...59

Module 1 Handouts...75

Module 2: The Women's Health Exam and Preventive Screenings...84

Module 2 Handouts...97

Module 3: Sexually Transmitted Infections...101

Module 3 Handouts...121

Module 4: Birth Control, Family Planning, and Abortion...125

Module 4 Handouts...153

Module 5: Fertility and Pregnancy...158

Module 5 Handouts...180

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