A Qualitative Case Study Analysis
- Madeline Jennings Thornton, Trinity ‘18
Faculty Mentor: Deborah S. Reisinger, Romance Studies
May 4, 2019
Maternal and reproductive health experiences of Central African and French-speaking refugee populations in the United States have not been well studied, despite the fact that the United States has resettled 50,000 Congolese refugee during a recent 5-year period. This quantitative case study analysis was conducted to fill a gap in the literature on the health of French-speaking refugee women by qualitatively examining their experiences with maternal and reproductive healthcare across their life course. In addition to presenting the experiences of each participant, this study aims to give voice to an often ignored population of refugee women and to provide agency to each participant to share her story. Although each refugee follows a unique path, the participants in this study all followed a general life course pattern. The experiences of each participant in this study were analyzed and categorized according to the following life course pattern:
- Living in a conflict area,
- Living in an intermediary period,
- Living in the United States.
Individual unstructured, conversational interviews were conducted with five French-speaking refugee women recruited through a snowball sample. Interviews were conducted in French in the participant’s home using an interview guide that included questions on general healthcare experiences, maternal and obstetric care and family planning history throughout each stage of the life course. Interviews were audio-recorded and transcribed. Analytic memos were created to identify emerging themes. The general healthcare experiences, as well as maternal and reproductive healthcare experiences, of each participant were discussed in the context of each stage of the life course. This thesis expands upon emerging themes from conversations with participants related to religion, abortion and family planning. Furthermore, this thesis discusses and analyzes the implications and importance of this research at a personal, statewide, national and international level.
Research Reflection (Audio)
Madeline Thornton reflects on her research process
I was first introduced to the French-speaking refugee community in Durham as a student in a service-learning course taught by Professor Deb Reisinger during my sophomore year at Duke. Our class partnered with a local refugee resettlement agency to connect student groups with newly arrived refugee families. Our French language skills allowed us to uniquely serve the francophone refugee families, a relatively large group of newly arrived refugees. What started as weekly English tutoring sessions soon turned into weekend afternoon gatherings, and soon I was visiting my assigned family to read stories, share a meal and simply catch up.
During these visits, I began to learn some of the challenges that many refugee women in the community face in accessing quality healthcare. As a Global Health student especially interested in maternal and reproductive health, I grew curious about the healthcare experiences of the women that I was spending so much time with, and thus the idea for my thesis was born!
One of my biggest challenges was deciding how to approach women of the refugee community to get involved in the project without being coercive or making women feel that they owed it to me to be interviewed for my thesis. I was especially nervous to approach women in the community that I had a close bond with. I did not want anyone to feel uncomfortable speaking with me about such intimate and private topics as sexual history and childbirth experiences. I was astounded by my participants’ willingness to let me in during the retelling of such special, private moments. All of these stories, some heart-warming and some tragic beyond words, are presented in my thesis.
Admittedly, my ability to speak French was vital to the success of these interviews. Because my thesis was focused on storytelling, it was so important to be able to speak with each woman in a familiar and comfortable language. Our shared comfort in speaking French led to a natural and trusting conversation, thus allowing strong personal narratives to be shared.
Throughout this entire process, I was especially struck by the incredible resiliency of the participants interviewed in this study. The maternal and reproductive health experiences of refugee women are powerful stories of perseverance and the strength of the human spirit. These stories have shown me the importance of understanding a person’s concerns and experiences through language and personal interaction. When given the agency to inform decisions and recommendations on their own healthcare, refugee women have the power to demand change in the treatment of refugee patients around the world.
I am currently in the process of applying to medical school. As I dream of my future career as a physician, my thesis has helped me to better understand the power and value of listening to someone’s story and experiences to better inform care for that person.
I chose to record my process reflection in the form of an audio file to highlight and mirror the process by which my participants shared their own stories during one-on-one interviews for this thesis project. I hope that any listener and reader of this thesis walks away with a deep appreciation for the importance of language and patient narratives to inform future action. In this thesis, I am honored to present the voices of each participant in an unassuming, unbiased manner, focusing instead on the rich experiences and stories told by each woman. It is only through personal interaction and storytelling that we can hope to make real connections and enact real change. Thank you, and enjoy.