Idil Hussein
Researcher, PhD student, Main researcher in charge of the study, Terveyden Ja Hyvinvoinnin Laitos (Finnish Institute for health and welfare), Finland.
RIVER-EU fieldwork with the Finnish Somali community kicked off at the end of 2021. The Finnish Somali community had been identified as an “empowering example” community due to the unexpectedly high vaccination coverage rates the community has achieved for MMR (measles mumps-rubella) vaccines. While the overall project studies barriers and enablers to vaccination in underserved communities, recruiting potential participants to take part in the Finnish study had its own barriers and enablers.
One great advantage in the Finnish context was that both the main researcher and the research assistant were of Somali origin. However, even being of the same ethnic background as the target population, we were obligated to utilize many channels to finally recruit enough study participants. These channels initially included social media (primarily Facebook). However, when we did not receive as many requests to join the study as we would have liked, we moved on to the message board at the local mosque and our research assistant’s community contacts. Finally, we recruited additional participants by snowball sampling, which we found to be the most successful method of recruitment. With the snowball sampling method, we asked each interviewed mother to ask her friends to take part, and she was able to effectively explain the objectives of the interview to her friends, which increased positive responses.
When interviewing Finnish Somali mothers, our first impression was that they did not wish to give detailed and elaborate answers. Upon further investigation, we realised that this was not necessarily hesitancy to provide detailed responses, but rather a reflection of their tendency to accept all, or nearly all childhood vaccines they were offered without question. In our target community it was very clear that the nurse offers the vaccine, and the mothers take it. Given that many expressed little doubt in the action they had taken (having their child(ren) vaccinated), they did not have an elaborate explanation to justify their decision or their overall positive attitude towards childhood vaccination.
This finding was repeated in some of the interviews done with the nurses. Many nurses agreed that the Finnish Somali population usually has a high MMR vaccine uptake, and some of the nurses in maternal and child healthcare clinics even stated that Somalis are very “easy” clients due to the fact that they usually do not question anything too much.
When assembling the results, we were pleased to find some of the same themes repeated throughout the interviews with both the mothers and the nurses – the most common theme being trust. It became very clear to us that there is a widespread trust amongst Finnish Somalis for healthcare professionals. In a Finnish nationwide study, Somalis trusted the healthcare system more than Russian and Kurdish origin populations 1Castaneda, Anu E., et al. “Maahanmuuttajien terveys ja hyvinvointi-Tutkimus venäläis-, somalialais-ja kurditaustaisista Suomessa.” (2012).. This finding seemed to be accurate in our study as participating mothers indicated full trust towards the Finnish healthcare system. Some mothers did recall interacting with healthcare professionals who seemed to hold prejudiced and even racist views towards Somalis. However, most did not report such incidents. Such views by healthcare professionals are a powerful barrier – not only for the individual they are targeted against, but also for achieving wider public health system targets as they discourage affected patients from accessing the maternal and child healthcare clinic.
All in all, interviewing Somali mothers and healthcare professionals was a very interesting endeavour. Now that the mothers and healthcare professionals have been interviewed, the data analysed and an article is being written, we must not forget the target audience. The municipalities from which the nurses took part will receive a report on the project. In terms of the mothers, we will prepare a summary of the results in both Finnish and Somali and publish it in the private Facebook group of Finnish Somalis. We used this channel in recruiting the mothers, and it is a channel that will enable us to reach many of the mothers who took part in the study (who we hope will then disseminate the results to other mothers). We hope that this endeavour was as enjoyable to the target audience as it was for us, and that our findings will benefit improving the vaccine equity of other communities across Europe.
References:
- 1Castaneda, Anu E., et al. “Maahanmuuttajien terveys ja hyvinvointi-Tutkimus venäläis-, somalialais-ja kurditaustaisista Suomessa.” (2012).