A Study on the Barriers like Intersectionality, Postcolonial Feminism, and Healthcare Access Encountered by African Refugee Women in the Midwestern United States During the COVID-19 Pandemic

Research Article

Abstract

African refugee women resettled in the United States face multi-layered systemic barriers to healthcare access, which were significantly compounded by the social and structural disruptions of the COVID-19 pandemic. This investigation highlights the healthcare utilization experiences of Congolese and Rwandan refugee women residing in Waterloo, Iowa, utilizing intersectional and postcolonial feminist theoretical frameworks to analyze how gender, race, legal status, and linguistic identity converge to shape clinical interactions. The socio-structural dynamics of healthcare exclusion come to light through semi-structured, in-depth virtual interviews with refugee women and community advocates from the Ethnic Minorities of Burma Advocacy & Resource Center (EMBARC). Linguistic barriers extend beyond basic translation issues to include functional health literacy, rendering navigation of complex medical systems and completion of intake protocols highly problematic. The absence of competent medical interpretation often forces reliance on informal interpreters, including children, which compromises confidentiality and degrades the quality of reproductive and maternal care. Deep-seated cultural orientations concerning medical authority, somatic expressions of distress, and gendered communication norms affect clinical encounters, where participants describe experiences of being rushed, dismissed, or culturally misunderstood by Western practitioners. Financial precariousness, lack of medical insurance, and transportation deficits further restrict health-seeking behaviors. The COVID-19 pandemic exacerbated these challenges by shifting clinical services to digital platforms, limiting physical outreach, and suspending the main community integration programs. These results indicate that addressing systemic health disparities requires structural reforms, including institutionalizing professional interpretation services, expanding community-partnered advocacy, and implementing culturally responsive care models