IHS Response Focus Group

Focus Group Details IHS Response to Reproductive Health Issues
by Gillian Ehrlich, March 1999

On February 3, 1999, the Native American Women’s Health Education Resource Center conducted a focus group of Native women who use Indian Health Services within the Aberdeen area of South Dakota as their primary care provider. Women from the various tribes within the Aberdeen area, ranging in age from 18 to 37 years, participated in the group. The purpose of this focus group was to gain perspectives concerning IHS’s response and treatment of Reproductive Health issues. This information will influence NAWHERC’s RTI (reproductive tract infection) education campaign.

Our questions focused on the information, preventative education, treatment and follow-up care presented to women during their visits to IHS. Treatment was reported to be inconsistent, ranging from “They did pretty well with that,” in describing prenatal care, to “None,” from an 18 year-old with abnormal pap smear results. Another participant was referred to a mental health counselor after going in for incapacitating menstrual cramping. Preventative education was nearly absent. Participants' memories of posters in the lobby were the closest examples of preventative education mentioned. These comments were common and distinct themes that emerged through stories of their experiences.

While some participants were “thankful” and felt “fortunate” IHS was available for their use, these same participants agreed that IHS has deficiencies in their services. Lack of information was mentioned repeatedly in the 2.5 hour session, especially in regards to birth control. In addition, while all participants had gone to IHS for birth control, not one participant had received information, written or verbal, concerning the use of condoms in conjunction with non-barrier contraceptive methods to protect against STI (sexually transmitted infection) transmission. Confidentiality was breached several times. One participant had been so concerned with possible violation that she did not go in for a prenatal exam until she was seven months pregnant. Inconsistency was another common criticism of the system: “of the four pap smears I’ve had in ‘98, they were all done by four different people,” said one woman.

The information gathered from the focus group will be instrumental in developing NAWHERC’s reproductive health agenda over the coming months. It is clear that advocacy, resources available to the community, patient rights, preventative information, and questions to ask a physician are as necessary as the details of any specific STD, RTI, or birth control method. It was a very powerful group of Native women that shared this very personal information. These women were clear that they want to continue learning the epidemiological and social skills to improve the quality of care for themselves, their family and their Nations. “It is good that we are coming to terms with it and hopefully we can teach our younger generations to pay more attention to their health since we weren’t given that opportunity.” A full report on the focus group findings is available.