Training immigrant health partners in Minnesota


In Irene Asong-Morfaw’s native Cameroon, the cultural opinion is that “boys are the heroes and boys can’t get in trouble.” This mindset, she feels, prevents boys and men from having to be responsible for their sexual health.  Asong-Morfaw says that a woman may know that there are ways to prevent pregnancy or STI’s but if her husband or partner does not approve of birth control or condom use she may feel she can’t pursue these options freely. That’s why she is part of the Partnership Project, a Planned Parenthood program designed to meet the reproductive and sexual health needs of African-born persons in the Twin Cities in a culturally appropriate way. The project uses community leaders as lay health educators to deploy culturally relevant sexual and reproductive health information into the community.

Minnesota’s immigrant population increased rapidly during the 1990s, and has continued to grow, though at a slower pace, during the past decade. A large and growing proportion of new immigrants come from from East and West African countries such as Somalia, Ethiopia, Liberia, and Kenya.

According to the Minnesota Department of Health (MDH), there was a twelve-fold increase in HIV/AIDS rates among foreign-born persons in Minnesota between 1990 and 2003.  Between 1990 and 2010, 58 percent of foreign-born persons living with HIV were from six countries (Cameroon, Ethiopia, Kenya, Liberia, Mexico, and Somalia). Planned Parenthood saw a chance to effect change by partnering with local African communities as a means of disseminating culturally relevant reproductive and sexual health information. After a series of focus groups with the African community, Planned Parenthood launched the Partnership Project in 2004.

Members of a particular culture or community are often better equipped to understand the particular challenges of their own community members. Studies have shown that lay educators have the ability to improve health outcomes and effect community change. In traditional roles, lay health educators are often trained to educate their communities about disease and improve access to health care. However, they are also an invaluable source of information for healthcare providers in that they are able to communicate unique obstacles for a particular cultural group. For example, a lay educator may understand the particular fasting traditions of Ramadan and how this may affect eating patterns. This would be vital information for a healthcare provider to know if they were helping patients to manage their blood sugar levels.

The Paartnership Project trains 10-12 volunteer educators a year, with training running for 26- 30 hours during four consecutive Saturdays. The program is taught by Frederick Ndip, Planned Parenthood’s Community Initiatives Manager, a nurse practitioner, a communications specialist, and various community cultural leaders.  The curriculum provides training and education regarding family planning options, sexually transmitted infections, and culturally specific communication strategies for addressing common myths and stigmas surrounding reproductive and sexual health. At the completion of the program, volunteers are expected to engage and educate their respective communities in formal or informal settings. The education may take place at planned events or during informal gatherings in places such as the educator’s home.

Irene Asong-Morfaw recently completed the training and found the experience educational and worthwhile. She originally applied to the program as a way to gain information that would help her feel more comfortable speaking with her children, ages 18-26, about sexual health. Since ending her training in the fall, Asong-Morfaw has felt more empowered to talk openly with about 15 people in her community, including her children, about the importance of understanding their reproductive and sexual health needs. Asong-Morfaw finds that people are very embarrassed and  about discussing birth control options or proper condom use but she wants people in her community to know and feel “it is not a taboo” to talk about sexual health.  She is especially focused on educating men in her community.

Ndip believes that the partnership the program creates with various African communities is the key to educating communities effectively. He said, “We are not going out into the community and saying we are experts, we know what you are going through.” The project has actively pursued more male educators to address the challenges of an often male-dominated culture in many African communities.    

According to Ndip, the project’s success lies in the 80 educators they have trained in the last eight years. Many of these educators continue to spread the word about sexual and reproductive health as volunteers for Planned Parenthood. Some have secured positions in non-profit organizations that work closely with African communities. Additionally, in the last few years there has been an increase in the number of African born patients seeking contraceptive care at their Brooklyn Park clinic.

The need for the program’s unique approach remains strong. The 2010 data from the MDH indicates that there continue to be disparities in rates of HIV infection in persons who are African-born. They make up less than one percent of the Minnesota population but ten percent of new HIV infections. Unfortunately African-born women are disproportionately affected, making up 29 percent of all new HIV infections amongst women in Minnesota in 2010. In contrast, African-born men accounted for five percent of new HIV infections among men in Minnesota.

Due to a record number of applicants last year, the program plans on having trainings in both the spring and fall 2012. If you are interested in becoming a lay health educator, visit the program website for more information.