Natural groups” refers to groups consisting of people who know each other already from other situations, such as sports teams, work, or women’s support groups. Researching with these groups maximizes the interaction between participants, and between participants and the facilitator. It provides access to a shared group culture [ 14]. In this case, the women gathered regularly to discuss issues that were important to them. With the support of the chair of a Somali women’s organization and a Community Health Service (CHS) educator, natural group discussions were facilitated.

Two natural group discussions were held and attended by 12 and 14 mothers (aged 23–66 years). The natural group discussions were conducted in Somali, lasted approximately 20 to 40 min, and took place in community centers in two different cities. A group interview protocol was developed by JS, who moderated the focused discussions [ 28].

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The Somali women in the study had not been aware of possible susceptibility to HPV through partners, even though they had been aware of a cultural double sexual standard, as also found in a study among Turkish and Moroccan mothers [ 33]. Also, cancer is perceived as a sensitive topic by the women [ 14]. The Somali mothers particularly attribute cervical cancer to metaphysical beliefs such as fate and God’s will [ 37]. However, the Islamic faith also plays the role of a cue to action: some participants state that their religion supports preventive care and/or medicine to improve health. Somali women have a hard life in their country. To this day, there are no actresses or models in this country. If the women want to become them, they must run away from their country. Moors J, Van den Reek Vermeulen E, Siesling M. Voedingsbodem voor radicalisering bij kleine etnische groepen in Nederland. Een verkennend onderzoek in de Somalische, Pakistaanse, Koerdische en Molukse gemeenschappen [Breeding ground for radicalization among small ethnic groups in the Netherlands. An exploratory study among Somali, Pakistani, Kurdish and Moluccan communities]. Tilburg; 2009

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Van Keulen HM, Otten W, Ruiter RA, Fekkes M, Van Steenbergen J, Dusseldorp E, et al. Determinants of HPV vaccination intentions among Dutch girls and their mothers: a cross-sectional study. BMC Public Health. 2013;13(1):111. Rahma Mohamed (born in 1990) is a Somali model. Rahma was working for such famous model agencies as Next Model Management (Paris), Models 1, MD Management, Just WM. Mistakes When Dating Sexy Somali Girls Online I think it is scary, because what if [you get HPV]? I find it strange: why do not they [the government] have vaccines for boys? Or is that not possible? [N 14 (young Somali woman)] This study explores the perceptions of Somali women in the Netherlands about the prevention of cervical cancer. Based on the HBM and intersectionality, the girls’ and the mothers’ perceptions have been distinguished in the following themes, in which gender and culture play particular roles: (1) Somali women and preventive healthcare; (2) Knowledge, language, and negotiating decisions; and (3) Sexual standards, culture, and religion. Van der Avoort H, Berbers G, Van Binnendijk R, Boogaards H, Boot H, Van den Dobbelsteen G, et al. The National Immunisation Programme in the Netherlands. Bilthoven: National Immunisation Programme; 2010.

Waris Dirie (born in 1965) is a fashion model, writer, and public figure of Somali origin. Waris Dirie became the first femme to publicly condemn the practice of female circumcision, was appointed a special UN ambassador and established a Fund to fight against FGM (Female Genital Mutilation). Jawahir Ahmed The worst thing that can happen is that he makes a girl pregnant, which of course is awful, but the boy can walk away. If she is sexually active and gets pregnant, then it is a problem. In Islam, you cannot have an abortion. So you have to take care of the child and you [will] have an eternal shame. Even if she was with a boy who she would marry, everyone would [still] think: ‘She slept with every guy, because she has a child.’ [N 11 (young Somali woman)]Hammarström A, Johansson K, Annandale E, Ahlgren C, Aléx L, Christianson M, et al. Central gender theoretical concepts in health research: the state of the art. J Epidemiol Community Health. 2014;68:185–90. Branković I, Verdonk P, Klinge I. Applying a gender lens on Human Papillomavirus infection: Cervical cancer screening, HPV DNA testing, and HPV vaccination. Int J Equity Health. 2013;12(1):14.