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Sharma E, Duclos D, Howard N. The nexus between maternity care and bordering practices: A qualitative study of provider perspectives on maternal healthcare provision for Afghan women migrating through Serbia to Western Europe. Soc Sci Med 2024; 350:116880. [PMID: 38688089 DOI: 10.1016/j.socscimed.2024.116880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/04/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
Serbia is a well-established transit country for Afghans travelling overland to seek protection in Western Europe, and Afghan women continue to experience pregnancy and birth during migration. This qualitative study aimed to explore the perspectives and experiences and of clinical and non-clinical perinatal care and support providers to Afghan women during migration through Serbia, using a critical border studies lens. Semi-structured interviews with 21 Serbia-based providers (conducted August 2021-October 2022 and analysed thematically) provided five inductive themes: (1) contours of life in Serbia for Afghan women; (2) providing maternity care and support to a highly mobile group; (3) enablers and barriers to accessing and using maternity care; (4) risks of onward migration; and (5) supporting women in a landscape of constant change. We identified ways in which regional geopolitics translated to bordering practices that interfered with maternity support provision to Afghan women in Serbia. We argue that non-exclusionary systems of care are needed to ensure women on the move receive adequate maternity support.
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Affiliation(s)
- Esther Sharma
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom.
| | - Diane Duclos
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom.
| | - Natasha Howard
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549, Singapore.
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Dube M, Ireland S, Bromley A, Steel M, Gao Y, Kildea S. "It's all about cultural understanding": A reflexive thematic analysis of women's experiences at a dedicated refugee midwifery group practice service. Women Birth 2024; 37:410-418. [PMID: 38158322 DOI: 10.1016/j.wombi.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/27/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Inequitable maternity care provision in high-income countries contributes to ongoing poor outcomes for women of refugee backgrounds. To address barriers to quality maternity care and improve health equity, a co-designed maternity service incorporating community-based group antenatal care, onsite social worker and interpreters, continuity of midwifery carer through a caseload design with 24/7 phone access was implemented for women of refugee background. OBJECTIVE To explore and describe women's experiences and perceptions of care from a dedicated Refugee Midwifery Group Practice service. DESIGN Qualitative exploratory descriptive study using focus group discussions and interpreters. SETTING The study was conducted at a community-based Refugee Midwifery Group Practice service in a tertiary maternity hospital in Brisbane, Australia. METHODS We conducted three focus group discussions (June - December 2020) with 16 women, born in six different countries, in three language groups: Sudanese Arabic, Somali, and English. We used reflexive thematic analysis to interpret women's perspectives and generate informed meanings of experiences of care. RESULTS We generated four themes 1) accessibility of care, 2) women feeling accepted, 3) value of relationality, and 4), service expansion and promotion. Results demonstrate positive experiences and acceptability due to easy access, strong woman-midwife relationships, and culturally safe care. CONCLUSION The service addressed concerns raised in an early evaluation and provides evidence that redesigning maternity services to meet the needs of women with a refugee background speaking multiple languages from many countries is possible and promotes access, use, and satisfaction with care, contributing to improved health equity and perinatal outcomes.
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Affiliation(s)
- Mpho Dube
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Sarah Ireland
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Angela Bromley
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Michelle Steel
- Mater Mothers Hospital, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| | - Yu Gao
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia.
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Ternström E, Small R, Lindgren H. Migrant women's experiences of an individual language-assisted information and support visit to the labor ward before giving birth - A qualitative study from Sweden. Sex Reprod Healthc 2023; 38:100915. [PMID: 37717410 DOI: 10.1016/j.srhc.2023.100915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 08/10/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Migrant women are less likely to receive an individualized maternal care where they feel safe, informed and supported but few measures have been undertaken to meet their needs. In Södertälje municipality in Sweden, community-based antenatal care midwives identify migrant women and offer them and their partners language-assisted information and support through an individual two-hour-visit to the labor ward. The aim of the present study was to explore migrant women's experiences of antenatal care including receiving language-assisted information and support during pregnancy through a two-hour INFOR-visit to the labor ward. METHODS Semi-structured interviews were conducted with 10 non-Swedish speaking migrant women, using an interpreter. Interview analysis was conducted using reflexive thematic analysis. RESULTS The individualized support, including thorough information given with language support available, sufficient time for questions and discussion, and a caring approach - did appear to inform and reassure the women. Overall, they felt that they were seen and treated as individuals during both pregnancy and birth and that their specific needs were listened to and met by the health care providers. Having professional interpreters was seen as essential for receiving the right information, something achieved at the individual visit. CONCLUSIONS The findings from this study provide evidence that a two-hour-visit to the labor ward during pregnancy has potential to empower migrant women during pregnancy and birth and to improve their experiences of maternity care. The two-hour-visit is a relatively simple intervention with the potential of not only improving migrant women's experiences of pregnancy and birth, but also their medical outcomes.
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Affiliation(s)
- Elin Ternström
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Rhonda Small
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Helena Lindgren
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Sophiahemmet University, Stockholm, Sweden.
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Obionu IM, Onyedinma CA, Mielewczyk F, Boyle E. UK maternity care experiences of ethnic minority and migrant women: Systematic review. Public Health Nurs 2023; 40:846-856. [PMID: 37548036 DOI: 10.1111/phn.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND The increasing population of immigrant and migrant women in the United Kingdom has implications to the provision of healthcare and for healthcare experiences. Eliciting women's experiences and perceptions of maternity care received is an important way of monitoring and evaluating the quality of maternity services. This study was designed to explore the maternity care experiences of ethnic minority and migrant women in the United Kingdom. METHODS A literature search for relevant studies was carried across seven databases. We included nine studies carried out between 2015 and February 2022 that met the inclusion criteria. Data were analyzed using a thematic analysis approach. RESULTS Findings showed that ethnic minority women and migrant women have had mixed experiences while utilizing maternity services in the United Kingdom. However, most of the experiences were negative and included issues related to communication, discrimination, culture, access to care, physical comfort, and continuity of care. Only one of the studies reported that the respondents had a wholly positive communication experience, one found that a few women felt the staff were respectful and one reported that the midwives gave the women treatment options that would respect their cultural and religious beliefs. CONCLUSION This study has highlighted some important gaps in the maternity care experiences specific to ethnic minority and migrant women in the United Kingdom which provides useful insights to future policy and clinical practice.
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Affiliation(s)
- Ifeoma Maureen Obionu
- College of Public Health and Social Justice, Saint Louis University, St Louis, Missouri
| | - Chioma Amarachi Onyedinma
- Department of Community Medicine University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| | - Frances Mielewczyk
- Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Elaine Boyle
- Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
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Mprah A, Haith-Cooper M, Duda-Mikulin E, Meddings F. A systematic review and narrative synthesis of fathers' (including migrant fathers') experiences of pregnancy and childbirth. BMC Pregnancy Childbirth 2023; 23:238. [PMID: 37041486 PMCID: PMC10088224 DOI: 10.1186/s12884-023-05568-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/01/2023] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVE The purpose of this review was to consider factors that influence the experiences of pregnancy and childbirth by fathers including migrant fathers. METHOD A systematic review and narrative synthesis were conducted as per the PRISMA guidelines. The spider tool was used to build a search strategy which was used to conduct literature search in eight identified electronic databases: ASSIA, CINAHL, EMBASE, MEDLINE, PsycINFO, PUBMED, Sage and Scopus. Grey literature was searched through the King's Fund Library database, Ethos, The North Grey Literature Collection, Social Care Online and other charity websites such as the Refugee Council and Joseph Rowntree Foundation. The search was conducted across all the databases in the week commencing January 7, 2019, and restricted to studies published in the English language. RESULTS The search across all the eight electronic databases identified 2564 records, 13 records through grey literature databases/websites and an additional 23 records identified through hand-searching/forward citation. The number of records after duplicates were removed was 2229. Record screening based on titles and abstracts identified 69 records for full text screening. Dual screening of these full text records identified 12 full records from 12 separate studies, eight of which were qualitative studies, three of which were quantitative studies and one mixed method study. FINDINGS This review has revealed three main themes: influence of society and health professionals; adjustment to a new life of fatherhood; and involvement in maternity care. However, the literature has focused on non-migrant father's experiences of pregnancy and childbirth, with little attention paid to fathers who may be migrants. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE This review has exposed a dearth of research on migrant fathers' experiences of pregnancy and childbirth in an era of increasing globalisation and migration between countries. Midwives and other health professionals should be alert to the needs of any father when providing maternity care. More research is needed which considers experiences of migrants and how choosing to move to a new country or being forced to move could influence migrant father's experiences and therefore their needs.
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Affiliation(s)
- Andy Mprah
- Faculty of Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.
| | - Melanie Haith-Cooper
- Faculty of Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Eva Duda-Mikulin
- Centre for Interdisciplinary Research into Health and Illness, University of Wroclaw, Wroclaw, Poland
| | - Fiona Meddings
- Faculty of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK
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Moffat M, Nicholson S, Darke J, Brown M, Minto S, Sowden S, Rankin J. A Qualitative Evaluation of a Health Access Card for Refugees and Asylum Seekers in a City in Northern England. Int J Environ Res Public Health 2023; 20:1429. [PMID: 36674184 PMCID: PMC9859311 DOI: 10.3390/ijerph20021429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Refugees and asylum seekers residing in the UK face multiple barriers to accessing healthcare. A Health Access Card information resource was launched in Newcastle upon Tyne in 2019 by Newcastle City Council, intended to guide refugees and asylum seekers living in the city, and the professional organisations that support them, to appropriate healthcare services provided locally. The aim of this qualitative evaluation was to explore service user and professional experiences of healthcare access and utilisation in Newcastle and perspectives on the Health Access Card. Eleven semi-structured interviews took place between February 2020 and March 2021. Participants provided diverse and compelling accounts of healthcare experiences and described cultural, financial and institutional barriers to care. Opportunities to improve healthcare access for these population groups included offering more bespoke support, additional language support, delivering training and education to healthcare professionals and reviewing the local support landscape to maximise the impact of collaboration and cross-sector working. Opportunities to improve the Health Access Card were also described, and these included providing translated versions and exploring the possibility of developing an accompanying digital resource.
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Affiliation(s)
- Malcolm Moffat
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Suzanne Nicholson
- Newcastle City Council, Public Health Team, Civic Centre, Newcastle upon Tyne NE1 8QH, UK
| | - Joanne Darke
- UK Health Security Agency North East, Health Protection Team, Civic Centre, Newcastle upon Tyne NE1 8QH, UK
| | - Melissa Brown
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Stephen Minto
- Northumbria Healthcare NHS Foundation Trust, One-to-One Centre Shiremoor, Brenkley Avenue, Shiremoor, Newcastle upon Tyne NE27 0PR, UK
| | - Sarah Sowden
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
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Gong Q, Bharj K. A qualitative study of the utilisation of digital resources in pregnant Chinese migrant women's maternity care in northern England. Midwifery 2022; 115:103493. [DOI: 10.1016/j.midw.2022.103493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/15/2022] [Accepted: 09/23/2022] [Indexed: 10/14/2022]
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Puthussery S, Tseng PC, Sharma E, Harden A, Griffiths M, Bamfo J, Li L. Disparities in the timing of antenatal care initiation and associated factors in an ethnically dense maternal cohort with high levels of area deprivation. BMC Pregnancy Childbirth 2022; 22:713. [PMID: 36123628 PMCID: PMC9484064 DOI: 10.1186/s12884-022-04984-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Late access to antenatal care is a contributor to excess mortality and morbidity among ethnic minority mothers compared to White British in the UK. While individual ethnicity and socioeconomic disadvantage are linked to late antenatal care initiation, studies have seldom explored patterns of late initiation and associated factors in ethnically dense socially disadvantaged settings. This study investigated disparities in the timing of antenatal care initiation, and associated factors in an ethnically dense socially disadvantaged maternal cohort. METHODS A retrospective cross-sectional study using routinely collected anonymous data on all births between April 2007-March 2016 in Luton and Dunstable hospital, UK (N = 46,307). Late initiation was defined as first antenatal appointment attended at > 12 weeks of gestation and further classified into moderately late (13-19 weeks) and extremely late initiation (≥ 20 weeks). We applied logistic and multinomial models to examine associations of late initiation with maternal and sociodemographic factors. RESULTS Overall, one fifth of mothers (20.8%) started antenatal care at > 12 weeks of gestation. Prevalence of late initiation varied across ethnic groups, from 16.3% (White British) to 34.2% (Black African). Late initiation was strongly associated with non-White British ethnicity. Compared to White British mothers, the odds of late initiation and relative risk of extremely late initiation were highest for Black African mothers [adjusted OR = 3.37 (3.05, 3.73) for late initiation and RRR = 4.03 (3.51, 4.64) for extremely late initiation]. The odds did not increase with increasing area deprivation, but the relative risk of moderately late initiation increased in the most deprived ([RRR = 1.53 (1.37, 1.72)] and second most deprived areas [RRR = 1.23 (1.10, 1.38)]. Late initiation was associated with younger mothers and to a lesser extent, older mothers aged > 35 years. Mothers who smoked during pregnancy were at higher odds of late initiation compared to mothers who did not smoke. CONCLUSIONS There is a need to intensify universal and targeted programmes/services to support mothers in ethnically dense socially disadvantaged areas to start antenatal care on time. Local variations in ethnic diversity and levels of social disadvantage are essential aspects to consider while planning services and programmes to ensure equity in maternity care provision.
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Affiliation(s)
- Shuby Puthussery
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Park Square, Luton, LU1 3JU, Bedfordshire, UK.
| | - Pei-Ching Tseng
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Park Square, Luton, LU1 3JU, Bedfordshire, UK
| | - Esther Sharma
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Park Square, Luton, LU1 3JU, Bedfordshire, UK
| | - Angela Harden
- School of Health Sciences, Division of Health Services Research and Management, City, University of London, Northampton Square, EC1V 0HB, London, England
| | - Malcolm Griffiths
- Department of Obstetrics and Gynaecology, The Luton and Dunstable University Hospital NHS Foundation Trust, Lewsey Rd, Luton, LU4 0DZ, Bedford, UK
| | - Jacqueline Bamfo
- Department of Obstetrics and Gynaecology, The Luton and Dunstable University Hospital NHS Foundation Trust, Lewsey Rd, Luton, LU4 0DZ, Bedford, UK
| | - Leah Li
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, WC1N 1EH, UK
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Zhang CX, Boukari Y, Pathak N, Mathur R, Katikireddi SV, Patel P, Campos-Matos I, Lewer D, Nguyen V, Hugenholtz GC, Burns R, Mulick A, Henderson A, Aldridge RW. Migrants' primary care utilisation before and during the COVID-19 pandemic in England: An interrupted time series analysis. Lancet Reg Health Eur 2022; 20:100455. [PMID: 35789753 PMCID: PMC9243519 DOI: 10.1016/j.lanepe.2022.100455] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background How international migrants access and use primary care in England is poorly understood. We aimed to compare primary care consultation rates between international migrants and non-migrants in England before and during the COVID-19 pandemic (2015-2020). Methods Using data from the Clinical Practice Research Datalink (CPRD) GOLD, we identified migrants using country-of-birth, visa-status or other codes indicating international migration. We linked CPRD to Office for National Statistics deprivation data and ran a controlled interrupted time series (ITS) using negative binomial regression to compare rates before and during the pandemic. Findings In 262,644 individuals, pre-pandemic consultation rates per person-year were 4.35 (4.34-4.36) for migrants and 4.60 (4.59-4.60) for non-migrants (RR:0.94 [0.92-0.96]). Between 29 March and 26 December 2020, rates reduced to 3.54 (3.52-3.57) for migrants and 4.2 (4.17-4.23) for non-migrants (RR:0.84 [0.8-0.88]). The first year of the pandemic was associated with a widening of the gap in consultation rates between migrants and non-migrants to 0.89 (95% CI 0.84-0.94) times the ratio before the pandemic. This widening in ratios was greater for children, individuals whose first language was not English, and individuals of White British, White non-British and Black/African/Caribbean/Black British ethnicities. It was also greater in the case of telephone consultations, particularly in London. Interpretation Migrants were less likely to use primary care than non-migrants before the pandemic and the first year of the pandemic exacerbated this difference. As GP practices retain remote and hybrid models of service delivery, they must improve services and ensure primary care is accessible and responsive to migrants' healthcare needs. Funding This study was funded by the Medical Research Council (MC_PC 19070 and MR/V028375/1) and a Wellcome Clinical Research Career Development Fellowship (206602).
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Affiliation(s)
- Claire X. Zhang
- Institute of Health Informatics, University College London, 222 Euston Rd, London NW1 2DA, United Kingdom
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London SW1H 0EU, United Kingdom
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford OX3 7LF, United Kingdom
| | - Yamina Boukari
- Institute of Health Informatics, University College London, 222 Euston Rd, London NW1 2DA, United Kingdom
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London SW1H 0EU, United Kingdom
| | - Neha Pathak
- Institute of Health Informatics, University College London, 222 Euston Rd, London NW1 2DA, United Kingdom
- Guy's & St Thomas's NHS Foundation Trust, London SE1 9RT, United Kingdom
| | - Rohini Mathur
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Srinivasa Vittal Katikireddi
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, United Kingdom
| | - Parth Patel
- Institute of Health Informatics, University College London, 222 Euston Rd, London NW1 2DA, United Kingdom
| | - Ines Campos-Matos
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London SW1H 0EU, United Kingdom
- UK Health Security Agency, Wellington House, 133–155, Waterloo Road, London SE1 8UG, United Kingdom
| | - Dan Lewer
- Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom
| | - Vincent Nguyen
- Institute of Health Informatics, University College London, 222 Euston Rd, London NW1 2DA, United Kingdom
- Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom
| | - Greg C.G. Hugenholtz
- Institute of Health Informatics, University College London, 222 Euston Rd, London NW1 2DA, United Kingdom
| | - Rachel Burns
- Institute of Health Informatics, University College London, 222 Euston Rd, London NW1 2DA, United Kingdom
| | - Amy Mulick
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Alasdair Henderson
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Robert W. Aldridge
- Institute of Health Informatics, University College London, 222 Euston Rd, London NW1 2DA, United Kingdom
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Lim M, Van Hulst A, Pisanu S, Merry L. Social Isolation, Loneliness and Health: A Descriptive Study of the Experiences of Migrant Mothers With Young Children (0–5 Years Old) at La Maison Bleue. Front Glob Womens Health 2022; 3:823632. [PMID: 35814837 PMCID: PMC9265247 DOI: 10.3389/fgwh.2022.823632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 06/02/2022] [Indexed: 11/24/2022] Open
Abstract
Background Migrant women with young children, including asylum seekers and refugees, have multiple vulnerability factors that put them at increased risk of social isolation and loneliness, which are associated with negative health outcomes. This study explored the experiences of social isolation and loneliness among migrant mothers with children aged 0–5 years as well as their perceptions on possible health impacts. Methods A qualitative descriptive study was conducted at La Maison Bleue, a non-profit organization providing perinatal health and social services to vulnerable women in Montreal, Canada. Recruitment and data collection occurred concurrently during the COVID-19 pandemic, between November and December 2020. Eleven women participated in individual semi-structured interviews and provided socio-demographic information. Interview data were thematically analyzed. Results Migrant women in this study described social isolation as the loss of family support and of their familiar social/cultural networks, and loneliness as the feelings of aloneness that stemmed from being a mother in a new country with limited support. Multiple factors contributed to women's and children's social isolation and loneliness, including migration status, socioeconomic circumstances, language barriers, and being a single mother. Women expressed that the COVID-19 pandemic exacerbated pre-existing experiences of social isolation and loneliness. Mothers' experiences affected their emotional and mental health, while for children, it reduced their social opportunities outside the home, especially if not attending childcare. However, the extent to which mothers' experiences of social isolation and loneliness influenced the health and development of their children, was less clear. Conclusion Migrant mothers' experiences of social isolation and loneliness are intricately linked to their status as migrants and mothers. Going forward, it is critical to better document pandemic and post-pandemic consequences of social isolation and loneliness on young children of migrant families. Supportive interventions for migrant mothers and their young children should not only target social isolation but should also consider mothers' feelings of loneliness and foster social connectedness and belongingness. To address social isolation and loneliness, interventions at the individual, community and policy levels are needed.
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Affiliation(s)
- Mona Lim
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | | | | | - Lisa Merry
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- West Central Montreal CIUSSS, SHERPA University Institute, Montreal, QC, Canada
- InterActions Centre de recherche et de partage des savoirs, CIUSSS du Nord-de-l'île-de-Montréal, Montreal, QC, Canada
- *Correspondence: Lisa Merry
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Tankink JB, Verschuuren AEH, Postma IR, van der Lans PJA, de Graaf JP, Stekelenburg J, Mesman AW. Childbirths and the Prevalence of Potential Risk Factors for Adverse Perinatal Outcomes among Asylum Seekers in The Netherlands: A Five-Year Cross-Sectional Study. Int J Environ Res Public Health 2021; 18:ijerph182412933. [PMID: 34948540 PMCID: PMC8700803 DOI: 10.3390/ijerph182412933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/26/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
This five-year cross-sectional study mapped the prevalence of several known risk factors for adverse perinatal outcomes in asylum-seeking women in The Netherlands. Characteristics of 2831 registered childbirths among residents of asylum seekers centers (ASCs) in The Netherlands from 2016 to 2020 were included. Results showed a high general and teenage birthrate (2.15 and 6.77 times higher compared to the Dutch, respectively). Most mothers were pregnant upon arrival, and the number of births was highest in the second month of stay in ASCs. Another peak in births between 9 and 12 months after arrival suggested that many women became pregnant shortly after arrival in The Netherlands. Furthermore, 69.5 percent of all asylum-seeking women were relocated between ASCs at least once during pregnancy, which compromises continuity of care. The high prevalence of these risk factors in our study population might explain the increased rate of adverse pregnancy outcomes in asylum seekers compared to native women found in earlier studies. Incorporating migration-related indicators in perinatal health registration is key to support future interventions, policies, and research. Ultimately, our findings call for tailored and timely reproductive and perinatal healthcare for refugee women who simultaneously face the challenges of resettlement and pregnancy.
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Affiliation(s)
- Julia B. Tankink
- Department of Obstetrics and Gynecology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands;
- Correspondence: (J.B.T.); (A.E.H.V.)
| | - Anouk E. H. Verschuuren
- Global Health Unit, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;
- Correspondence: (J.B.T.); (A.E.H.V.)
| | - Ineke R. Postma
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;
| | - Peggy J. A. van der Lans
- Department of Obstetrics and Gynecology, Hospital Twente ZGT/MST, 7512 KZ Enschede, The Netherlands;
| | - Johanna P. de Graaf
- Department of Obstetrics and Gynecology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands;
| | - Jelle Stekelenburg
- Global Health Unit, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;
- Department of Obstetrics and Gynecology, Medical Center Leeuwarden, Henri Dunantweg 2, 8934 AD Leeuwarden, The Netherlands
| | - Annelies W. Mesman
- Netherlands Association for Community Health Services (GGD GHOR Nederland), Zwarte Woud 2, 3524 SJ Utrecht, The Netherlands;
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Rocholl A, Lange U. Challenges and chances by involving community interpreters in the regular health care of pregnant women and young mothers from third countries with language barriers. A qualitative study within the project RundUm – Transcultural network in the care of pregnancy and birth / Herausforderungen und Chancen bei der Hinzuziehung von Sprach- und Integrationsmittlerinnen in die Regelversorgung von Schwangeren und jungen Müttern aus Drittstaaten. Eine qualitative Erhebung im Rahmen des Projektes RundUm – Transkulturelles Netzwerk zur Begleitung bei Schwangerschaft und Geburt. International Journal of Health Professions 2021; 8:86-97. [DOI: 10.2478/ijhp-2021-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Einleitung
Zur sprachlichen Verständigung und Partizipation an den Versorgungsstrukturen des Sozial- und Gesundheitswesens bei Menschen mit Sprachbarrieren und einem Migrations- oder Fluchthintergrund entwickelte sich der Tätigkeitsbereich der Sprach- und Integrationsmittler/-in in Abgrenzung zum/zur Dolmetscher/-in. Im Rahmen des Forschungsprojektes RundUm begleiteten Sprach- und Integrationsmittlerinnen des Sprachmittlerdienstes SprInt in Essen Schwangere und junge Mütter zu Terminen der Regelversorgung im Gesundheitswesen. Die Chancen und Herausforderungen innerhalb der geburtshilflichen Versorgung aus Sicht der Sprach- und Integrationsmittlerinnen sind Gegenstand der vorliegenden Studie.
Methode
Im Rahmen von qualitativen Experteninterviews wurden 14 Sprach- und Integrationsmittelnde des Sprachmittlerdienstes SprInt in Essen befragt. Die Transkripte wurden inhaltsanalytisch ausgewertet.
Ergebnisse
Herausforderungen zeigen sich in der Kontaktaufnahme zu den Klientinnen und in Aspekten der Zusammenarbeit mit professionellen Fachkräften und dem Verhältnis zwischen professionellen Akteuren/-innen der Regelversorgung und ihren Patientinnen/Frauen. Fehlende sprachliche Kompetenzen der Sprachmittlerin im Themengebiet der geburtshilflichen Versorgung, die Konfrontation mit interkulturellen Unterschieden und eine Unsicherheit der professionellen Akteure/-innen im Umgang mit Sprach- und Integrationsmittlung beeinflussen die Tätigkeit. Daneben bieten unterschiedlich praktizierte Rollenverständnisse der SprInterinnen Chancen und Konfliktpunkte in der Zusammenarbeit im Versorgungsnetzwerk Schwangerer und junger Mütter.
Diskussion
Die Bedeutung der Arbeit der Sprach- und Integrationsmittlerinnen für eine bedarfsgerechte geburtshilfliche Versorgung von Frauen mit Sprachbarrieren bietet Chancen für eine öffentliche Diskussion um die Anerkennung des Tätigkeitsprofils. Anpassung und Ausbau von themenspezifischen Qualifikationsmaßnahmen können dabei helfen, Kompetenzen zur Übernahme einer Brücken- und Lotsenfunktion im Sprachund Integrationsmittlungsprozess zu entwickeln und nachfolgend zu praktizieren. Dies impliziert abgesicherte Finanzierungsmöglichkeiten für die Hinzuziehung von Sprach- und Integrationsmittlerinnen in die Regelversorgung von Schwangeren und jungen Müttern und eine Implementierung in interprofessionelle Netzwerkstrukturen.
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Frank GD, Fox D, Njue C, Dawson A. The maternity experiences of women seeking asylum in high-income countries: a meta-ethnography. Women Birth 2021; 34:531-539. [PMID: 33414082 DOI: 10.1016/j.wombi.2020.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 10/22/2022]
Abstract
PROBLEM The maternity care experiences and perinatal outcomes of women seeking asylum in high-income countries (HICs) are poorer than the general population of pregnant women in that HIC. There is a paucity of literature on the maternity experiences of women seeking asylum in HICs. BACKGROUND There is an increasing number of women seeking asylum in HICs due to escalating violence and human rights abuses. Asylum-seeking women are a distinct group whom are likely to have different needs to refugees or migrants as a result of their undocumented status. AIM This literature review aimed to explore the emotional, physical and health information needs of women seeking asylum in the perinatal period in HICs, to provide insights to better address their maternity needs. METHOD A meta-ethnography described by Noblit and Hare, was applied to analyse the studies, to reflect the voices of women seeking asylum, hosted in HICs in their perinatal period. FINDINGS Eight studies were included in the review. The overarching theme was 'just having to survive.' Four sub-themes were revealed which highlighted the vulnerability of asylum-seeking women. They included: 'I was never sure if I had understood', 'feeling ignored and alone', 'ongoing dislocation and recurrent relocation' and 'knowing there's someone who cares for you'. DISCUSSION Improved maternity care for women seeking asylum requires culturally appropriate respectful maternity care and supportive strategies such as consistent access to language services. CONCLUSION It is recommended that future research is targeted to explore the maternity experience of women seeking asylum in HICs, such as Australia.
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Affiliation(s)
- Glenys D Frank
- University of Technology (UTS), Sydney, PO Box 123, Broadway, NSW, 2007, Australia.
| | - Deborah Fox
- University of Technology (UTS), Sydney, PO Box 123, Broadway, NSW, 2007, Australia
| | - Carolyne Njue
- University of Technology (UTS), Sydney, PO Box 123, Broadway, NSW, 2007, Australia
| | - Angela Dawson
- University of Technology (UTS), Sydney, PO Box 123, Broadway, NSW, 2007, Australia
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SHARMA E, HOWARD N, DUCLOS D. Navigating new lives: A scoping review and thematic synthesis of forced migrant women's perinatal experiences. J Migr Health 2020; 1-2:100014. [PMID: 34405168 PMCID: PMC8352206 DOI: 10.1016/j.jmh.2020.100014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 11/29/2020] [Accepted: 11/29/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND For health systems and maternity services to respond effectively to forced displacement, an understanding of the lived experiences of women seeking protection during childbearing is required. This study aim was to systematically review existing literature on the perinatal experiences of forced migrant women. METHODS We conducted a scoping review including MEDLINE, CINAHL Plus, Web of Science and PsychINFO databases and manual search of references. Included studies were quality-assessed and analysed using inductive thematic synthesis. FINDINGS In total 39 studies were included, involving 624 forced migrant women in 12 countries. Three inductive themes were: (1) "The nature of being a forced migrant," describing multiple liminalities experienced by women; (2) support during the perinatal period, showing women's (re)negotiation of shifting kinship and support networks; and (3) interactions with maternity services, revealing variations in maternity care experiences. CONCLUSION Findings highlight the systemic power structures forced migrant women must (re)negotiate during the perinatal period and the supportive and empowering role maternity services can play through provision of woman-centred care. Further research is needed to understand the lived perinatal experiences of forced migrant in low-income and transit country contexts.
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Affiliation(s)
- Esther SHARMA
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
| | - Natasha HOWARD
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
- National University of Singapore, Saw Swee Hock School of Public Health, 12 Science Drive 2, 117549, Singapore
| | - Diane DUCLOS
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
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Ugarte-Gurrutxaga MI, Molina-Gallego B, Mordillo-Mateos L, Gómez-Cantarino S, Solano-Ruiz MC, Melgar de Corral G. Facilitating Factors of Professional Health Practice Regarding Female Genital Mutilation: A Qualitative Study. Int J Environ Res Public Health 2020; 17:ijerph17218244. [PMID: 33171622 PMCID: PMC7664698 DOI: 10.3390/ijerph17218244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/26/2020] [Accepted: 11/05/2020] [Indexed: 01/26/2023]
Abstract
Introduction: According to figures released by UNICEF (United Nations Children’s Fund), more than 200 million girls and women have suffered female genital mutilation (FGM) in 30 African and Middle East countries. An increasing number of African women who come from ethnic groups where FGM is practised are arriving in Western countries. Healthcare professionals play a fundamental role in its prevention. Goals: To learn about the factors that healthcare professionals consider as facilitators for prevention and action when faced with female genital mutilation. Methods: A cross-sectional descriptive study developed on the basis of the qualitative methodological perspective, where 43 healthcare professionals participated. A series of analysis dimensions were established, based on which, the interview and discussion group scripts were designed. Results: Addressing FGM requires a series of structural adaptations of the healthcare system that facilitate the recording and monitoring of cases, both for treatment and for prevention. In addition, it is necessary to establish coordination between the healthcare, social services and education sectors. Conclusions: The existence of a protocol of action and training in its use is one of the key tools to take into account.
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Affiliation(s)
- M Idoia Ugarte-Gurrutxaga
- Department of Nursing, Physical and Occupational Therapy University of Castilla-La Mancha, Campus Toledo, 13001 Ciudad Real, Spain; (M.I.U.-G.); (B.M.-G.); (S.G.-C.); (G.M.d.C.)
| | - Brígida Molina-Gallego
- Department of Nursing, Physical and Occupational Therapy University of Castilla-La Mancha, Campus Toledo, 13001 Ciudad Real, Spain; (M.I.U.-G.); (B.M.-G.); (S.G.-C.); (G.M.d.C.)
| | - Laura Mordillo-Mateos
- Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina (Toledo), Spain
- Correspondence: ; Tel.: +34-629-861-084
| | - Sagrario Gómez-Cantarino
- Department of Nursing, Physical and Occupational Therapy University of Castilla-La Mancha, Campus Toledo, 13001 Ciudad Real, Spain; (M.I.U.-G.); (B.M.-G.); (S.G.-C.); (G.M.d.C.)
| | | | - Gonzalo Melgar de Corral
- Department of Nursing, Physical and Occupational Therapy University of Castilla-La Mancha, Campus Toledo, 13001 Ciudad Real, Spain; (M.I.U.-G.); (B.M.-G.); (S.G.-C.); (G.M.d.C.)
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Collins C, Skarparis K. The impact of human trafficking in relation to maternity care: A literature review. Midwifery 2020; 83:102645. [PMID: 32035342 DOI: 10.1016/j.midw.2020.102645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To map the relevant literature and inform future research on the issues related to and experiences of pregnancy and maternity care for women who have been trafficked. DESIGN A scoping review was undertaken to identify literature on the issues and experiences of pregnancy and maternity care for women who have been trafficked. RESULTS 45 papers were identified and six key themes were derived from the literature: the impact of trafficking on health; access to maternity care; experiences of maternity care; social factors; knowledge and experience of staff; and identification and referral. KEY CONCLUSIONS Women who have been trafficked are at risk of physical and emotional health issues that may affect maternal and fetal outcomes. Multiple barriers to care exist for women who have been trafficked, and social factors including housing, poverty and dispersal policies may impact upon both health and access to care. Healthcare staff do not feel adequately prepared to respond to the needs of this vulnerable group and no midwifery-specific guidance exists. IMPLICATIONS FOR PRACTICE Midwives need awareness of the complex range of health and social factors that may affect women who have been trafficked. Midwives and maternity care professionals require more specialised training to better identify, refer and support women who have been trafficked.
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