Cultural competence and experiences of maternity health care providers on care for migrant women: A qualitative meta‐synthesis

Birth ◽  
2021 ◽  
Author(s):  
Shefaly Shorey ◽  
Esperanza Debby Ng ◽  
Soo Downe
2014 ◽  
Vol 4 (3) ◽  
pp. 191-201 ◽  
Author(s):  
Kristen Choi ◽  
Julia S. Seng

BACKGROUND: Posttraumatic stress disorder (PTSD) affects 8% of pregnant women, and the biggest risk factor for pregnancy PTSD is childhood maltreatment. The care they receive can lead to positive outcomes or to retraumatization and increased morbidity. The purpose of this study is to gather information from a range of clinicians about their continuing education needs to provide perinatal care to women with a maltreatment history and PTSD.METHOD: Maternity health care professionals were interviewed by telephone. Network sampling and purposive sampling were used to include physicians, nurse practitioners, midwives, nurses, and doulas (n = 20), and results were derived from content analysis.RESULTS: Most providers received little or no training on the issue of caring for women with a history of childhood maltreatment or PTSD during their original education but find working with this type of patient rewarding and wish to learn how to provide better care. Providers identified a range of educational needs and recommend offering a range of formats and time options for learning.CONCLUSIONS: Maternity health care providers desire to work effectively with survivor moms and want to learn best practices for doing so. Thus, educational programming addressing provider needs and preferences should be developed and tested to improve care experiences and pregnancy outcomes for women with a history of trauma or PTSD.


2019 ◽  
Vol 29 (6) ◽  
pp. 1048-1055 ◽  
Author(s):  
Can Liu ◽  
Mia Ahlberg ◽  
Anders Hjern ◽  
Olof Stephansson

Abstract Background An increasing number of migrants have fled armed conflict, persecution and deteriorating living conditions, many of whom have also endured risky migration journeys to reach Europe. Despite this, little is known about the perinatal health of migrant women who are particularly vulnerable, such as refugees, asylum-seekers, and undocumented migrants, and their access to perinatal care in the host country. Methods Using the Swedish Pregnancy Register, we analyzed indicators of perinatal health and health care usage in 31 897 migrant women from the top five refugee countries of origin between 2014 and 2017. We also compared them to native-born Swedish women. Results Compared to Swedish-born women, migrant women from Syria, Iraq, Somali, Eritrea and Afghanistan had higher risks of poor self-rated health, gestational diabetes, stillbirth and infants with low birthweight. Within the migrant population, asylum-seekers and undocumented migrants had a higher risk of poor maternal self-rated health than refugee women with residency, with an adjusted risk ratio (RR) of 1.84 and 95% confidence interval (95% CI) of 1.72–1.97. They also had a higher risk of preterm birth (RR 1.47, 95% CI 1.21–1.79), inadequate antenatal care (RR 2.56, 95% CI 2.27–2.89) and missed postpartum care visits (RR 1.15, 95% CI 1.10–1.22). Conclusion Refugee, asylum-seeking and undocumented migrant women were vulnerable during pregnancy and childbirth. Living without residence permits negatively affected self-rated health, pregnancy and birth outcomes in asylum-seekers and undocumented migrants. Pregnant migrant women’s special needs should be addressed by those involved in the asylum reception process and by health care providers.


2019 ◽  
Vol 29 (Supp2) ◽  
pp. 359-364 ◽  
Author(s):  
Brian McGregor ◽  
Allyson Belton ◽  
Tracey L. Henry ◽  
Glenda Wrenn ◽  
Kisha B. Holden

 Racial/ethnic disparities have long persisted in the United States despite concerted health system efforts to improve access and quality of care among African Americans and Latinos. Cultural competence in the health care setting has been recognized as an important feature of high-quality health care delivery for decades and will continue to be paramount as the society in which we live becomes increasingly culturally diverse. Unfortunately, there is limited empirical evidence of patient health benefits of a culturally competent health care workforce in integrated care, its feasibility of imple­mentation, and sustainability strategies. This article reviews the status of cultural competence education in health care, the merits of continued commitment to training health care providers in integrated care settings, and policy and practice strategies to ensure emerging health care professionals and those already in the field are prepared to meet the health care needs of racially and ethnically diverse populations. Ethn Dis. 2019;29(Supp 2):359-364. doi:10.18865/ed.29.S2.359


2018 ◽  
Vol 27 (3) ◽  
pp. 284-288 ◽  
Author(s):  
Miranda Brunett ◽  
René Revis Shingles

Clinical Scenario: The level of cultural competence of health care providers has been studied. However, limited scholarship has examined whether the cultural competence of the health care provider affects patient satisfaction. Focused Clinical Question: Does cultural competence of health care providers influence patient satisfaction with their experience with their provider? Summary of Key Findings: Having a culturally competent health care provider, or one who a patient perceives as culturally competent, does increase patient satisfaction. Clinical Bottom Line: Cultural competence in health care plays an important role in patients being satisfied with their providers, as well as patients willingly and actively participating in their treatment. Strength of Recommendation: Questions 1 to 5 and 9 of the critical appraisal skills program were answered “yes” for all studies in the critically appraised topic. Thus, the authors strongly support the findings.


2016 ◽  
Vol 28 (3) ◽  
pp. 269-277 ◽  
Author(s):  
Francine Darroch ◽  
Audrey Giles ◽  
Priscilla Sanderson ◽  
Lauren Brooks-Cleator ◽  
Anna Schwartz ◽  
...  

Purpose: This article examines the concept and use of the term cultural safety in Canada and the United States. Design: To examine the uptake of cultural awareness, cultural sensitivity, cultural competence, and cultural safety between health organizations in Canada and the United States, we reviewed position statements/policies of health care associations. Findings: The majority of selected health associations in Canada include cultural safety within position statements or organizational policies; however, comparable U.S. organizations focused on cultural sensitivity and cultural competence. Discussion: Through the work of the Center for American Indian Resilience, we demonstrate that U.S. researchers engage with the tenets of cultural safety—despite not using the language. Conclusions: We recommend that health care providers and health researchers consider the tenets of cultural safety. Implications for Practice: To address health disparities between American Indian populations and non–American Indians, we urge the adoption of the term and tenets of cultural safety in the United States.


2020 ◽  
Author(s):  
Anna Tengia Kessy ◽  
George Chombe Msalale

Abstract Background: In most sub-Sahara African countries, herbal medicines are widely used during pregnancy or delivery for various motives despite their unclear pharmacology and potential toxicity. All risky exposures, including use of herbs during pregnancy or delivery should be restricted in order to facilitate achieving the Sustainable Development Goal (SDG) 3: “ensure healthy lives and promote wellbeing for all including reduction of morbidity and mortality among mothers and newborns”. This study assessed use of herbal medicines during pregnancy or delivery and determined factors associated with the practice in Tabora, Tanzania.Methods: This cross-sectional quantitative study gathered information from 340 women who delivered a live-born baby in the preceding two years. Using a two-stage-sampling technique, we selected and interviewed women attending reproductive, maternal and child health clinics in public health facilities in Tabora, central Tanzania. We compared proportions using chi-square test and performed a Poisson regression analysis to determine independent correlates of herbal use.Results: Of 340 recruited women, 208 (61.2 %; 95%CI: 55.4, 66.3%) used herbal medicines during pregnancy or delivery. Major reasons for use included shortening of labour duration, 81 (38.9%) and reducing labour pain, 58 (27.9%). The independent predictors of herbal use were number of antenatal visits and the stance of maternity health care providers on the use of herbs. Women who made less than four visits had 24% higher prevalence ratio of using herbal medicines as compared to those who made at least four visits (aPR:1.24; 95%CI: 1.02, 1.50, p=0.03). Furthermore, the adjusted prevalence ratio of using herbs was 35% higher among women who were not discouraged by the health care providers against using herbs versus those who were discouraged (aPR: 1.35; 95%CI: 1.13, 1.60, p=0.01). Conclusions: Use of herbal medicines during pregnancy or delivery in Tanzania is high. This calls for comprehensive investigations on the effects of using herbs during pregnancy or delivery as a step towards understanding some of the challenges in achieving SDG 3. Additionally, maternity health care providers ought to strengthen provision of health education messages during antenatal visits on the undesirable effects of using herbs.


2011 ◽  
Vol 20 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Christine Abbyad ◽  
Trina Reed Robertson

Preparation for birthing has focused primarily on Caucasian women. No studies have explored African American women’s birth preparation. From the perceptions of 12 African American maternity health-care providers, this study elicited perceptions of the ways in which pregnant African American women prepare for childbirth. Focus group participants answered seven semistructured questions. Four themes emerged: connecting with nurturers, traversing an unresponsive system, the need to be strong, and childbirth classes not a priority. Recommendations for nurses and childbirth educators include: (a) self-awareness of attitudes toward African Americans, (b) empowering of clients for birthing, (c) recognition of the role that pregnant women’s mothers play, (d) tailoring of childbirth classes for African American women, and (e) research on how racism influences pregnant African American women’s preparation for birthing.


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