Background The number of international migrants continues to increase worldwide. Depending on their country of origin and migration experience, migrants may be at greater risk of maternal and neonatal morbidity and mortality. Having compassionate and culturally competent healthcare providers is essential to optimise perinatal care. The “Operational Refugee and Migrant Maternal Approach” (ORAMMA) project developed cultural competence training for health professionals to aid with providing perinatal care for migrant women. This presents an evaluation of ORAMMA training and explores midwives’ experiences of the training and providing care within the ORAMMA project. Methods Cultural competence was assessed before and after midwives (n = 35) received ORAMMA compassionate and culturally sensitive maternity care training in three different European countries. Semi-structured interviews (n = 12) explored midwives’ experiences of the training and of caring for migrant women within the ORAMMA project. Results A significant improvement of the median score pre to post-test was observed for midwives’ knowledge (17 to 20, p < 0.001), skills (5 to 6, p = 0.002) and self-perceived cultural competence (27 to 29, p = 0.010). Exploration of midwives’ experiences of the training revealed themes of “appropriate and applicable”, “made a difference” and “training gaps” and data from ORAMMA project experiences identified three further themes; “supportive care”, “working alongside peer supporters” and “challenges faced”. Conclusions The training improved midwives’ knowledge and self-perceived cultural competence in three European countries with differing contexts and workforce provision. A positive experience of ORAMMA care model was expressed by midwives, however clearer expectations of peer supporters’ roles and more time within appointments to assess the psychosocial needs of migrant women were desired. Future large-scale research is required to assess the long-term impact of the ORAMMA model and training on practice and clinical perinatal outcomes.

Migrant and refugee pregnant women constitute a highly vulnerable group to mental disorders. The rates of mental illness of migrants and refugees are higher than those of host populations, with migrant women being more likely to suffer from prenatal depression. A Policy Paper was developed based on a literature review conducted in Medline, Scopus and Google Scholar. Filtering criteria were: year of publication (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017), study topic relevance, and English language. A total of 63 documents were identified. Most of the documents were scientific papers while a large number of documents were reports of EU committees and networks on migrant issues or annual reports of international bodies. From the analysis of existing evidence, four major topics emerged for the perinatal health of migrant women: 1) Prevalence and risk factors for antenatal mental disorders, 2) Assessment of mental disorders, 3) Healthcare professionals' training on supporting migrant and refugee pregnant women, and 4) Interventions for the mental health of migrant women. Midwives and other members of interdisciplinary teams have to be trained and culturally competent to successfully meet the needs of migrant and refugee pregnant women.

The COVID-19 pandemic brought into the spotlight the technological needs of carers together with accessibility and availability of disease-related web-based services. Athens Alzheimer Association undertook the cultural adaptation of the platform iSupport in Greece. The process included multiple methodological steps based on Ecological Validity Model, and the platform was pilot tested to 15 carers of people with dementia. The duration of this project lasted for one year (April 2020-March 2021). Today more than 160 carers in Greece have registered on the platform. All 23 lessons are easily accessible by the isupportdementia-greece website.

Background ORAMMA is a European capacity-building project (GR, NL, UK) for pregnant migrant, asylum-seeking and refugee (MAR) women to improve maternal and newborn outcomes. ORAMMA is an operational and strategic approach for mother-centred, community-oriented, gender-sensitive, interdisciplinary and compassionate care, to meet the needs of MAR women in Europe. Objectives ORAMMA developed training for midwives and other primary health and social care (PC) professionals to meet the needs of MAR women. Methodology comprised three phases: evidence synthesis and needs assessment, training material development, and community enablement through locally recruited women in the innovative role of Maternal Peer Supporters (MPSs). Results Needs assessment highlighted the need to train ORAMMA’s teams of midwives and other PC professionals to care for women who suffered undue hardship, oftentimes leading to PTSD, i.e., victims of trafficking, rape, underage women, sufferers of acute or chronic conditions, and sole family carers. The experiences encountered informed curriculum development for midwives and other PC professionals. Interprofessional training for integrated perinatal care delivery was developed for and delivered in three phases, i.e., detection of pregnancy (GP coordination), care during pregnancy (midwive coordination), and support after birth (social worker coordination), with special modules developed in a participatory manner on: migration status and policies, maternity care for MAR women, and communication and culturally sensitive practices. Conclusions Training midwives and other PC professionals along with members of MAR communities in the MPS role was identified to be a key element to efficiently support women and their families, to propagate key perinatal and public health messages, and to advocate for the rights of MAR women to ensure access equity to quality care in a highly responsive manner. ORAMMA’s tools are available in easily accessible platform online. Key messages ORAMMA developed multilingual material to meet the needs of PC professionals and of MAR women, in an innovative manner and with high relevance for cross-border knowledge transfer. ORAMMA addressed key aspects in delivery and access, focusing on cultural awareness and communication; its relevance extends well beyond perinatal care to improved family outcomes and public health.

Migrant and refugee women face specific health risks and challenges during the perinatal period, presenting with complex physical, psychological, and mental health issues. Compassionate antenatal and postnatal care is urgently required across Europe given how outcomes during this period determine the health wellbeing throughout a person’s life. The current study aimed to describe the perinatal health care provided to refugee and migrant women in Greece, as well as to identify the barriers to delivering quality health care to these population groups. Data were gathered via qualitative research, and via document analysis, including grey literature research. Two focus groups were convened; one with five midwives in Athens (representing NGOs in refugee camps and public maternity hospitals) and another in Crete with twenty-six representatives of key stakeholder groups involved in the perinatal care of refugees and migrant women. Desk research was conducted with in a stepwise manner comprising two steps: (a) a mapping exercise to identify organizations/institutes of relevance across Greece, i.e., entities involved in perinatal healthcare provision for refugees and migrants; (b) an electronic search across institutional websites and the World Wide Web, for key documents on the perinatal care of refugee and migrant women that were published during the 10-year period prior to the research being conducted and referring to Greece. Analysis of the desk research followed the principles of content analysis, and the analysis of the focus group data followed the principles of an inductive thematic analysis utilizing the actual data to drive the structure analysis. Key findings of the current study indicate that the socioeconomic status, living and working conditions, the legal status in the host country, as well as providers’ cultural competence, attitudes and beliefs and communication challenges, all currently represent major barriers to the efficient and culturally appropriate provision of perinatal care. The low capacity of the healthcare system to meet the needs of women in these population groups in the context of maternal care in a country that has suffered years of austerity has been amply recorded and adds further contextual constraints. Policy reform is urgently required to achieve cultural competence, to improve transcultural care provision across maternity care settings, and to ensure improved maternal and children’s outcomes.