Addressing Obstetric Health Disparities among Refugee Populations: Training the Next Generation of Culturally Humble OB/GYN Medical Providers

Ajjarapu, Avanthi; Story, William T.; Haugsdal, Michael L

doi:10.1080/10401334.2020.1813585

Cited by 7 publications

(3 citation statements)

References 41 publications

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“…[30][31][32] Hiring from one's own neighborhood or refugee camp ensures a more culturally aware, language-appropriate, and socially acceptable experience between providers and patients. 33…”

Section: Staffing the Reserve Corpsmentioning

confidence: 99%

COVID-19 and Gaza: The Ideal Time to Establish a Medical Reserve Corps of Public Health Preventive Medicine Specialists

Mahayosnand

Sabra

2021

Health Security

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Section: Staffing the Reserve Corpsmentioning

confidence: 99%

COVID-19 and Gaza: The Ideal Time to Establish a Medical Reserve Corps of Public Health Preventive Medicine Specialists

Mahayosnand

Sabra

2021

Health Security

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“…Furthermore, in contrast with previous audit studies that did not focus on refugees specifically, our findings present evidence for negative attitudes among healthcare providers in care for refugee women [ 10 , 19 – 24 ]. Previous research on refugee women’s experiences and healthcare staff’s attitudes shows that racial and ethnic discrimination in care is common [ 5 , 56 – 58 ]. This is concerning, as racism adversely affects the quality of care refugee women receive and is associated with a lack of trust and delayed care seeking [ 59 – 68 ].…”

Section: Discussionmentioning

confidence: 99%

Suboptimal factors in maternal and newborn care for refugees: Lessons learned from perinatal audits in the Netherlands

Verschuuren,

Tankink,

Postma

et al. 2024

PLoS ONE

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Introduction Refugees and their healthcare providers face numerous challenges in receiving and providing maternal and newborn care. Research exploring how these challenges are related to adverse perinatal and maternal outcomes is scarce. Therefore, this study aims to identify suboptimal factors in maternal and newborn care for asylum-seeking and refugee women and assess to what extent these factors may contribute to adverse pregnancy outcomes in the Netherlands. Methods We conducted a retrospective analysis of national perinatal audit data from 2017 to 2019. Our analysis encompassed cases with adverse perinatal and maternal outcomes in women with a refugee background (n = 53). Suboptimal factors in care were identified and categorized according to Binder et al.’s Three Delays Model, and the extent to which they contributed to the adverse outcome was evaluated. Results We identified 29 suboptimal factors, of which seven were related to care-seeking, six to the accessibility of services, and 16 to the quality of care. All 53 cases contained suboptimal factors, and in 67.9% of cases, at least one of these factors most likely or probably contributed to the adverse perinatal or maternal outcome. Conclusion The number of suboptimal factors identified in this study and the extent to which they contributed to adverse perinatal and maternal outcomes among refugee women is alarming. The wide range of suboptimal factors identified provides considerable scope for improvement of maternal and newborn care for refugee populations. These findings also highlight the importance of including refugee women in perinatal audits as it is essential for healthcare providers to better understand the factors associated with adverse outcomes to improve the quality of care. Adjustments to improve care for refugees could include culturally sensitive education for healthcare providers, increased workforce diversity, minimizing the relocation of asylum seekers, and permanent reimbursement of professional interpreter costs.

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“… 68–71 Cultural humility trainings are not yet widely implemented nor evaluated in medicine, but some examples show promise. 72 , 73 Curricular components include experiential service-learning, 74 , 75 simulation, 72 , 73 , 76 and reflexive practices (e.g., journaling). 77 , 78 Structural humility, 79 , 80 anti-racism, 79 and implicit bias training, 81 , 82 which some states and health facilities now require, 83–85 may bolster cultural humility skills-building.…”

Section: Discussionmentioning

confidence: 99%

The Social Contexts of Birthing People with Public- and Private-Payer Prenatal Care: Illuminating an Understudied Aspect of the Patient Experience

Garrett

Simon

2022

Health Equity

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Purpose: In pursuit of more equitable and person-centered health care, patients and professional medical societies increasingly call for better clinician understanding of patients' perspectives and social contexts. A foundational but understudied aspect of patients' social contexts are the ideas they encounter about health-related behaviors. We investigated this aspect of the social contexts of birthing people, comparing those with public versus private insurance to discover setting-specific insights. Methods: Based on ethnographic fieldwork, we created an original survey featuring 29 statements about 12 prenatal, perinatal, and postpartum health behaviors (e.g., drinking alcohol, epidural use, breastfeeding). Participants were 248 individuals receiving prenatal care in Northern California in 2009–2011, split evenly between public- and private-payer coverage. Participants reported whether they were familiar or unfamiliar with each statement. Results: Ninety-eight percent of all participants had heard contradictory ideas about ≥1 health behavior (mean=3.9 behaviors for public- and 5.4 for private-coverage respondents). For 20 of the 29 behavior-related ideas, exposure varied significantly by coverage type. Among other differences, public-coverage respondents were much more familiar with ideas related to risk and constrained autonomy (e.g., that serious perinatal complications are common; that new mothers should try to breastfeed even if they do not want to). Conclusions: Birthing people are exposed to a wide range of ideas about health behaviors, many of which vary by the structural systems in which they are embedded. Understanding and engaging this complexity can help clinicians to provide more respectful, person-centered, and equitable maternity care.

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Addressing Obstetric Health Disparities among Refugee Populations: Training the Next Generation of Culturally Humble OB/GYN Medical Providers

Cited by 7 publications

References 41 publications

COVID-19 and Gaza: The Ideal Time to Establish a Medical Reserve Corps of Public Health Preventive Medicine Specialists

COVID-19 and Gaza: The Ideal Time to Establish a Medical Reserve Corps of Public Health Preventive Medicine Specialists

Suboptimal factors in maternal and newborn care for refugees: Lessons learned from perinatal audits in the Netherlands

The Social Contexts of Birthing People with Public- and Private-Payer Prenatal Care: Illuminating an Understudied Aspect of the Patient Experience

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