Assessing maternal healthcare inequities among migrants: a qualitative study

Almeida, Lígia Maria Moreira Ferreira de; Caldas, José Manuel Peixoto; Ayres-de-Campos, Diogo; Dias, Sónia

doi:10.1590/0102-311x00060513

Cited by 20 publications

(27 citation statements)

References 16 publications

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“…On the one hand, more research is needed into how to tailor the various dimensions of involvement to migrant and ethnic minorities' needs and preferences. Further inquiry into health care staff's beliefs, expectations and attitudes towards involvement is also needed, including how these may be influenced not only by (lack of) cultural competence but also by factors such as migrants' origin, status and duration of stay in the host country [75,79]. On the other hand, it is necessary to make resources available for effective implementation.…”

Section: Resultsmentioning

confidence: 99%

“…A study from the UK found that non-English-speaking Somali women experienced poorer communication with health professionals when compared to English-speaking Somalis [62]. Immigrant women with low proficiency in the host country's language living in Canada, the USA, England and Portugal also experienced barriers in communication, which limited their access to maternal care services [60,71,[74][75][76][77].…”

Section: Communicationmentioning

confidence: 99%

“…Involvement in decision-making regarding maternal care appears to be influenced by migrant and ethnic minority women's socio-cultural background and beliefs about and previous experiences with care provision, difficulties in accessing information and expressing preferences, health care professionals' attitudes towards involvement and use of obstetric procedures. While some migrant groups are more acquainted with paternalistic doctor-patient relationships and expect health professionals to make decisions without involving them [74,75], others lack the language skills to understand available options and to take part in decision-making [60,74]. However, involvement in decision-making may also be detracted by health care professionals.…”

Section: Decision-makingmentioning

confidence: 99%

“…However, involvement in decision-making may also be detracted by health care professionals. A study carried out in Portugal found that although Eastern European immigrants wanted to take part in care decision-making, they felt their intents were abridged by doctors who seemed uncomfortable in answering their questions and in providing information or discussing clinical procedures with them [75,76].…”

Section: Decision-makingmentioning

confidence: 99%

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Involvement in maternal care by migrants and ethnic minorities: a narrative review

et al. 2020

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Background: Guidelines for improving the quality of maternal health services emphasise women's involvement in care. However, evidence about migrant and ethnic minorities' preferences for participation in maternal care remains unsystematised. Understanding these populations' experiences with and preferred forms of involvement in care provision is crucial for imbuing policies and guidelines with sensitivity to diversity and for implementing people-centred care. This paper presents a narrative synthesis of empirical studies of involvement in maternal health care by migrants and ethnic minorities based on four key dimensions: information, communication, expression of preferences and decision-making. Methods: Studies indexed in PubMed and Scopus published until December 2019 were searched. Original quantitative, qualitative and mixed methods studies written in English and reporting on migrant and ethnic minority involvement in maternal care were included. Backward reference tracking was carried out. Three researchers conducted full-text review of selected publications. Results: In total, 22 studies met the inclusion criteria. The majority of studies were comparative and addressed only one or two dimensions of involvement, with an emphasis on the information and communication dimensions. Compared to natives, migrants and ethnic minorities were more likely to (1) lack access to adequate information as a result of health care staff's limited time, knowledge and misconceptions about women's needs and preferences; (2) report suboptimal communication with care staff caused by language barriers and inadequate interpreting services; (3) be offered fewer opportunities to express preferences and to have preferences be taken less into account; and (4) be less involved in decisions about their care due to difficulties in understanding information, socio-cultural beliefs and previous experiences with care provision less attuned with playing an active role in decision-making and care staff detracting attitudes.

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Section: Resultsmentioning

confidence: 99%

Section: Communicationmentioning

confidence: 99%

Section: Decision-makingmentioning

confidence: 99%

Section: Decision-makingmentioning

confidence: 99%

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Involvement in maternal care by migrants and ethnic minorities: a narrative review

et al. 2020

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“…Included immigrant women were born outside the national territory and have foreign parents themselves: Eastern European countries, Brazil and African countries of Portuguese speaking (most representative ethnic groups of the Portuguese immigration context, at the date). Results showed that misinformation about legal rights and inadequate clarification during medical appointments frequently interacted with social determinants, such as low social-economic status, unemployment, and poor living conditions, to result in lower perceived quality of healthcare (Almeida et al, 2013b;Almeida et al, 2014a). …”

Section: Maternal Healthcare In Migrants: a Systematic Reviewmentioning

confidence: 99%

Social Determinants of Health in Pregnancy, Postpartum and early Motherhood: the impact of Migration

Almeida¹,

Caldas²

2014

m.rcs

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The present investigation sought to establish itself as an interface between Public Health and Social Medicine. Its main purpose relied in assessing theoretical inequalities in access, utilization and quality of maternal health care in immigrant recent mothers and its interaction with social determinants of health. The underlying research plan was designed to explore specific clinical, individual and social determinants in maternal health (during pregnancy and postpartum). Another specific goal is the assessment of access, utilization and quality of the received care (adequacy and satisfaction of responses offered by the public health system), establishing a comparison between health status, perceptions and needs of immigrant and native women in the same conditions and motherhood stages. Data was collected in all reference hospitals and several civilian associations of Porto metropolitan area, to better reach the targeted population: recent immigrant mothers from the countries with the highest representation in Portugal at the date (Brazil, African countries of Portuguese speaking and Eastern European countries), as well as Portuguese women (for comparison). To accomplish the defined objectives, three studies were performed using data obtained in all defined backgrounds, following different methodological approaches and designs (qualitative and quantitative strategies).

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