Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in Denmark

Villadsen, Sarah Fredsted; Ims, Hodan Jama; Andersen, Anne‐Marie Nybo

doi:10.3390/ijerph16183396

Cited by 11 publications

(4 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Here the women attend care with a team of midwives, who have a special interest and experience in intercultural communication. According to the midwives at these places, they have better abilities to use interpreters and more flexibility in their daily schedules (40). In the last two decades, the work environment for midwives has been discussed in Denmark, as midwives have one of the highest prevalences of burnout in Denmark (41).…”

Section: Study Setting: Antenatal Care In Denmarkmentioning

confidence: 99%

Unlocking the mechanisms of change in the MAMAACT intervention to reduce ethnic disparity in stillbirth and newborns' health: integration of evaluation findings

Villadsen,

Johnsen,

Damsted Rasmussen

et al. 2024

Front. Health Serv.

Self Cite

View full text Add to dashboard Cite

Ethnic disparities in stillbirth exist in Europe and suboptimal care due to miscommunication is one contributing cause. The MAMAACT intervention aimed to reduce ethnic disparity in stillbirth and newborns' health through improved management of pregnancy complications. The intervention encompassed training of antenatal care midwives in cultural competencies and intercultural communication combined with health education materials for the expecting parents about symptoms of pregnancy complications. The evaluation consisted of a qualitative in-depth implementation analysis and a process evaluation embedded in a cluster randomized trial including 19 of 20 maternity wards in Denmark. In this article, the findings from the different evaluation perspectives are integrated. The integration follows the principles of realist evaluation by analyzing to what extent the MAMAACT activities were generating mechanisms of change in interaction with the context. The integration analysis shows that the health education materials in the MAMAACT intervention contributed to heightened health literacy concerning pregnancy complications among pregnant women. Additionally, the training of midwives in cultural competency and intercultural communication raised awareness among midwives. Nonetheless, the exclusive emphasis on midwives and the inflexibility in care provision hindered them from changing their communication practices. To enhance the cultural competence in maternity care, it is essential to implement more comprehensive initiatives involving healthcare professionals in maternity care at all levels, from pregraduate to postgraduate. Adequate interpreter services and management support should also be ensured. Currently, the Danish antenatal care system faces challenges including inadequate information transfer between healthcare sectors, insufficient differentiation of care, and inflexibility in midwife scheduling. This results in a lack of responsiveness to the individual needs of women with immigrant backgrounds, potentially reproducing health inequities.

show abstract

Section: Study Setting: Antenatal Care In Denmarkmentioning

confidence: 99%

Unlocking the mechanisms of change in the MAMAACT intervention to reduce ethnic disparity in stillbirth and newborns' health: integration of evaluation findings

Villadsen,

Johnsen,

Damsted Rasmussen

et al. 2024

Front. Health Serv.

Self Cite

View full text Add to dashboard Cite

show abstract

“…To reduce ethnic disparities in maternal and child health, screening tools for targeted and differentiated care, as well as universal ANC, must be improved. 22…”

Section: The Current Situation Of Antenatal Care Services Available F...mentioning

confidence: 99%

Antenatal Care Services for Migrant Workers in Northern Thailand: Challenges, Initiatives, and Recommendations for Improvement

Wungrath

2023

Journal of Child Science

View full text Add to dashboard Cite

This review article emphasizes the importance of addressing the unique health care needs of migrant workers in northern Thailand, with a focus on antenatal care services. There has been an increase in the number of migrant workers in the region. The challenges include language and cultural barriers, legal and administrative issues, inadequate health facilities and staff, and stigma and discrimination. However, by implementing a comprehensive set of recommendations, including strengthening collaboration, developing culturally sensitive programs, and increasing health care facility accessibility, stakeholders can create a more inclusive and supportive health care environment for migrant workers. This will ultimately contribute to healthier pregnancies and better outcomes for both mothers and their newborns. Prioritizing the needs of migrant workers is crucial for the successful integration of this population into the local health care workforce, thereby improving the health care system in northern Thailand.

show abstract

“…The MAMAACT intervention was developed as a response to a nationwide register-based epidemiological study that showed vast ethnic and social inequities in stillbirth and infant mortality in Denmark [21], despite free and universal access to antenatal care [22]. Before developing an intervention, we needed to gain more insights into the determinants, needs and contexts, so new research was conducted using register-based epidemiology [23], a case-series study of patient files [24], organisational analysis of Danish antenatal care [25] and qualitative data including pregnant women and midwives [23]. These new perspectives were synthesised with previous research linking stillbirths among migrants to suboptimal obstetric care in Sweden [26] as well as the sociological theory of cultural health capital regarding power imbalances in healthcare encounters [27] and the concept of health literacy [28].…”

Section: Evidence Perspectives Using the Mamaact Intervention As An E...mentioning

confidence: 99%

Evidence in public health: An integrated, multidisciplinary concept

Jervelund

Villadsen

2022

Scand J Public Health

Self Cite

View full text Add to dashboard Cite

Aims: Traditionally, evidence in public health has been founded in health sciences using the hierarchy of evidence. In this Commentary, we argue that we need a combination of evidence based on a broad range of scientific disciplines and methodologies to best translate research into improved public health. Methods: Using existing concepts of evidence such as the hierarchy of evidence and the evidence typology, we discuss their pitfalls in public health science and suggest a way forward. We use the case of the MAMAACT intervention to exemplify our claims. Results: Public health does not apply an either/or perspective, but an integrated, theoretically informed approach based on mixed and multiple methods to understand complex health problems and how to tackle them. Ideally, public health decisions should always incorporate scientific evidence, although we need to fully acknowledge that the quality of evidence is defined by more than just being placed highest in the hierarchy of evidence. No method or study design is superior in obtaining evidence, but we need the combined and supplemented contributions from a range of scientific approaches to form a whole. Thus, we propose an integrated, multidisciplinary concept of evidence in the form of cogwheels, where the public health problem followed by the research question(s) will guide the components to be studied and the use of method(s) in an interplay with the decisions of the scientific perspective(s) that include choice of theories. Conclusions: We cannot understand or solve public health challenges without multidisciplinary approaches in a complimentary formation.

show abstract

Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in Denmark

Cited by 11 publications

References 27 publications

Unlocking the mechanisms of change in the MAMAACT intervention to reduce ethnic disparity in stillbirth and newborns' health: integration of evaluation findings

Unlocking the mechanisms of change in the MAMAACT intervention to reduce ethnic disparity in stillbirth and newborns' health: integration of evaluation findings

Antenatal Care Services for Migrant Workers in Northern Thailand: Challenges, Initiatives, and Recommendations for Improvement

Evidence in public health: An integrated, multidisciplinary concept

Contact Info

Product

Resources

About