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Bali AG, Vasilevski V, Sweet L. Barriers and facilitators of access to maternity care for African-born women living in Australia: a meta-synthesis of qualitative evidence. Syst Rev 2024; 13:215. [PMID: 39123244 PMCID: PMC11312702 DOI: 10.1186/s13643-024-02628-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Adverse perinatal health outcomes are notably high among African-born women living in Australia. This problem is partly attributed to their lower engagement in maternity care services as compared to Australian-born women. Various barriers might limit African-born women's access to and use of services; however, these barriers are not well documented. Therefore, this review aimed to synthesise current qualitative evidence on barriers and facilitators of access to maternity care for African-born women living in Australia. METHODS The search was conducted in MEDLINE, CINAHL, Embase, PsychInfo, and Maternity and Infant Care databases on 16 April 2023. All articles retrieved were meticulously screened for eligibility by two independent reviewers with any disagreements resolved through discussion. The quality of the included articles was evaluated using the Mixed Methods Appraisal Tool. Studies were screened in Covidence and analysed in NVivo. The findings were organised and presented using Levesque's framework of healthcare access. RESULTS Out of 558 identified papers, 11 studies comprising a total of 472 participants met the eligibility criteria. The review highlighted provider-side barriers such as shortage of information, unmet cultural needs, long waiting times, low engagement of women in care, discrimination, and lack of continuity of care. User-side barriers identified include communication issues, difficulty navigating the health system, and lack of trustful relationships with healthcare providers. In contrast, the review pinpointed provider-side facilitators including positive staff attitudes, service availability, and the proximity of facilities to residential homes, while user-side facilitators such as cultural assimilation and feeling valued by healthcare providers were noted. CONCLUSIONS This review identified barriers and facilitators of access to maternity care for African-born women living in Australia. Empirical evidence that would inform potential changes to policy and practice to address African-born women's unique health needs was highlighted. Designing and implementing a culturally safe service delivery model could remove the identified access barriers and improve African-born women's engagement in maternity care. Moreover, reinforcing factors associated with positive healthcare experiences is essential for improving maternity care access for this priority population. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023405458.
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Affiliation(s)
- Ayele Geleto Bali
- School of Nursing and Midwifery, Deakin University, Burwood, VIC, Australia.
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Melbourne, VIC, Australia.
| | - Vidanka Vasilevski
- School of Nursing and Midwifery, Deakin University, Burwood, VIC, Australia
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Melbourne, VIC, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Burwood, VIC, Australia
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Melbourne, VIC, Australia
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Shuman HL, Grupp AM, Robb LA, Akers KG, Bedi G, Shah MA, Janis A, Caldart CG, Gupta U, Vaghasia JK, Panneerselvam A, Kazeem AO, Amutah-Onukagha NN, Levine DL. Approaches and geographical locations of respectful maternity care research: A scoping review. PLoS One 2023; 18:e0290434. [PMID: 37616299 PMCID: PMC10449213 DOI: 10.1371/journal.pone.0290434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Peripartum mistreatment of women contributes to maternal mortality across the globe and disproportionately affects vulnerable populations. While traditionally recognized in low/low-middle-income countries, the extent of research on respectful maternity care and the types of mistreatment occurring in high-income countries is not well understood. We conducted a scoping review to 1) map existing respectful maternity care research by location, country income level, and approach, 2) determine if high-income countries have been studied equally when compared to low/low-middle-income countries, and 3) analyze the types of disrespectful care found in high-income countries. METHODS A systematic search for published literature up to April 2021 using PubMed/MEDLINE, EMBASE, CINAHL Complete, and the Maternity & Infant Care Database was performed. Studies were included if they were full-length journal articles, published in any language, reporting original data on disrespectful maternal care received from healthcare providers during childbirth. Study location, country income level, types of mistreatment reported, and treatment interventions were extracted. This study was registered on PROSPERO, number CRD42021255337. RESULTS A total of 346 included studies were categorized by research approach, including direct labor observation, surveys, interviews, and focus groups. Interviews and surveys were the most common research approaches utilized (47% and 29% of all articles, respectively). Only 61 (17.6%) of these studies were conducted in high-income countries. The most common forms of mistreatment reported in high-income countries were lack of informed consent, emotional mistreatment, and stigma/discrimination. CONCLUSIONS Mapping existing research on respectful maternity care by location and country income level reveals limited research in high-income countries and identifies a need for a more global approach. Furthermore, studies of respectful maternity care in high-income countries identify the occurrence of all forms of mistreatment, clashing with biases that suggest respectful maternity care is only an issue in low-income countries and calling for additional research to identify interventions that embrace an equitable, patient-centric empowerment model of maternity care.
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Affiliation(s)
- Hannah L. Shuman
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Annika M. Grupp
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Lauren A. Robb
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Katherine G. Akers
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Gurbani Bedi
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Miloni A. Shah
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Andrea Janis
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Caroline G. Caldart
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Urvashi Gupta
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Janki K. Vaghasia
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Aishwarya Panneerselvam
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Aisha O. Kazeem
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Ndidiamaka N. Amutah-Onukagha
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Diane L. Levine
- Department of Public Health and Community Medicine, Tufts University, Boston, Massachusetts, United States of America
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Navarro-Prado S, Sánchez-Ojeda MA, Plaza Del Pino FJ, Vázquez-Sánchez MÁ, Tovar-Gálvez MI, Azirar-Mohamed N. Coping Strategies during Childbirth Related to Cultural Identity: Companionship, Choice of Analgesia and Maternal Satisfaction. Healthcare (Basel) 2023; 11:1714. [PMID: 37372832 DOI: 10.3390/healthcare11121714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Childbirth is a biological process and how it is experienced and managed is influenced by numerous factors, among them, socio-cultural or health care received. OBJECTIVE The objective of this study is to ascertain whether cultural factors influence the way in which women deal with childbirth through the treatment of pain, companionship and maternal satisfaction. METHODS This study is a non-experimental, quantitative, ex post facto, cross-sectional study of women who gave birth in a border town in southern Spain. The sample consisted of 249 women. RESULTS No relationship was found between cultural factors and the choice of epidural analgesia, alternative methods to alleviate pain, being accompanied nor maternal satisfaction. There was a significant relationship between the type of companionship and with maternal satisfaction. CONCLUSIONS Cultural factors did not influence how women dealt with dilation and childbirth. Results found that the person accompanying the mother was important for increasing maternal satisfaction. The intercultural training of healthcare professionals is necessary.
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Affiliation(s)
- Silvia Navarro-Prado
- Department of Nursing, Faculty of Health Sciences of Melilla, University of Granada, 52017 Melilla, Spain
| | | | | | | | - María Isabel Tovar-Gálvez
- Department of Nursing, Faculty of Health Sciences of Ceuta, University of Granada, 51001 Ceuta, Spain
| | - Nurimán Azirar-Mohamed
- Centre for the Temporary Stay of Immigrants of the Autonomous City of Melilla, 52004 Melilla, Spain
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Pazandeh F, Moridi M, Safari K. Labouring women perspectives on mistreatment during childbirth: a qualitative study. Nurs Ethics 2023; 30:513-525. [PMID: 36921625 DOI: 10.1177/09697330231158732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
BACKGROUND Respectful care during labour and childbirth, which has recently received a great deal of attention around the world, is vital for providing high-quality maternity care. However, this area has been underexplored in developing countries including Iran. RESEARCH AIM This study aimed to assess postpartum women's views regarding disrespect and abuse during labour and childbirth in Iran. METHODS A qualitative study that involved a purposive sample of 21 postpartum women was conducted in Tehran, Iran, between 2019 and 2020. Following the semi-structured individual interviews, a conventional content analysis was performed. ETHICAL CONSIDERATIONS This research approved by Shahid Beheshti University of Medical Sciences in Tehran, Iran, with the ethical approval number 1396.810. Following explanation of the study's objectives, eligible women consented to participate in the study. The confidentiality of the participants' information and the anonymity of the analysis were maintained at all stage of the study. All data was stored on the password protected file in the researcher computer The findings were only disseminated in summary form, with no identifying of individual participants. RESULTS Analysis of the data resulted in two main themes: 'inappropriate interaction' and 'inadequate quality care'. The 'inappropriate interaction' theme includes 'lack of empathy' and 'verbal abuse'. The second theme includes five sub-themes 'lack of participation in decision-making', 'lack of privacy', 'ignorance of women's pain and medical needs', 'rushed labour and painful procedures', and "unsatisfying facilities'. CONCLUSION Providing supportive care, respectful communication, adequate participation in decision-making, maintaining privacy, attending to women's labour pain and medical needs, and improving the quality of the physical birth environment are all examples of what labouring women consider to be respectful maternity care. To minimise disrespect and maltreatment of women during childbirth, an all-inclusive strategy engaging women, communities, healthcare professionals, managers, and educators is required.
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Affiliation(s)
| | - Maryam Moridi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Kolsoom Safari
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia
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Azugbene EA. Maternal Health Experiences and Health Care Utilization of African Immigrant Women: A Review of The Literature. Matern Child Health J 2023:10.1007/s10995-023-03644-1. [PMID: 36988796 DOI: 10.1007/s10995-023-03644-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION This systematic review summarizes the maternal health experiences and healthcare utilization of African immigrant women who have immigrated to the United States using an adapted version of the healthcare utilization model. METHODS Published journal articles from the year 2000 to 2022 were identified from seven large databases; 13 studies satisfied the inclusion criteria. RESULTS The results of the study are reported according to the individual and contextual factors for healthcare utilization for African immigrant women in the United States. Individual factors that facilitated the use of maternal healthcare were having transportation, higher health literacy levels, insurance, and family support. Contextual factors that facilitated maternal health utilization included access to interpreters and female doctors. DISCUSSION Facilitators and barriers to maternal health utilization were impacted by cultural and environmental factors. First, African immigrant women included in the studies, believe pregnancy and childbirth are safe and normal, therefore prenatal care is unnecessary. Second, the fear of obstetrical interventions, especially from women who have had female genital mutilation. Third, the misconceptions regarding pain medications and the roles of hospital staff. Further research is necessary for addressing the facilitators and barriers to healthcare utilization in African immigrant women.
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Affiliation(s)
- Ehiremen Adesua Azugbene
- Maternal and Child Health Translational Research Team (MCHTRT), College of Public Health Solutions, Arizona State University, Phoenix, AZ, United States.
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Lakin K, Kane S. A critical interpretive synthesis of migrants' experiences of the Australian health system. Int J Equity Health 2023; 22:7. [PMID: 36624465 PMCID: PMC9827657 DOI: 10.1186/s12939-022-01821-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/25/2022] [Indexed: 01/10/2023] Open
Abstract
While the health of and healthcare use by migrants has received significant scholarly and policy attention in Australia, current debates highlight that a critical examination of the theoretical underpinnings of these inquiries and responses is needed. We conducted a systematic review and critical interpretive synthesis (CIS) to critically examine how the policy and scholarly literature conceptualises migrants' interactions with and experiences of the Australian health system. Guided by PRISMA, we searched for literature without imposing any limits. We also searched key State and Federal Government websites for relevant policy documents. Our initially broad inclusion criteria became refined as the CIS progressed. We prioritised the likely relevance and theoretical contribution of the papers to our inquiry over methodological quality. The CIS of 104 papers revealed that the Australian scholarly literature and policy documents consistently homogenise and reduce migrants according to an assumed, (1) cultural identity, (2) linguistic affiliation, and/or (3) broad geographic origin. Based on these three critiques and drawing on the theoretical literature, we propose a synthesising argument on how the Australian literature could better conceptualise migrants' experiences of the Australian health system. We contend that both research and policy should explicitly recognise and engage with the multifaceted and shifting ways that migrants define themselves, generally, and during their encounters with destination country health systems. Engagement with this notion is necessary for also understanding how aspects of migrants' identities are dynamically co-constructed during their interactions with the health system. These understandings have implications for improving the design and implementation of policies and programs directed at improving the responsiveness of Australia's health system to the needs and expectations of migrant communities specifically, and destination countries broadly.
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Affiliation(s)
- Kimberly Lakin
- Nossal Institute for Global Health, School of Population and Global Health, The University of Melbourne, Level 2, 32 Lincoln Square, Melbourne, 3010, Australia
| | - Sumit Kane
- Nossal Institute for Global Health, School of Population and Global Health, The University of Melbourne, Level 2, 32 Lincoln Square, Melbourne, 3010, Australia.
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Khumoetsile Daphney S, Tinda R, Antoinette DP, Petra B. Experiences of midwives regarding provision of culturally competent care to women receiving maternal care in South Africa. Midwifery 2023; 116:103527. [PMID: 36323078 DOI: 10.1016/j.midw.2022.103527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 04/21/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
Due to the cultural diversity in South Africa, midwives are challenged to provide culturally competent, congruent, and sensitive maternal care. Using a qualitative descriptive design, this study aimed to explore and describe the experiences of midwives providing culturally competent care to women receiving maternal care within overburdened public hospitals. Purposive sampling of thirty-four (n = 34) midwives employed to provide maternal care (antenatal, intrapartum, and postpartum) at five public hospitals in the North West Province of South Africa was done. Semi-structured interviews were conducted in English and transcribed verbatim. Data was analysed thematically with the assistance of an independent co-coder. Data revealed that midwives viewed communication as a key component of cultural competence. Midwives do not necessarily understand the concept "cultural competence." It is recommended that a policy of culturally competent maternal care be developed and implemented by midwives in practice.
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Affiliation(s)
| | - Rabie Tinda
- Associate Professor, North-West University, School of Nursing Science, NuMIQ Focus Area, South Africa.
| | - Du Preez Antoinette
- Senior Lecturer, North-West University, School of Nursing Science, NuMIQ Focus Area, South Africa.
| | - Bester Petra
- Associate Professor, Africa Unit for Transdisciplinary Health Research, North-West University, South Africa.
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Navarro-Prado S, Sánchez-Ojeda MA, Marmolejo-Martín J, Kapravelou G, Fernández-Gómez E, Martín-Salvador A. Cultural influence on the expression of labour-associated pain. BMC Pregnancy Childbirth 2022; 22:836. [PMID: 36376827 PMCID: PMC9664611 DOI: 10.1186/s12884-022-05173-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/01/2022] [Indexed: 11/16/2022] Open
Abstract
Background Every woman expresses pain differently during birth since it depends on a multitude of predictive factors. The medical care received, companionship during birth, cultural background and language barriers of the women in labour can influence on the expression of pain. This study aims to evaluate the expression of pain during birth and its associated factors in women treated in a Spanish border town. Methods The study included 246 women in labour. The expression of pain during labour was evaluated using the validated ESVADOPA scale. A descriptive analysis and association study were performed between cultural identity and dimensions of the scale. Multiple linear regression models were performed to assess the association between cultural identity, origin, language barrier, and companionship during labour. Results The women included in the study comprised 68.7% Berbers, 71.5% Muslims and 82.1% were accompanied during labour. An association between cultural identity and greater body expression of pain (p = 0.020; Cramer’s V = 0.163) in addition to its verbal expression was found during the latent phase of labour, (p = 0.028; Cramer’s V = 0.159). During the active phase of labour, cultural identity was associated with pain expression through greater body response, verbal expression, expression of the facial muscles, anxiety, inability to relax and vegetative symptoms. The different factors studied that had a predictive value were companionship (p = 0.027) during the latent phase of labour and Berber origin (p = 0.000), language barrier (p = 0.014) and companionship (p = 0.005) during the active phase of labour. The models designed predict pain expression in the latent phase by companionship and type of companionship (β = 1.483; 95%CI = 0.459–2.506, β = 0.238; 95%CI = 0.029–0. 448, respectively), and in the active phase by background, language barrier and companionship (β = 0.728; 95%CI = 0.258–1.198, β = 0.738; 95%CI = 0.150–1.326, β = 1.888; 95%CI = 0.984–2.791, respectively). Conclusion Culture, origin, language barrier and companionship during labour influences the manner in which women in labour express their pain. An understanding of this may help midwives correctly interpret the signs of pain expression and be able to offer the appropriate assistance depending on a woman's particular characteristics. There is a clear need for new models of maternity care that will take the cultural and language characteristics of women in labour into consideration. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05173-1.
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Vik ES, Hashi RMA, Hamud ME, Aasheim V, Kringeland T, Aasekjær K. Migrant Somali women’s experiences with their first contact with the labor ward prior to admission: A qualitative study. Eur J Midwifery 2022; 6:45. [PMID: 35958805 PMCID: PMC9302448 DOI: 10.18332/ejm/150584] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The first contact with the labor ward is a crucial moment in any birth and can be especially challenging when the woman has a migrant background. The aim of the study was to explore migrant Somali women’s experiences with their first contact with the labor ward prior to admission, in Norway. METHODS In this qualitative study, data were collected through semi-structured individual interviews and Systematic Text Condensation was the method used to analyze the data. Ten Somali-born women who had given birth in Norway were included. RESULTS The migrant Somali women’s first contact with the labor ward prior to admission was challenging, due to one-way communication, poor health literacy, and a fear of interventions or adverse outcomes. To improve care, the migrant Somali women highlighted a need for: 1) flexibility, tailored information and practical guidance before birth; and 2) face-to-face assessment in early labor. CONCLUSIONS The findings in this study indicate that the needs of laboring migrant Somali women are not fully met by antenatal or pre-hospital maternity care services. To improve the critical first contact with the labor ward for migrant Somali women, this study suggests that antenatal care services offer practical guidance on whom to contact and what to expect at the hospital in early labor. Face-to-face assessment of maternal and fetal well-being should be the first choice of care for Somali women in early labor who are unfamiliar with the healthcare system after immigration. Interpretation services need strengthening and our findings support a need for increased continuity of care.
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Affiliation(s)
- Eline S. Vik
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Randa M. A. Hashi
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Maryam E. Hamud
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Vigdis Aasheim
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Tone Kringeland
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Katrine Aasekjær
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Tefera M, Assefa N, Roba KT, Gedefa L, Brewis A, Schuster RC. Women's hospital birth experiences in Harar, eastern Ethiopia: a qualitative study using Roy's Adaptation Model. BMJ Open 2022; 12:e055250. [PMID: 35803641 PMCID: PMC9272130 DOI: 10.1136/bmjopen-2021-055250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The aim of the study was to explore women's birth in public hospitals in the Harari Region of eastern Ethiopia. DESIGN An exploratory phenomenological qualitative study design was used. SETTING Two public hospitals (Hiwot Fana Specialized University Hospital and Jugal General Hospital). PARTICIPANTS AND METHODS The study enrolled women who gave birth at the selected hospitals through purposive sampling. We conducted in-depth interviews with 38 women who gave birth to singleton, full-term babies via vaginal delivery (47%; n=18) or caesarean section (53%; n=20) with no pregnancy-related complications. Interviews were audio-recorded and transcribed on the spot and the interviews were analysed using a deductive content analysis approach. Data were analysed using the four components of Roy's Adaptation Model (RAM) as a guiding framework of women's experiences: physiological, self-concept, role and function, and interdependence. RESULTS Various behaviours were identified: under physiological mode, common behaviours identified included labour pain, fatigue, surgical site pain and anaesthesia-related complication. The women's major problems in self-concept mode were concern for future pregnancy, lack of privacy, newborn health status, relationship with healthcare providers and lack of family support. Due to the prolonged hospital stay and surgical site pain, the women who were unable to care for themselves, their newborn babies and their families adapted poorly to role and function mode. Finally, women who had no family support and who got less attention from healthcare providers reported ineffective adaption for interdependence mode. CONCLUSIONS Application of RAM principles could be used to improve care for Ethiopian women, providing an intervention framework that can gauge and respond to interacting factors that can make women vulnerable to negative birth experiences.
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Affiliation(s)
- Maleda Tefera
- College of Health and Medical Science, School of Nursing and Midwifery, Haramaya University, Dire Dawa, Ethiopia
| | - Nega Assefa
- College of Health and Medical Science, School of Nursing and Midwifery, Haramaya University, Dire Dawa, Ethiopia
| | - Kedir Teji Roba
- College of Health and Medical Science, School of Nursing and Midwifery, Haramaya University, Dire Dawa, Ethiopia
| | - Letta Gedefa
- College of Health and Medical Science, School of Nursing and Midwifery, Haramaya University, Dire Dawa, Ethiopia
| | - Alex Brewis
- Arizona State University, Tempe, Arizona, USA
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Munezero T, Tomita A. Hypertension and Its Associated Mental Health Challenges Among Female African Refugees in Durban, South Africa. J Nerv Ment Dis 2021; 209:802-808. [PMID: 34310523 DOI: 10.1097/nmd.0000000000001387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Hypertension is a serious medical condition that leads to various adverse health complications when left untreated. In addition to psychological challenge that female migrant refugees are exposed to premigration, they encounter barriers to care postmigration from xenophobia that affects their hypertension. We investigated the extent and mental health drivers of hypertension in refugees in Durban, South Africa. We interviewed 178 adult female African help-seeking refugees/migrants for hypertension (blood pressure ≥130/90 mm Hg) and mental health challenges (e.g., adverse childhood experience [ACE] and depression using the Center for Epidemiologic Studies-Depression scale). Eighty-six percent (n = 153) of participants were hypertensive, and based on the adjusted regression models, exposure to at least one ACE (adjusted odds ratio [aOR], 2.83; 95% confidence interval [CI], 1.11-7.26) and depression (aOR, 3.54; 95% CI, 1.10-11.37) were associated with hypertension, independent of smoking, alcohol, obesity, and physical exercise status. Hypertension and its associated mental health challenges are overlooked conditions in this population, with further efforts for screening being needed.
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Mdoe P, Mills TA, Chasweka R, Nsemwa L, Petross C, Laisser R, Chimwaza A, Lavender T. Lay and healthcare providers' experiences to inform future of respectful maternal and newborn care in Tanzania and Malawi: an Appreciative Inquiry. BMJ Open 2021; 11:e046248. [PMID: 34588235 PMCID: PMC8483042 DOI: 10.1136/bmjopen-2020-046248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Disrespectful care, which remains prevalent in low and middle-income countries (LMICs), acts as a barrier to women accessing skilled birth attendance, compromising care when services are available. Building on what was positive in facilities, we aimed to explore lay and healthcare providers' experience of respectful care to inform future interventions. SETTING Five maternity facilities in Mwanza Tanzania and Lilongwe Malawi. PARTICIPANTS 94 participants in Malawi (N=46) and Tanzania (N=48) including 24 women birthing live baby within the previous 12 months; 22 family members and 48 healthcare providers who regularly provided maternity care in the included facilities DESIGN: The study was guided by Appreciative Inquiry (AI). Semistructured, one-to-one interviews were conducted between January and December 2019. Interviews were audio-recorded, translated where necessary, transcribed verbatim, and analysed using the framework approach. RESULTS Four main themes describing participants positive experience and their vision of respectful care were identified: (1) empathic healthcare provider-woman interactions including friendly welcome and courteous language, well-timed appropriate care and information sharing, (2) an enabling environment, characterised by improvement of physical environment, the use of screens, curtains and wall partitions for privacy, availability of equipment and provision of incentives to staff, (3) supportive leadership demonstrated by the commitment of the government and facility leaders to provision of respectful care, ensuring availability of guidelines and policies, supportive supervision, reflective discussion and paying staff salaries timely, (4) providers' attitudes and behaviours characterised by professional values through readiness, compassionate communication and commitment. CONCLUSION The positive experiences of service users, families and healthcare providers provided insight into key drivers of respectful care in facilities in Tanzania and Malawi. Interventions targeting improved environment and privacy, healthcare provider communication and developing positive leadership structures in facilities could provide the basis for sustained improvement in respectful and dignified maternal and newborn care in LMICs.
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Affiliation(s)
- Paschal Mdoe
- Obstetrics and Gynecology, Haydom Lutheran Hospital, Mbulu, Tanzania
- Division of Nursing, Midwifery and Social work, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
| | - Tracey A Mills
- Department of International Public Heath, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Robert Chasweka
- Department of Nursing and Midwifery, Kamuzu College of Nursing, University of Malawi, Lilongwe, Malawi
| | - Livuka Nsemwa
- Department of Nursing and Midwifery, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Chisomo Petross
- Department of Nursing and Midwifery, Kamuzu College of Nursing, University of Malawi, Lilongwe, Malawi
| | - Rose Laisser
- Department of Nursing and Midwifery, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Angela Chimwaza
- Department of Nursing and Midwifery, Kamuzu College of Nursing, University of Malawi, Lilongwe, Malawi
| | - Tina Lavender
- Department of International Public Heath, Liverpool School of Tropical Medicine, Liverpool, UK
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13
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Billett H, Vazquez Corona M, Bohren MA. Women from migrant and refugee backgrounds' perceptions and experiences of the continuum of maternity care in Australia: A qualitative evidence synthesis. Women Birth 2021; 35:327-339. [PMID: 34429270 DOI: 10.1016/j.wombi.2021.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 08/01/2021] [Accepted: 08/09/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Women who were born overseas represent an increasing proportion of women giving birth in the Australian healthcare system. PROBLEM Women from migrant and refugee backgrounds have an increased risk of poor pregnancy and birth outcomes, including experiences of care. AIM To understand how women from migrant and refugee backgrounds perceive and experience the continuum of maternity care (pregnancy, birth, postnatal) in Australia. METHODOLOGY We conducted a qualitative evidence synthesis, searching MEDLINE, CIHAHL, and PsycInfo for studies published from inception to 23/05/2020. We included studies that used qualitative methods for data collection and analysis, that explored migrant/refugee women's experiences or perceptions of maternity care in Australia. We used a thematic synthesis approach, assessed the methodological limitations of included studies, and used GRADE-CERQual to assess confidence in qualitative review findings. RESULTS 27 studies met the inclusion criteria, representing women in Australia from 42 countries. Key themes were developed into 24 findings, including access to interpreters, structural barriers to service utilisation, experiences with health workers, trust in healthcare, experiences of discrimination, preferences for care, and conflicts between traditional cultural expectations and the Australian medical system. CONCLUSION This review can help policy makers and organisations who provide care to women from migrant and refugee backgrounds to improve their experiences with maternity care. It highlights factors linked to negative experiences of care as well as factors associated with more positive experiences to identify potential changes to practices and policies that would be well received by this population.
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Affiliation(s)
- Hannah Billett
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.
| | - Martha Vazquez Corona
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Meghan A Bohren
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia. https://twitter.com/
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14
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Hastings-Tolsma M, Temane A, Tagutanazvo OB, Lukhele S, Nolte AG. Experience of midwives in providing care to labouring women in varied healthcare settings: A qualitative study. Health SA 2021; 26:1524. [PMID: 34192066 PMCID: PMC8182560 DOI: 10.4102/hsag.v26i0.1524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 03/24/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Midwives are essential to timely, effective, family-centred care. In South Africa, patients have often expressed dissatisfaction with the quality of midwifery care. Negative interpersonal relationships with caregivers, lack of information, neglect and abandonment were consistent complaints. Less is known about how midwives experience providing care. AIM This research explored and described the experiences of midwives in providing care to labouring women in varied healthcare settings. SETTING Midwives practicing in the Gauteng province, South Africa, in one of three settings: private hospitals, public hospitals or independent maternity hospital. METHODS A convenience sample of midwives (N = 10) were interviewed. An exploratory and descriptive design, with individual semi-structured interviews conducted, asked a primary question: 'How is it for you to be a midwife in South Africa?' Transcribed interviews were analysed using thematic coding. RESULTS Five themes were found: proud to be a midwife, regulations and independent function, resource availability, work burden and image of the midwife. CONCLUSION Midwives struggle within systems that fail to allow independent functioning, disallowing a voice in making decisions and creating change. Regardless of practice setting, midwives expressed frustration with policies that prevented utilisation consistent with scope of practice, as well as an inability to practice the midwifery model of care. Those in public settings expressed concern with restricted resource appropriation. Similarly, there is clear need to upscale midwifery education and to establish care competencies to be met in providing clinical services. CONTRIBUTION This research provides evidence of the midwifery experience with implications for needed health policy change.
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Affiliation(s)
- Marie Hastings-Tolsma
- Louise Herrington School of Nursing, Faculty of Nursing/Midwifery, Baylor University, Dallas, Texas, United States of America
| | - Annie Temane
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Oslinah B. Tagutanazvo
- Department of Midwifery Science, Faculty of Health Sciences, University of Eswatini, Mbabane, Eswatini
| | - Sanele Lukhele
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Anna G. Nolte
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
- Netcare Education, Netcare, Johannesburg, South Africa
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15
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Moridi M, Pazandeh F, Hajian S, Potrata B. Development and psychometric properties of Midwives' Knowledge and Practice Scale on Respectful Maternity Care (MKP-RMC). PLoS One 2020; 15:e0241219. [PMID: 33141835 PMCID: PMC7608882 DOI: 10.1371/journal.pone.0241219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/09/2020] [Indexed: 11/18/2022] Open
Abstract
Objective To develop a scale for evaluating knowledge and practice of midwives on Respectful Maternity Care (RMC). Methods An exploratory sequential mixed method study was conducted from January 2018 to July 2019 in two non-teaching public hospitals in Tehran, Iran. In the first part of the study, a literature review and qualitative study were carried out in order to develop the preliminary item pool. Then face, content and construct validity and reliability (internal consistency and test-retest) were assessed. Results The MKP-RMC scale has 23-item in knowledge and 23-item in practice section that loaded in three factors: Giving emotional support, providing safe care and preventing mistreatment. Exploratory factor analysis accounted for 43.47% and 58.62% of observed variance in knowledge and practice sections, respectively. The internal consistency and internal correlation coefficient of both section of MKP-RMC indicated acceptable reliability. Conclusion The MKP-RMC is a valid and reliable tool for measuring midwives' knowledge and practice of respectful care during labor and childbirth. The MKP-RMC could be used in maternity services to evaluate and improve quality of childbirth care through development of educational interventions for effective behavioral change. Confirmation of validity and reliability of translated version of the scale in other maternity care providers and different contexts is recommended.
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Affiliation(s)
- Maryam Moridi
- Department of Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Pazandeh
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- * E-mail:
| | - Sepideh Hajian
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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16
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Moridi M, Pazandeh F, Hajian S, Potrata B. Midwives' perspectives of respectful maternity care during childbirth: A qualitative study. PLoS One 2020; 15:e0229941. [PMID: 32150593 PMCID: PMC7062245 DOI: 10.1371/journal.pone.0229941] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/17/2020] [Indexed: 11/28/2022] Open
Abstract
The adoption of respectful maternity care during labor and birth is a complex process which needs both scientific and interpersonal skills of providers. In this regard, identifying the potential barriers and applying effective strategies for implementing respectful maternity care are essential. This study aimed to explore the perceptions of Iranian midwives regarding respectful maternity care during labor and childbirth. This was a qualitative study which was conducted from September-December 2018 in two non-teaching public hospitals in Tehran, Iran. Twenty-four semi-structured interviews were conducted with midwives, who had more than one year work experience in labor and childbirth units, through a purposive sampling method. A content analysis approach was used to analyze the data and identify themes. Three themes were extracted including “showing empathy”, “women-centered care” and “protecting rights”. Showing empathy reflects that “establishing a friendly relationship” and “being with women”. Women-centered care encompassed “keeping women safe” and “participating in decision making”. Protecting rights reflected a need for “safeguarding dignity” as well as “giving equal care” and “preparing appropriate environment”. Iranian midwives considered respectful maternity care a broader concept than just preventing mistreatment. Providing supportive care through friendly interaction with women was the first step for providing respectful maternity care. Respectful care is also promoted by providing safe care, implementing evidence-based care and involving women in their care as well as by providing an appropriate environment for women, families and caregivers.
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Affiliation(s)
- Maryam Moridi
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Pazandeh
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- * E-mail:
| | - Sepideh Hajian
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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17
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Lusambili AM, Naanyu V, Wade TJ, Mossman L, Mantel M, Pell R, Ngetich A, Mulama K, Nyaga L, Obure J, Temmerman M. Deliver on Your Own: Disrespectful Maternity Care in rural Kenya. PLoS One 2020; 15:e0214836. [PMID: 31910210 PMCID: PMC6946164 DOI: 10.1371/journal.pone.0214836] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 12/06/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Under the Free Maternity Policy (FMP), Kenya has witnessed an increase in health facility deliveries rather than home deliveries with Traditional Birth Attendants (TBA) resulting in improved maternal and neonatal outcomes. Despite these gains, maternal and infant mortality and morbidity rates in Kenya remain unacceptably high indicating that more needs to be done. AIM Using data from the Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project's qualitative gender assessment, this paper examines women's experience of disrespectful care during pregnancy, labour, and delivery. The goal is to promote an improved understanding of the actual care conditions to inform the development of interventions that can lift the standard of care, increase maternity facility use, and improve health outcomes for both women and newborns. METHODOLOGY We conducted sixteen focus group discussions (FGDs), two each for adolescent females, adult females, adult males, and community health committee members. As well, twenty-four key Informants interviews (KII) were also conducted including religious leaders, and persons from local government representatives, Ministry of Health (MOH), and local women's organizations. Data were captured through audio recordings and reflective field notes. RESEARCH SITE Kisii and Kilifi Counties in Kenya. FINDINGS Findings show nursing and medical care during labour and delivery were at times disrespectful, humiliating, uncompassionate, neglectful, or abusive. In both counties, male health workers were preferred by women giving birth, as they were perceived as more friendly and sensitive. Adolescent females were more likely to report abuse during maternity care while women with disabled children reported being stigmatized. Structural barriers related to transportation and available resources at facilities associated with disrespectful care were identified. CONCLUSIONS A focus on quality and compassionate care as well as more facility resources will lead to increased, successful, and sustainable use of facility care. Interpreting these results within a systems perspective, Kenya needs to implement, enforce, and monitor quality of care guidelines for pregnancy and delivery including respectful maternity care of pregnant women. To ensure these procedures are enforced, measurable benchmarks for maternity care need to be established, and hospitals need to be regularly monitored to ensure these benchmarks are achieved.
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Affiliation(s)
- Adelaide M. Lusambili
- Centre for Excellence in Women and Child Health, Aga Khan University, Nairobi, East Africa, Kenya
| | - Violet Naanyu
- Centre for Excellence in Women and Child Health, Aga Khan University, Nairobi, East Africa, Kenya
| | - Terrance J. Wade
- Department of Health Sciences, Brock University, St Catharines, Ontario, Canada
| | | | - Michaela Mantel
- Centre for Excellence in Women and Child Health, Aga Khan University, Nairobi, East Africa, Kenya
| | - Rachel Pell
- Aga Khan Foundation, Canada Ottawa, ON, Canada
| | | | | | - Lucy Nyaga
- Centre for Excellence in Women and Child Health, Aga Khan University, Nairobi, East Africa, Kenya
| | - Jerim Obure
- Centre for Excellence in Women and Child Health, Aga Khan University, Nairobi, East Africa, Kenya
| | - Marleen Temmerman
- Centre for Excellence in Women and Child Health, Aga Khan University, Nairobi, East Africa, Kenya
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18
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Herval ÁM, de Oliveira FPSL, Machado KM, Vasconcelos M, Ferreira RC, Ferreira EFE, Amaral JHLD, Vargas AMD, Gomes VE. Mothers' perception about health education in brazilian primary health care: A qualitative study. Int J Paediatr Dent 2019; 29:669-676. [PMID: 30817034 DOI: 10.1111/ipd.12489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 01/15/2019] [Accepted: 02/25/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Health education actions are strategic actions aimed at health promotion. Moreover, better health education practices have been linked to comprehensive care developed by primary health services. AIM To understand the perception of mothers about the health education developed by the Primary Health Care (PHC) services. DESIGN We adopted a qualitative research approach, conducted using semi-structured interviews, and assuming, as the theoretical reference, the attributes derived from PHC. Pregnant women and mothers of children under 1 year old attended by Brazilian Family Health teams were included. RESULTS Eight pregnant women and twelve mothers of children under 1 year of age participated in the study. These mothers perceive educational actions as necessary only for primiparous mothers. They value the guidance of informal networks and maternity hospitals to the detriment of primary services, and they do not adhere to care that conflicts with their previous knowledge. The evidence shows that the educational actions of the primary health services do not adequately respond to the attributes of community orientation, family focus, and cultural competence. CONCLUSION It is necessary to modify the educational practices in order to incorporate and value the existing knowledge in the territory, thereby adapting the care guidelines to the local context.
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Affiliation(s)
- Álex Moreira Herval
- Dentistry School, Federal University of Minas Gerais - Social and Preventive Department, Belo Horizonte, Minas Gerais, Brazil
| | | | - Kecyanne Malheiros Machado
- Dentistry School, Federal University of Minas Gerais - Social and Preventive Department, Belo Horizonte, Minas Gerais, Brazil
| | - Mara Vasconcelos
- Dentistry School, Federal University of Minas Gerais - Social and Preventive Department, Belo Horizonte, Minas Gerais, Brazil
| | - Raquel Conceição Ferreira
- Dentistry School, Federal University of Minas Gerais - Social and Preventive Department, Belo Horizonte, Minas Gerais, Brazil
| | - Efigênia Ferreira E Ferreira
- Dentistry School, Federal University of Minas Gerais - Social and Preventive Department, Belo Horizonte, Minas Gerais, Brazil
| | - João Henrique Lara do Amaral
- Dentistry School, Federal University of Minas Gerais - Social and Preventive Department, Belo Horizonte, Minas Gerais, Brazil
| | - Andréa Maria Duarte Vargas
- Dentistry School, Federal University of Minas Gerais - Social and Preventive Department, Belo Horizonte, Minas Gerais, Brazil
| | - Viviane Elisângela Gomes
- Dentistry School, Federal University of Minas Gerais - Social and Preventive Department, Belo Horizonte, Minas Gerais, Brazil
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19
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Esegbona-Adeigbe S. Cultural qualities and antenatal care for black African women: A literature review. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/bjom.2018.26.8.532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Shakibazadeh E, Namadian M, Bohren MA, Vogel JP, Rashidian A, Nogueira Pileggi V, Madeira S, Leathersich S, Tunçalp Ӧ, Oladapo OT, Souza JP, Gülmezoglu AM. Respectful care during childbirth in health facilities globally: a qualitative evidence synthesis. BJOG 2017; 125:932-942. [PMID: 29117644 PMCID: PMC6033006 DOI: 10.1111/1471-0528.15015] [Citation(s) in RCA: 208] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 11/26/2022]
Abstract
Background What constitutes respectful maternity care (RMC) operationally in research and programme implementation is often variable. Objectives To develop a conceptualisation of RMC. Search strategy Key databases, including PubMed, CINAHL, EMBASE, Global Health Library, grey literature, and reference lists of relevant studies. Selection criteria Primary qualitative studies focusing on care occurring during labour, childbirth, and/or immediately postpartum in health facilities, without any restrictions on locations or publication date. Data collection and analysis A combined inductive and deductive approach was used to synthesise the data; the GRADE CERQual approach was used to assess the level of confidence in review findings. Main results Sixty‐seven studies from 32 countries met our inclusion criteria. Twelve domains of RMC were synthesised: being free from harm and mistreatment; maintaining privacy and confidentiality; preserving women's dignity; prospective provision of information and seeking of informed consent; ensuring continuous access to family and community support; enhancing quality of physical environment and resources; providing equitable maternity care; engaging with effective communication; respecting women's choices that strengthen their capabilities to give birth; availability of competent and motivated human resources; provision of efficient and effective care; and continuity of care. Globally, women's perspectives of what constitutes RMC are quite consistent. Conclusions This review presents an evidence‐based typology of RMC in health facilities globally, and demonstrates that the concept is broader than a reduction of disrespectful care or mistreatment of women during childbirth. Innovative approaches should be developed and tested to integrate RMC as a routine component of quality maternal and newborn care programmes. Tweetable abstract Understanding respectful maternity care – synthesis of evidence from 67 qualitative studies. Understanding respectful maternity care – synthesis of evidence from 67 qualitative studies.
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Affiliation(s)
- E Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M Namadian
- Social Determinants of Health Research Centre, Zanjan University of Medical Sciences, Zanjan, Iran
| | - M A Bohren
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - J P Vogel
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - A Rashidian
- Department of Information, Evidence and Research, Eastern Mediterranean Region, World Health Organization, Cairo, Egypt.,Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - V Nogueira Pileggi
- GLIDE Technical Cooperation and Research, Ribeirão Preto, São Paulo, Brazil.,Department of Paediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - S Madeira
- Social Department of Ribeirão Preto, Medical School, University of São Paulo, São Paulo, Brazil
| | - S Leathersich
- King Edward Memorial Hospital for Women, Subiaco, WA, Australia
| | - Ӧ Tunçalp
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - O T Oladapo
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - J P Souza
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - A M Gülmezoglu
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
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