Evaluation of the pilot TAPUAKI Pacific pregnancy and parenting education programme

Holistic antenatal education class interventions: a systematic review of the prioritisation and involvement of Indigenous Peoples' of Aotearoa New Zealand, Australia, Canada and the United States over a 10-year period 2008 to 2018

BACKGROUND

Research into the effectiveness of antenatal education classes is crucial for Indigenous Peoples from Aotearoa New Zealand, Australia, Canada and the United States who experience poorer maternal and infant health outcomes compared to non-Indigenous populations. Our systematic review questions were intended to determine the extent of Indigenous Peoples prioritisation and involvement in antenatal education classes, and to understand the experience of Indigenous Peoples from these countries in antenatal education classes.

METHODS

Using a standardised protocol, we systematically searched five electronic databases for primary research papers on antenatal education classes within the four countries noted and identified 17 papers that met the criteria. We undertook a qualitative meta-synthesis using a socio-critical lens.

RESULTS

Systematic review of the academic literature demonstrates that Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States are not prioritised in antenatal education classes with only two of 17 studies identifying Indigenous participants. Within these two studies, Indigenous Peoples were underrepresented. As a result of poor engagement and low participation numbers of Indigenous Peoples in these antenatal education classes, it was not possible to understand the experiences of Indigenous Peoples.

CONCLUSION

Given that Indigenous Peoples were absent from the majority of studies examined in this review, it is clear little consideration is afforded to the antenatal health needs and aspirations of Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States. To address the stark antenatal health inequities of Indigenous Peoples, targeted Indigenous interventions that consider culture, language, and wider aspects of holistic health must be privileged.

TRIAL REGISTRATION

PROSPERO Registration ID: CRD4202017658.

Assessing Women's Health Needs in the Underserved Island Communities of Vanuatu

INTRODUCTION

Vanuatu is a South Pacific island nation with limited resources and dispersed communities. Healthcare provision and population health data is lacking; and women have been an historically undervalued, underserved group. This needs assessment was completed by mothers in the area surrounding a health clinic in Vanuatu to better inform the clinic's service expansion.

METHODS

In a period of six weeks, 60 parous women, between 17 and 66 years old, were interviewed in their native language (Bislama). Participants provided verbal responses to 29 questions targeting family health needs and pregnancy experiences. The questionnaire was constructed from WHO and UNICEF surveys. Descriptive statistics were calculated.

RESULTS

Primary care complaints were the most common health concerns reported by participants. Few women (43.3%, 26/60) knew what a sexually transmitted infection was, and 38.3% (23/60) knew a place offering HIV testing. Thirty percent (18/60) never had a pelvic exam. During their last pregnancies, 98.3% (59/60) received prenatal care with a median of five visits and variable health education. Injectable (65.2%, 15/23) and oral contraception (21.7%, 5/23) were the most utilized family planning methods; one person used condoms (4.3%, 1/23). Eighty-seven percent (52/60) felt unsafe walking through their neighborhoods at night.

DISCUSSION

General knowledge and utilization of women's health resources were limited in this group. The community-based primary care setting could be an important site for future provision of women's health services. Future studies and interventions in family planning, sexual health, and prenatal care could aid this community.