scholarly journals A qualitative review of maternal health care provision for migrant and refugee women

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Kasper ◽  
L-M Mohwinkel ◽  
A C Nowak

Abstract Background The number migrants increased worldwide. Pregnant migrant/refugee women are considered a vulnerable group. How do professionals manage their care? The aim was to summarize the current evidence regarding maternal health care provision for migrant/refugee women. Methods We conducted a systematic review and searched the databases PubMed (MEDLINE); CINAHL; PSYNDEX, PsycINFO and Cochrane Library. Studies were judged for eligibility: a study had to address maternal health care provision for migrant/refugee women who immigrated to an OECD member state. Publication date was restricted to 1990-2019, and language to English or German. Results 16 primary (qualitative) studies were included. Heterogeneity of the included studies exists regarding e.g. origin of the women, migration background, receiving country. Nevertheless, synthesis can provide valuable information on challenges and how to deal with migrant/refugee women in maternal health care. Communication difficulties pose challenges on professionals (15 studies). Possibilities to deal with them: bridge-languages, non-verbal communication and interpreters. In addition, finding one's way in the unknown health care system is a barrier for women, which professionals can meet by informing the women and coordinating care (8 studies). The perceived diversity of women can lead to conflicts in care (10 studies). While some studies recommend 'cultural recipes', other authors emphasize the individuality of women and prefer a holistic care approach. Conclusions Professionals face different barriers when providing maternal health care to migrant/refugee such as communication barriers, coordinating care and handling women's diversity. Initiating and enhancing public health activities such as training courses for professionals that convey general principles such as woman-centered care, communication techniques are valuable opportunities to improve migrant/refugee women's maternal health care provision. Key messages Maternal health care professionals face different barriers when providing maternal health care to migrant/refugee such as communication barriers, coordinating care and handling women's diversity. Initiating and enhancing public health activities such as training courses for maternal health care professionals are valuable opportunities to improve migrant/refugee women’s maternal care.

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Kasper

Abstract Background About 1/3 of the persons seeking asylum in Germany are female. The majority of all refugee women in Germany are currently of childbearing age. The maternity period requires specialized care. Maternal health care professionals monitor the physiological processes of maternity and the psychosocial well-being in order to allow an uncomplicated transition to maternity. On arriving in Germany there are different types of accommodation for refugee women: 1) shared reception centers (e.g. tents, containerbuildings, gyms), 2) collective shelters for particularly vulnerable refugees and 3) private apartments. Depending on the woman’s accommodation maternal health care professionals are confronted with different situations and conditions in providing care for these women. The aim is to analyze the impact of refugee women’s accommodation on maternal health care provision and professional’s actions. Methods Structured expert interviews were conducted with maternal health care professionals. The interviews were analyzed following the standards of qualitative thematic analysis with a special focus on refugee women’s accommodation and its impact on maternal health care provision. Results The accommodation situation does impact the provision of maternal health care as well as the actions and doings of maternal health care professionals. On the one hand there is a change in tasks, which are no subject to original maternal health care, such as organizing transportation. On the other hand there are challenges in actually executing particular maternal health care actions, such as taking the medical history or performing examinations where there is no or little privacy. Conclusions Accommodation conditions impact maternal health care provision in various ways. Therefore an enhancement of housing for refugee women may improve maternal health care provision and therefore maternal health for refugee women.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Kasper

Abstract Background In the recent past, the number of forcibly displaced people increased worldwide. About 1/3 of the persons seeking asylum in Germany are female. The majority of all refugee women who are coming to Germany are currently of childbearing age. Refugee women are considered a highly vulnerable refugee subgroup, as they frequently experience physical strains and psychological burdens while fleeing their home countries and being pregnant at the same time. Moreover, pregnancy and the following period require specialized care and support in order to allow a transition to maternity without complications. The aim of this project is to analyze maternal health care services for refugee women on the level of interaction with maternal health care professionals in Germany. Methods Maternal health care professionals in outpatient and clinical settings with experiences of caring for refugee women were recruited. Semi-structured interviews were conducted. The interviews were analyzed following the standards of qualitative thematic analysis. Results Maternal health care professionals face challenges in implementing and providing maternal health care concerning their professional practices and interventions. Due to a lack of resources (e.g. translators, time) and other conditions, gynaecologists and midwives are forced to find new solutions that maintain (medical care), adapt (vaginal examination) or miss out on (informed consent) ordinary professional practices. Key messages Maternal health care professionals face different barriers when providing maternal health care to migrant/refugee such as communication barriers and problems in relationship building. The identification of challenges and opportunities for professionals in maternal health care provision may contribute to improve maternal health (care) for refugee women.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Kasper

Abstract Background In the recent past, the number of forcibly displaced people increased worldwide. About 1/3 of the persons seeking asylum in Germany are female. The majority of all refugee women who are coming to Germany are currently of childbearing age. Refugee women are considered a highly vulnerable refugee subgroup, as they frequently experience physical strains and psychological burdens while fleeing their home countries and being pregnant at the same time. Moreover, pregnancy and the following period require specialized care and support in order to allow a transition to maternity without complications. The aim of this project is to analyze maternal health care services for refugee women on the level of interaction with maternal health care professionals in Germany. Methods Maternal health care professionals in outpatient and clinical settings with experiences of caring for refugee women were recruited. Semi-structured interviews were conducted. The interviews are currently analyzed following the standards of qualitative thematic analysis. Results Maternal health care professionals experience challenges in executing particular maternal health care actions, such as taking the medical history where there is no communication possible or performing examinations where there is no or little privacy (e.g. in camps). In addition there are changes in tasks, which are no subject to originally maternal health care, such as organizing translation and transportation. Furthermore they face a shortage of resources (e.g. translators, time), which constrains them to find solutions on an individual level. Conclusions Maternal health care professionals provide maternal health care to refugee women under special circumstances (e.g. communication barriers, discontinuity of care). As there are limited resources (e.g. translators, time) they develop solutions and strategies on an individual level. Key messages Challenges and opportunities are disclosed by examining maternal health care professionals’ actions. Maternal health care improves through understanding maternal health care professionals’ strategies.


Author(s):  
Jane Duckett ◽  
Neil Munro

Abstract Context: Over the last two decades a growing body of research has shown authoritarian regimes trying to increase their legitimacy by providing public goods. But there has so far been very little research on whether or not these regimes are successful. Methods: This article analyzes data from a 2012–2013 nationally representative survey in China to examine whether health care provision bolsters the communist regime’s legitimacy. Using multivariate ordinal logistic regression, we test whether having public health insurance and being satisfied with the health care system are associated with separate measures of the People’s Republic of China’s regime legitimacy: support for “our form of government” (which we call “system support”) and political trust. Findings: Having public health insurance is positively associated with trust in the Chinese central government. Health care system satisfaction is positively associated with system support and trust in local government. Conclusions: Health care provision may bolster the legitimacy of authoritarian regimes, with the clearest evidence showing that concrete benefits may translate into trust in the central government. Further research is needed to understand the relationship between trends in provision and legitimacy over time and in other types of authoritarian regime.


Author(s):  
Ursula Trummer ◽  
Sonja Novak-Zezula ◽  
Mariola Chrzanowska ◽  
Christos Michalakelis ◽  
Roido Mitoula ◽  
...  

There is robust evidence that homelessness and the associated life conditions of a homeless person may cause and exacerbate a wide range of health problems, while healthcare for the homeless is simultaneously limited in accessibility, availability, and appropriateness. This article investigates legal frameworks of health care provision, existing knowledge on numbers of homeless to be considered, and current means of health care provision for four EU countries with different economic and public health background: Austria, Greece, Poland, and Romania. National experts investigated the respective regulations and practices in place with desk research. The results show differences in national frameworks of inclusion into health care provision and knowledge on the number of people experiencing homelessness, but high similarity when it comes to main actors of actual health care provision for homeless populations. In all included countries, despite their differences in economic investments and universality of access to public health systems, it is mainly NGOs providing health care to those experiencing homelessness. This phenomenon fits into conceptual frameworks developed around service provision for vulnerable population groups, wherein it has been described as “structural compensation,” meaning that NGOs compensate a structural inappropriateness that can be observed within public health systems.


2021 ◽  
Vol 5 (2) ◽  
pp. 84-100
Author(s):  
Marinah Syovinya Muteti

The County Governments in Kenya are faced with poor service delivery especially in the provision of maternal health care services. Maternal health care services in public hospitals are not meeting up to the quality standard as outlined by the Ministry of Health in Kenya. The paper sought to determine the influence of leadership and universal health coverage on public health maternal health care in Kitui County. This study was guided by Transformational Leadership Theory and Theory X & Y. The study focused on 11 public hospitals providing maternity services in Kitui County. The target population of the study was 203 health officers that include 26 doctors, 10 specialists, 41 clinical officers and 126 nurses across the 13 level 4 hospitals providing maternity services in Kitui County. Data was collected by use of structured closed ended questionnaire. Data analysis was conducted using SPSS Version 25.0 Software. Pearson Correlation showed that leadership and universal health coverage have a positive correlation with public health maternal health care service delivery. Model summary results indicated that leadership and universal health coverage explain 52.1 percent of public health maternal health care service delivery. Coefficient regression revealed that coefficient of leadership has appositive and significant influence (β=.203, p=.001<0.05) on and public health maternal health care service delivery. It was also found that coefficient of Universal Health Coverage and public health maternal health care service delivery have a positive and significant relationship (β=.662, p=.000<0.05). The study concludes that leadership is one of the key health systems factors affecting the performance of maternal health services at facility level. Conclusion can be made further that universal health coverage improves public health maternal health care service delivery. The study recommends for the need of maternal health care providers to review their leadership guidelines and styles with aim of enhancing quality of leadership in the management of hospitals. Though universal health coverage is on trial, the study recommends for the need to adequately support the implementation of universal health coverage.


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