Maternal health care provision for refugee women

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Kasper
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Professionals ◽  
Maternal Health Care ◽  
Professional Practices ◽  
Health Care Provision ◽  
Care Provision ◽  
Structured Interviews ◽  
Childbearing Age ◽  
Refugee Women

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.

scholarly journals The Impact of Refugee Women’s Accommodation on Maternal Health Care Provision

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Kasper
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Professionals ◽  
Maternal Health Care ◽  
Special Focus ◽  
Health Care Provision ◽  
Care Provision ◽  
Childbearing Age ◽  
Refugee Women ◽  
The Impact

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.

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
Keyword(s):  
Public Health ◽  
Health Care ◽  
Maternal Health ◽  
Health Care Professionals ◽  
Communication Barriers ◽  
Maternal Health Care ◽  
Health Care Provision ◽  
Care Provision ◽  
Refugee Women ◽  
Training Courses

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.

scholarly journals Maternal health care for refugee women in Germany: A qualitative approach on the interaction level

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Kasper
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Maternal Health Care ◽  
Structured Interviews ◽  
Childbearing Age ◽  
Individual Level ◽  
Refugee Women ◽  
Challenges And Opportunities

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.

Body symbolics, obstetric practices, and the improvement of maternal health in Cambodia

2020 ◽  
pp. 450-471
Author(s):  
Clémence Schantz
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Professionals ◽  
Participant Observation ◽  
The Body ◽  
Clinical Settings ◽  
Mixed Method Research ◽  
Structured Interviews ◽  
Phnom Penh ◽  
Frequent Use

Cambodia is one of the nine countries worldwide to have reduced its maternal mortality rate by more than 75 per cent between 1990 and 2015. Whilst prior to the 2000s, childbirth in Cambodia used to be a private event, it has now become a biomedical event for women and their families. This chapter describes the findings of mixed-method research challenging the idealized vision of the United Nations regarding maternal health in Cambodia by describing obstetrical practices on the ground, from an empirical study led in several clinical settings in Phnom Penh, through participant observation, semi-structured interviews with health-care professionals and patients, questionnaires with pregnant women, to the examination of medical records from four Phnom Penh maternity wards. The findings demonstrate that the biomedicalization of childbirth in Cambodia has been accompanied by technologized delivery with extremely frequent use of surgical practices. In order to understand the population’s adherence to these practices, the chapter draws out a number of anthropological and demographic arguments. These biomedical practices are part of a symbolism of the body where the body is conceived as a receptacle, where the body humours must be able to circulate appropriately, and where the hot/cold balance must be respected. Childbirth as an opening of the body represents a danger for women because it threatens this equilibrium.

scholarly journals RoadMApp: A feasibility study for a smart travel application to improve maternal health delivery in a low resource setting in Zimbabwe

2020 ◽  
Author(s):  
Zibusiso Nyati-Jokomo ◽  
Israel Mbekezeli Dabengwa ◽  
Liberty Makacha ◽  
Newton Nyapwere ◽  
Yolisa Prudence Dube ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Pregnant Women ◽  
Travel Time ◽  
Mobile Technology ◽  
Maternal Health Care ◽  
Health Facilities ◽  
Childbearing Age ◽  
Low Resource ◽  
Custom Made

Abstract Background: Travel time and healthcare financing are critical determinants of the provision of quality maternal health care in low resource settings. Despite the availability of pregnancy-related mHealth and smart travel applications, there is a lack of evidence on their usage to travel to health facilities for routine antenatal care and emergencies. There is a shortage of information about the feasibility of using a custom-made mobile technology that integrates smart travel and mHealth. This paper explores the feasibility of implementing a custom-made geographically enabled mobile technology-based tool (RoadMApp) to counter the adverse effects of long travel times for maternal care in Kwekwe District, Zimbabwe. Methods: We frame the paper using the first two steps (listen & plan) of the Spiral Technology Action Research (STAR model).The paper uses an exploratory case study design and Participatory Learning Approaches (PLA) with stakeholders (community members) and in-depth interviews with key informants (health care service providers, pregnant women, transport operators). 193 participants took part in the study. We conducted focus group discussions with pregnant women, women of childbearing age, men (household heads), and elderly women. The discussion questions centered on travel time, availability of transport, cellular network coverage, and perceptions of the RoadMApp application. Data were analysed thematically using Nvivo Pro 12. Results: Most parts of rural Kwekwe are far from health facilities and have an inefficient road and telecommunications network. Hence, it is hard to predict if RoadMApp will integrate into the lives of the community - especially those in rural areas. Since these issues are pillars of the design of the RoadMApp mHealth, the implementation will probably be a challenge. Conclusion: Communities are keen to embrace the RoadMApp application. However, the feasibility of implementing RoadMApp in Kwekwe District will be a challenge because of maternal health care barriers such as poor road network, poor phone network, and the high cost of transport. There is a need to investigate the social determinants of access to maternity services to inform RoadMApp implementation.

scholarly journals HEALTH CARE PROVIDERS’ VIEWS CONCERNING KNOWLEDGE AND PRACTICES OF TRADITIONAL BIRTH ATTENDANTS IN TAJIKISTAN: A QUALITATIVE STUDY

2021 ◽  
Vol 3 (2) ◽  
pp. 479-495
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Skilled Birth Attendant ◽  
Maternal Health Care ◽  
Traditional Birth Attendants ◽  
Care Providers ◽  
Birth Attendants

Introduction: This study seeks to explore health care providers’ perspectives of the traditional birth attendants’ knowledge and practices. Methods: This qualitative study was conducted in 2018 with 16 health care professionals working at various levels of maternal health care system in two purposefully selected research settings, Khorog town and Dushanbe, which have different social, economic and ethnic backgrounds. Semi-structured face-to-face interviews were conducted to gather the data. Duration of interviews ranged from 30-60 min. NVivo software for qualitative research was used to analyse the results. Results: This study has shown that health care workers have extremely negative views of the knowledge and practices of traditional birth attendants. They highlight the lack of adequate knowledge of traditional birth attendants on biomedical aspects of birth, poor skills in infections control and lack of use of clean delivery practices. They also claim that the traditional birth attendants’ practices also lead to different complications while they are woefully unprepared to recognize obstetric complications during birth. Conclusion: The study recommends providing a skilled birth attendant in every area. It also recommends avoiding a homogeneous approach to address maternal health issues in diverse countries of the Global South and reviewing maternal health care policies and programs to provide the most marginalized groups of women with skilled birth services to improve their maternal health and further decrease maternal mortality in Tajikistan.

scholarly journals RoadMApp: A feasibility study for a smart travel application to improve maternal health delivery in a low resource setting in Zimbabwe

2020 ◽  
Author(s):  
Zibusiso Nyati-Jokomo ◽  
Israel Mbekezeli Dabengwa ◽  
Liberty Makacha ◽  
Newton Nyapwere ◽  
Yolisa Prudence Dube ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Travel Time ◽  
Service Providers ◽  
Maternal Health Care ◽  
Health Facilities ◽  
Childbearing Age ◽  
Low Resource Settings ◽  
Low Resource ◽  
Custom Made

Abstract Background: Travel time and health care financing are key determinants to the provision of quality maternal health care in low resource settings. Despite the availability of pregnancy-related mHealth and smart travel applications, there is a lack of evidence on their usage to travel to health facilities for routine antenatal care and emergencies in low resource settings like Zimbabwe. Little is known about the feasibility of the usage of custom-made mobile technologies that integrate smart travel and mHealth. This paper explores the feasibility of implementing a custom-made geographically enabled mobile technology-based tool (RoadMApp) to counter the negative effects of long travel times and poor financing strategies for maternal care in Kwekwe District, Zimbabwe. Methods: Focus group discussions were conducted with pregnant women, women of childbearing age, men (household heads) and elderly women. Participatory learning approaches with stakeholders (community members) and in-depth interviews with key informants (health care service providers, transport operators) were utilised. In total 193 people took part in the study. The discussion questions centred on travel time, availability of transport, cellular network coverage and perceptions of the RoadMApp application. Data was analysed thematically using Nvivo Pro 12.Results: Most parts of rural Kwekwe have long distances to health facilities and an inefficient road and telecommunications network. Hence, it is hard to predict if RoadMApp will integrate into the lives of the community - especially those in rural areas. Since these issues are pillars of the design of the RoadMApp application, the implementation is likely to be challenging.Conclusion: Communities are keen to embrace the RoadMApp application. However, the feasibility of implementing RoadMApp in Kwekwe District will be challenging due to maternal health care barriers such as poor road network, poor phone network and the high cost of transport. There is, therefore, a need to investigate the social determinants of access to maternity services in order to inform the RoadMApp implementation.

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