scholarly journals Perinatal health of refugee and asylum-seeking women in Sweden 2014–17: a register-based cohort study

2019 ◽  
Vol 29 (6) ◽  
pp. 1048-1055 ◽  
Author(s):  
Can Liu ◽  
Mia Ahlberg ◽  
Anders Hjern ◽  
Olof Stephansson
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Asylum Seekers ◽  
Low Birthweight ◽  
Perinatal Care ◽  
Perinatal Health ◽  
Undocumented Migrants ◽  
Migrant Women ◽  
Care Providers ◽  
Self Rated Health

Abstract Background An increasing number of migrants have fled armed conflict, persecution and deteriorating living conditions, many of whom have also endured risky migration journeys to reach Europe. Despite this, little is known about the perinatal health of migrant women who are particularly vulnerable, such as refugees, asylum-seekers, and undocumented migrants, and their access to perinatal care in the host country. Methods Using the Swedish Pregnancy Register, we analyzed indicators of perinatal health and health care usage in 31 897 migrant women from the top five refugee countries of origin between 2014 and 2017. We also compared them to native-born Swedish women. Results Compared to Swedish-born women, migrant women from Syria, Iraq, Somali, Eritrea and Afghanistan had higher risks of poor self-rated health, gestational diabetes, stillbirth and infants with low birthweight. Within the migrant population, asylum-seekers and undocumented migrants had a higher risk of poor maternal self-rated health than refugee women with residency, with an adjusted risk ratio (RR) of 1.84 and 95% confidence interval (95% CI) of 1.72–1.97. They also had a higher risk of preterm birth (RR 1.47, 95% CI 1.21–1.79), inadequate antenatal care (RR 2.56, 95% CI 2.27–2.89) and missed postpartum care visits (RR 1.15, 95% CI 1.10–1.22). Conclusion Refugee, asylum-seeking and undocumented migrant women were vulnerable during pregnancy and childbirth. Living without residence permits negatively affected self-rated health, pregnancy and birth outcomes in asylum-seekers and undocumented migrants. Pregnant migrant women’s special needs should be addressed by those involved in the asylum reception process and by health care providers.

Trauma-Informed Care With Childhood Maltreatment Survivors: What Do Maternity Professionals Want to Learn?

2014 ◽  
Vol 4 (3) ◽  
pp. 191-201 ◽  
Author(s):  
Kristen Choi ◽  
Julia S. Seng
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Health Care Professionals ◽  
Childhood Maltreatment ◽  
Perinatal Care ◽  
Care Providers ◽  
History Of ◽  
Maternity Health ◽  
Maternity Health Care

BACKGROUND: Posttraumatic stress disorder (PTSD) affects 8% of pregnant women, and the biggest risk factor for pregnancy PTSD is childhood maltreatment. The care they receive can lead to positive outcomes or to retraumatization and increased morbidity. The purpose of this study is to gather information from a range of clinicians about their continuing education needs to provide perinatal care to women with a maltreatment history and PTSD.METHOD: Maternity health care professionals were interviewed by telephone. Network sampling and purposive sampling were used to include physicians, nurse practitioners, midwives, nurses, and doulas (n = 20), and results were derived from content analysis.RESULTS: Most providers received little or no training on the issue of caring for women with a history of childhood maltreatment or PTSD during their original education but find working with this type of patient rewarding and wish to learn how to provide better care. Providers identified a range of educational needs and recommend offering a range of formats and time options for learning.CONCLUSIONS: Maternity health care providers desire to work effectively with survivor moms and want to learn best practices for doing so. Thus, educational programming addressing provider needs and preferences should be developed and tested to improve care experiences and pregnancy outcomes for women with a history of trauma or PTSD.

scholarly journals “I was trying to speak to their human side” coping responses of Belgium’s undocumented migrants to barriers in health-care access

2020 ◽  
Vol 16 (3) ◽  
pp. 253-267
Author(s):  
Dirk Lafaut ◽  
Gily Coene
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Access ◽  
Access To Health Care ◽  
Undocumented Migrants ◽  
Care Providers ◽  
Content Type ◽  
Coping Responses ◽  
Care Access ◽  
Access To Health

Purpose Undocumented migrants experience major legal constraints in their health-care access. Little is known on how undocumented migrants cope with these limitations in health-care access as individuals. The purpose of this study is to explore the coping responses of undocumented migrants when they experience limited health-care access in face-to-face encounters with health-care providers. Design/methodology/approach The authors conducted multi-site ethnographic observations and 25 semi-structured in-depth interviews with undocumented migrants in Belgium. They combined the “candidacy model” of health-care access with models from coping literature on racism as a framework. The candidacy model allowed them to understand access to health care as a dynamic and interactive negotiation process between health-care workers and undocumented migrants. Findings Responses to impaired health-care access can be divided into four main strategies: (1) individuals can react with a self-protective response withdrawing from seeking further care; (2) they can get around the obstacle; (3) they can influence the health-care worker involved by deploying discursive or performative skills; or (4) they can seek to confront the source of the obstacle. Research limitations/implications These findings point to the importance of care relations and social networks, as well as discursive and performative skills of undocumented migrants when negotiating barriers in access to health care. Originality/value This study refines the candidacy model by highlighting how individuals respond on a micro-level to shifts towards exclusionary health policies and, by doing so dynamically, change provision of health-care services.

Dual loyalty, medical ethics, and health care in offshore asylum-seeker detention

2019 ◽  
pp. 260-272 ◽  
Author(s):  
Deborah Zion
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Asylum Seekers ◽  
Ethical Issues ◽  
Care Providers ◽  
Ethical Considerations ◽  
Dual Loyalty ◽  
Christmas Island ◽  
Care Workers ◽  
Refugees And Asylum Seekers

This chapter examines the ethical issues related to the practice of health care in an environment where human rights are absent, specifically relating to the conditions for refugees and asylum seekers who arrive by sea in Australian territory. The ethical considerations of working within the offshore detention environment are discussed. Health-care workers in these harsh environments often have divided loyalties, when duties to their patients conflict with duties to their employer or to the state. The author draws on published accounts and interviews with health-care providers who have worked on Manus Island and Nauru and Christmas Island, the sites used by Australia for offshore detention of asylum seekers.

scholarly journals Perinatal health care providers’ approaches to recommending and providing pertussis vaccination in pregnancy: a qualitative study

CMAJ Open ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. E377-E382
Author(s):  
Hana Mijović ◽  
Devon Greyson ◽  
Emily Gemmell ◽  
Marie-Ève Trottier ◽  
Maryline Vivion ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Perinatal Health ◽  
Care Providers ◽  
Perinatal Health Care ◽  
In Pregnancy

scholarly journals Preventing maternal and early childhood obesity: the fetal flaw in Australian perinatal care

2014 ◽  
Vol 20 (2) ◽  
pp. 123 ◽  
Author(s):  
Margaret Miller ◽  
Lydia Hearn ◽  
Paige van der Pligt ◽  
Jane Wilcox ◽  
Karen J. Campbell
Keyword(s):  
Health Care ◽  
Weight Gain ◽  
Weight Management ◽  
Health Care Providers ◽  
Perinatal Care ◽  
Perinatal Period ◽  
Care Providers ◽  
Maternal Weight ◽  
Gestational Weight ◽  
Child Bearing

Almost half of Australian women of child-bearing age are overweight or obese, with a rate of 30–50% reported in early pregnancy. Maternal adiposity is a costly challenge for Australian obstetric care, with associated serious maternal and neonatal complications. Excess gestational weight gain is an important predictor of offspring adiposity into adulthood and higher maternal weight later in life. Current public health and perinatal care approaches in Australia do not adequately address excess perinatal maternal weight or gestational weight gain. This paper argues that the failure of primary health-care providers to offer systematic advice and support regarding women’s weight and related lifestyle behaviours in child-bearing years is an outstanding ‘missed opportunity’ for prevention of inter-generational overweight and obesity. Barriers to action could be addressed through greater attention to: clinical guidelines for maternal weight management for the perinatal period, training and support of maternal health-care providers to develop skills and confidence in raising weight issues with women, a variety of weight management programs provided by state maternal health services, and clear referral pathways to them. Attention is also required to service systems that clearly define roles in maternal weight management and ensure consistency and continuity of support across the perinatal period.

UTILIZATION OF MATERNAL HEALTH SERVICES AMONG INTERNAL MIGRANTS IN MUMBAI, INDIA

2016 ◽  
Vol 48 (6) ◽  
pp. 767-796 ◽  
Author(s):  
Nilesh C. Gawde ◽  
Muthusamy Sivakami ◽  
Bontha V. Babu
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Structured Interview ◽  
Maternal Health Care ◽  
Migrant Women ◽  
Care Providers ◽  
Provider Perspectives

SummaryThis study aimed to understand access to maternal health care and the factors shaping it amongst poor migrants in Mumbai, India. A cross-sectional mixed methods approach was used. It included multistage cluster sampling and face-to-face interviews, through structured interview schedules, of 234 migrant women who had delivered in the two years previous to the date they were interviewed. Qualitative in-depth interviews of migrant women, health care providers and health officials were also conducted to understand community and provider perspectives. The results showed that access to antenatal care was poor among migrants with less than a third of them receiving basic antenatal care and a quarter delivering at home. Multivariate analysis highlighted that amongst migrant women those who stayed in Mumbai during pregnancy and delivery had better access to maternal health care than those who went back to their home towns. Poor maternal health care was also due to weaker demand for health care as a result of the lack of felt-need among migrants due to socio-cultural factors and lack of social support for, and knowledge of, health facilities in the city. Supply-side factors such as inadequate health infrastructure at primary and secondary levels, lack of specific strategies to improve access to health care for migrants and cumbersome administrative procedures that exclude migrants from certain government programmes all need to be addressed. Migrants should be integral to the urban development process and policies should aim at preventing their exclusion from basic amenities and their entitlements as citizens.

scholarly journals Implementation of an Online Learning Module for Health Care Providers to Improve Discussions About Weight Gain with Pregnant Women (FS16-01-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Jocelyn Graham ◽  
Rhonda Bell ◽  
Dolly Bondariazadeh ◽  
Terri Miller ◽  
Chloe Burnett
Keyword(s):  
Health Care ◽  
Online Learning ◽  
Weight Gain ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Perinatal Care ◽  
Perinatal Outcomes ◽  
Care Providers ◽  
Learning Module ◽  
Evaluation Survey

Abstract Objectives This study evaluated the uptake, satisfaction and intentions of health care providers (HCP) after completing an accredited online learning module focused on how they can support women in achieving a healthy diet, physical activity and appropriate gestational weight gain (GWG). Methods Alberta Health Services, University of Calgary, and the ENRICH Research team partnered to launch an accredited e-learning module in June 2018, aimed at HCP (MDs, nurses, RDs, others) involved in perinatal care in Alberta. The aim of the module is to improve HCP knowledge and strategies for discussing healthy GWG and related behaviours with pregnant women. Results were obtained in Dec 2018 from an evaluation survey assessing participants’ perceived changes in knowledge, skills (5-point Likert scale) and intentions (open-ended questions) to incorporate new strategies into their practice in the next 3 months as a result of completing the module. Results By Dec 2018, 216 people had registered for the module (70 MDs (40%), 61 RNs (28%), 31 RDs (14%) and 54 others); 80 (38%) had completed the module and 77 (96%) of them submitted the evaluation survey Mean satisfaction rating was 4.42/5. Self-assessment of knowledge and skills also increased after completing the module. Registrants reported that the case scenarios and inclusion of tools and resources were important (mean rating 4.2 and 4.1 respectively) components of the module. The majority of registrants found the module easy to navigate and information was appropriate to their learning needs. Most completers agreed (31/77) or strongly agreed (44/77) that they learned something in the module that they will incorporate into practice. Registrants reported that they intended to: improve their counselling strategies (21; by using empowering, client-centred language), use a tool mentioned in the module (11), improve patient education opportunities (8), and find ways to support a collaborative approach to prenatal care (7). Conclusions The module appears to positively impact self-reported knowledge of healthy pregnancy weight gain concepts and counselling skills. Supporting health care providers to have effective discussions with pregnant women about lifestyle and GWG is an important step towards better compliance with recommendations and improving perinatal outcomes. Funding Sources Funding was provided through a Collaborative Research and Innovation Opportunity (CRIO) Program grant from Alberta Innovates as part of the ENRICH research program.

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