Structural and cultural competencies in maternity care for ethnic minority and migrant women: practitioner perspectives from Aotearoa New Zealand

IF 0.7 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Vartika Sharma, Nikki Singh, Annie Chiang, Janine Paynter, Rachel Simon-Kumar
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Abstract

Purpose With global migration, the number of ethnic minority and migrant women receiving maternity health care in dominantly Anglo-European societies has increased significantly but they consistently have among the worst pregnancy and maternal outcomes. This paper aims to analyse gaps in structural (migration-related inequalities) and cultural (responsiveness to ethno-cultural practices) competencies among maternal health practitioners in Aotearoa New Zealand (NZ). Design/methodology/approach Using a semi-structured interview guide, in-depth interviews were conducted with 13 maternal health practitioners in NZ. Data were analysed using a thematic analysis framework. Findings The results highlight significant barriers around language and communication, cultural stereotyping by professionals, ethnic women’s own constraints around family and cultural expectations and their lack of knowledge about reproductive health. In addition, practitioners’ own ethnic differences are inseparable from their approach to structural and cultural competencies; there were instances of ‘over-’ or ‘under-’ reading of culture, practitioner constructions of ideal pregnancies and anti-racism concerns that shaped maternal care practices that were sensitive to, but also marginalised, ethnic migrant women who attended maternity services. Originality/value To the best of the authors’ knowledge, this is the only study in NZ that examines the impact of complex dynamics of migration and culture on knowledge, beliefs and values of practitioners, in context of their own personal biographies. Identifying strategies to improve the way diversity is practiced in hospital settings can be transformational in improving maternal outcomes for ethnic migrant women in NZ.
少数民族和移民妇女产妇保健的结构和文化能力:来自新西兰奥特罗阿的从业者观点
随着全球移徙,以盎格鲁-欧洲社会为主的少数民族和移徙妇女接受产妇保健的人数显著增加,但她们的妊娠和产妇结局一直是最差的。本文旨在分析新西兰奥特罗阿(新西兰)产妇保健从业人员在结构(与移民有关的不平等)和文化(对民族文化习俗的反应)能力方面的差距。设计/方法/方法采用半结构化访谈指南,对新西兰的13名产妇保健从业人员进行了深入访谈。使用专题分析框架对数据进行分析。研究结果突出了语言和沟通方面的重大障碍、专业人员的文化定型观念、少数民族妇女自身在家庭和文化期望方面的制约以及她们对生殖健康缺乏知识。此外,从业者自身的种族差异与他们对结构和文化能力的看法是分不开的;对文化的“过度”或“不足”解读,从业者对理想怀孕的建构,以及反种族主义的担忧,这些都影响了孕产妇护理实践,这些实践对参加产科服务的少数民族移民妇女很敏感,但也被边缘化。原创性/价值据作者所知,这是新西兰唯一一项研究,在他们自己的个人传记的背景下,研究移民和文化的复杂动态对从业者的知识、信仰和价值观的影响。确定战略以改进医院环境中实践多样性的方式,可以在改善新西兰族裔移民妇女的产妇结果方面发挥变革性作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Migration Health and Social Care
International Journal of Migration Health and Social Care PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
1.30
自引率
0.00%
发文量
21
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