Helen J Rogers1,2, Lily Hogan3, Dominiek Coates4, Caroline S E Homer4,5, Amanda Henry3,6,7. 1. Child, Youth and Family Services, South Eastern Sydney Local Health District, Sydney, NSW, 2010, Australia. Helen.Rogers@health.nsw.gov.au. 2. School of Women's and Children's Health, University of NSW (UNSW), Sydney, NSW, 2052, Australia. Helen.Rogers@health.nsw.gov.au. 3. School of Women's and Children's Health, University of NSW (UNSW), Sydney, NSW, 2052, Australia. 4. Centre for Midwifery and Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia. 5. Maternal and Child Health, Burnet Institute, Melbourne, VIC, 3004, Australia. 6. Department of Women's and Children's Health, St George Hospital, Sydney, NSW, 2217, Australia. 7. Australia Global Women's Health Program, The George Institute for Global Health, Sydney, NSW, 2042, Australia.
Abstract
BACKGROUND: Women from migrant and refugee backgrounds who live in high-income countries are at increased risk of adverse perinatal outcomes, including mental health issues, preterm birth and maternal and infant mortality. There is a need to implement and evaluate models of care to meet their specific needs in order to improve health outcomes, their experiences of care, and overcome barriers to access. In Sydney, Australia, a unique model of care was implemented to support women and families from migrant and refugee backgrounds to access health and community-based services through the continuum of pregnancy to the early parenting period. This model of care is known as the Cross Cultural Workers (CCWs) in Maternity and Child and Family Health Service (the CCW Service). The aim of this study was to explore the perceptions of service providers regarding the CCW Service and identify recommendations for improvement. METHODS: A mixed-methods study was conducted consisting of surveys and face to face semi-structured interviews. Service providers were recruited from hospital-based maternity and community-based services. Survey data were analysed descriptively. Interviews were analysed using qualitative content analysis. RESULTS: Sixty-nine service providers completed surveys and 19 were interviewed. The CCW Service was highly regarded by service providers who perceived it to be critical in improving care for women from migrant and refugee backgrounds. The overarching theme from the interviews was the ability of the CCW Service to act as a 'bridge to health' through the provision of culturally responsive care. There were three main categories; supporting access to health and community-based services, improving the healthcare experience, and organisational factors, including part-time hours, capacity, heavy workloads and confusion/lack of clarity regarding the CCW role, which affected CCWs' capacity to optimally support service providers in providing culturally responsive care. These limitations meant CCWs were not able to meet demand, and fully operationalise the model. CONCLUSION: Service providers perceived the CCW model to be a culturally responsive model of care tailored to the needs of women and families from migrant and refugee backgrounds, that reduces barriers to access, and has the potential to improve perinatal outcomes, and women's experience and satisfaction with care.
BACKGROUND:Women from migrant and refugee backgrounds who live in high-income countries are at increased risk of adverse perinatal outcomes, including mental health issues, preterm birth and maternal and infant mortality. There is a need to implement and evaluate models of care to meet their specific needs in order to improve health outcomes, their experiences of care, and overcome barriers to access. In Sydney, Australia, a unique model of care was implemented to support women and families from migrant and refugee backgrounds to access health and community-based services through the continuum of pregnancy to the early parenting period. This model of care is known as the Cross Cultural Workers (CCWs) in Maternity and Child and Family Health Service (the CCW Service). The aim of this study was to explore the perceptions of service providers regarding the CCW Service and identify recommendations for improvement. METHODS: A mixed-methods study was conducted consisting of surveys and face to face semi-structured interviews. Service providers were recruited from hospital-based maternity and community-based services. Survey data were analysed descriptively. Interviews were analysed using qualitative content analysis. RESULTS: Sixty-nine service providers completed surveys and 19 were interviewed. The CCW Service was highly regarded by service providers who perceived it to be critical in improving care for women from migrant and refugee backgrounds. The overarching theme from the interviews was the ability of the CCW Service to act as a 'bridge to health' through the provision of culturally responsive care. There were three main categories; supporting access to health and community-based services, improving the healthcare experience, and organisational factors, including part-time hours, capacity, heavy workloads and confusion/lack of clarity regarding the CCW role, which affected CCWs' capacity to optimally support service providers in providing culturally responsive care. These limitations meant CCWs were not able to meet demand, and fully operationalise the model. CONCLUSION: Service providers perceived the CCW model to be a culturally responsive model of care tailored to the needs of women and families from migrant and refugee backgrounds, that reduces barriers to access, and has the potential to improve perinatal outcomes, and women's experience and satisfaction with care.
Authors: Melanie E Gibson-Helm; Helena J Teede; I-Hao Cheng; Andrew A Block; Michelle Knight; Christine E East; Euan M Wallace; Jacqueline A Boyle Journal: Birth Date: 2015-04-11 Impact factor: 3.689
Authors: Vicki Flenady; Aleena M Wojcieszek; Philippa Middleton; David Ellwood; Jan Jaap Erwich; Michael Coory; T Yee Khong; Robert M Silver; Gordon C S Smith; Frances M Boyle; Joy E Lawn; Hannah Blencowe; Susannah Hopkins Leisher; Mechthild M Gross; Dell Horey; Lynn Farrales; Frank Bloomfield; Lesley McCowan; Stephanie J Brown; K S Joseph; Jennifer Zeitlin; Hanna E Reinebrant; Joanne Cacciatore; Claudia Ravaldi; Alfredo Vannacci; Jillian Cassidy; Paul Cassidy; Cindy Farquhar; Euan Wallace; Dimitrios Siassakos; Alexander E P Heazell; Claire Storey; Lynn Sadler; Scott Petersen; J Frederik Frøen; Robert L Goldenberg Journal: Lancet Date: 2016-01-19 Impact factor: 79.321