Dataset Information

A qualitative analysis of factors that influence Vietnamese ethnic minority women to seek maternal health care.

ABSTRACT: BACKGROUND:Dien Bien Province in northwest Vietnam is predominantly populated with ethnic minority groups, who experience worse maternal and child health outcomes than the general population. Various factors are associated with maternal health care utilisation in Vietnam, including ethnic minority status, which is recognised as a key determinant of inequity in health outcomes. The aim of this study is to explore how and why ethnic minority women utilise maternal health services, and the factors that influence women and families' decisions to access or not access facility-based care. METHODS:We used a qualitative approach, interviewing primary health care professionals (n?=?22) and key informants (n?=?2), and conducting focus groups with Thai and Hmong women (n?=?42). A thematic analysis was performed. RESULTS:There were three main themes. 1. Prioritising treatment over prevention: women talked about accessing health services for health problems, such as unusual signs or symptoms during pregnancy, and often saw limited utility in accessing services when they felt well, or for a normal physiological event such as childbirth. Health professionals also saw their role as being mainly treatment-oriented, rather than prevention-focused. 2. Modernisation of traditional practices: health professionals and ethnic minority women discussed recent improvements in infrastructure, services, and economic circumstances that had increased access to health services. However, these improvements were less pronounced in Hmong communities, suggesting inequity. 3. Perceptions of quality influenced service utilisation: both health professionals and ethnic minority women perceived primary care facilities to be of lower quality compared to hospital, and some women made decisions about accessing services based on these perceptions, preferring to travel further and spend more to access higher quality services. Health professionals' perceptions of low service quality appeared to influence their referral practices, with even uncomplicated cases referred to higher level services as a matter of course. CONCLUSIONS:Primary health care facilities were technically available and accessible to ethnic minority women, however these services were likely to be underutilised if they were perceived to be of low quality. Some women had the means to access higher quality facilities, but others were limited to lower quality facilities, potentially reinforcing inequities in health outcomes.

SUBMITTER: McKinn S

PROVIDER: S-EPMC6626358 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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A qualitative analysis of factors that influence Vietnamese ethnic minority women to seek maternal health care.

McKinn Shannon S Linh Duong Thuy DT Foster Kirsty K McCaffery Kirsten K

BMC pregnancy and childbirth 20190712 1

<h4>Background</h4>Dien Bien Province in northwest Vietnam is predominantly populated with ethnic minority groups, who experience worse maternal and child health outcomes than the general population. Various factors are associated with maternal health care utilisation in Vietnam, including ethnic minority status, which is recognised as a key determinant of inequity in health outcomes. The aim of this study is to explore how and why ethnic minority women utilise maternal health services, and the ...[more]

PMID: 31299937

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Project description:BackgroundMother-to-child transmission (MTCT) is one of the main transmission routes of HIV, and the probability of MTCT can be dramatically reduced with comprehensive interventions. In southwest and western regions in China, the level of development in rural areas is relatively backwards and retains some original features, which also increases the difficulty of controlling infectious diseases. The Liangshan Prefecture started the prevention of MTCT programme in 2009. However, the implementation of the programme is not ideal, and the coverage of HIV testing is still low. Many Yi (local major ethnicity) women did not take antenatal care (ANC) and just gave birth to their babies at home for a variety of reasons.MethodsWomen with pregnancy history in the last 5 years were recruited from two townships based on cluster sampling. Face-to-face interviews were conducted to collect data. Descriptive analysis was performed to describe demographic characteristics, history of pregnancy and ANC uptake, knowledge of and attitudes towards ANC. Multivariable analysis was used to identify factors associated with uptake of ANC.ResultsAmong 538 women who completed the questionnaires, 77.9% knew that ANC was necessary during and after pregnancy. However, only 24.2% actually accessed ANC. Almost all women (94.6%) expressed their willingness to receive ANC for pregnancy but barriers towards actual uptake of ANC existed including shyness, lack of independence and unavoidable cost. Multivariate analysis showed that no experience of living outside of Zhaojue for more than 6 months, higher number of births, not knowing the necessity of ANC during pregnancy and not knowing the government's promotion policies for ANC were associated with lack of ANC uptake.ConclusionAlthough ethnic minority women in rural Liangshan expressed strong intention to use ANC, actual uptake of ANC was low. Knowledge of ANC and HIV prevention for MTCT should be improved among this population, and efforts should be made to help them overcome barriers to accessing ANC.

Project description:Current research has identified how ethnic minority women experience poorer health outcomes during the perinatal period. In the United Kingdom, specialist perinatal mental health services provide mental health treatment for women throughout the perinatal period. Service users have previously highlighted that perinatal services are hard to access and lack cultural sensitivity, whereas healthcare professionals have described limited opportunities and resources for developing cultural competency. We explored the experiences of ethnic minority women with National Health Service (NHS) specialist perinatal teams and identified what culturally sensitive perinatal mental health care means to this group. Individual semi-structured interviews were conducted, and an interpretative phenomenological analysis framework was used to analyse the interview transcripts. Participants were recruited from NHS specialist perinatal teams and online via social media. Six women were interviewed. Four group experiential themes central to the experiences of participants emerged: (1) strengthening community networks and peer support; (2) valuing cultural curiosity; (3) making sense of how culture, ethnicity, race and racism impact mental health; and (4) tailoring interventions to ethnic minority women and their families. The findings capture how ethnic minority women experience specialist perinatal teams and offer insights into practising culturally sensitive care. Perinatal mental health professionals can support ethnic minority women by strengthening their access to community resources and peer support; being curious about their culture; helping them to make sense of how culture, ethnicity, race and mental health interact; and applying cultural and practical adaptations to interventions. A Lived Experience Advisory Group (LEAG) of women from ethnic minority groups contributed to the design and conduct of this study. The LEAG had lived experience of perinatal mental health conditions and accessing specialist perinatal teams. The LEAG chose to co-produce specific aspects of the research they felt fit with their skills and available time throughout five group sessions. These aspects included developing the interview topic guide, a structure for debriefing participants and advising on the social media recruitment strategy.

Project description:BackgroundCervical cancer screening (CCS) and human papillomavirus vaccination (HPVV) are effective measures against cervical cancer (CC). Attendance in HPVV and CCS provides the greatest protection, while combined non-attendance in HPVV and CCS provides little to no protection. It is hence concerning that some large ethnic minority groups show considerably lower HPVV and CCS attendance than other women-especially women from Middle-Eastern and North African (MENA) countries and Pakistan. Little is, however, known about the reasons for this low combined attendance pattern n.AimTo explore perceptions of and barriers to HPVV and CCS, among MENA and Pakistani women in Denmark.MethodFocus group interviews were conducted. Data was transcribed verbatim, and analysed using systematic text condensation.FindingsSeventeen long-term resident women originating from six major MENA countries and Pakistan were included. Mean age was 36 years. We found that these women, across different age groups and descent, had sparse knowledge and understanding about CC, and their perceived relevance of disease prevention was low. Compared to HPVV, their barriers to CCS were more fixed and often linked to socio-cultural factors such as taboos related to female genitals and sexuality. Moreover, they presented unmet expectations and signs of mistrust in the healthcare system. However, at the end of the interviews, participants became more attentive toward CC prevention, particularly toward HPVV.ConclusionElements of insufficient knowledge and understanding of CC and its prevention were found among a group of MENA and Pakistani women. Their socio-cultural background further represents a barrier particularly towards CCS. Additionally, negative experiences and unmet expectations lessen their trust in the healthcare system. All of which underlines the need for new tailored CC preventive strategies for this group. Based on our findings we suggest that future studies develop and evaluate interventions aiming to improve HPVV and CCS, including user-involvement.

Project description:Objectives To explore the perspectives of ethnic minority community leaders in relation to: the impact of the COVID-19 pandemic on their communities; and their community’s perception, understanding and adherence to government guidelines on COVID-19 public health measures. Design A phenomenological approach was adopted using qualitative semistructured interviews. Settings Community organisations and places of worships in the West Midlands, England. Participants Community leaders recruited through organisations representing ethnic minority communities and religious places of worship. Results A total of 19 participants took part. Participants alluded to historical and structural differences for the observed disparities in COVID-19 morbidity and mortality. Many struggled with lockdown measures which impeded cultural and religious gatherings that were deemed to be integral to the community. Cultural and social practices led to many suffering on their own as discussion of mental health was still deemed a taboo within many communities. Many expressed their community’s reluctance to report symptoms for the fear of financial and physical health implications. They reported increase in hate crime which was deemed to be exacerbated due to perceived insensitive messaging from authority officials and historical racism in the society. Access and adherence to government guidelines was an issue for many due to language and digital barriers. Reinforcement from trusted community and religious leaders encouraged adherence. Points of support such as food banks were vital in ensuring essential supplies during the pandemic. Many could not afford or have access to masks and sanitisers. Conclusion The study highlights the perceived impact of the COVID-19 pandemic on ethnic minority communities. Government agencies and public health agencies need to integrate with the community, and community leaders can enable dissemination of key messages to deliver targeted yet sensitive public health advice which incorporates cultural and religious practices. Addressing the root causes of disparities is imperative to mitigate current and future pandemics.

Project description:BackgroundApproximately one in five women will experience mental health difficulties in the perinatal period. However, for a large group of women, symptoms of adverse perinatal mental health remain undetected and untreated. This is even more so for women of ethnic minority background, who face a variety of barriers which prevents them from accessing appropriate perinatal mental health care.AimsTo explore minority ethnic women's experiences of access to and engagement with perinatal mental health care.MethodsSemi-structured interviews were conducted with 18 women who had been diagnosed with perinatal mental health difficulties and who were supported in the community by a specialist perinatal mental health service in South London, United Kingdom. Women who self-identified as being from a minority ethnic group were purposefully selected. Data were transcribed verbatim, uploaded into NVivo for management and analysis, which was conducted using reflective thematic analysis.ResultsThree distinct overarching themes were identified, each with two or three subthemes: 'Expectations and Experiences of Womanhood as an Ethnic Minority' (Shame and Guilt in Motherhood; Women as Caregivers; Perceived to Be Strong and Often Dismissed), 'Family and Community Influences' (Blind Faith in the Medical Profession; Family and Community Beliefs about Mental Health and Care; Intergenerational Trauma and Family Dynamics) and 'Cultural Understanding, Empowerment, and Validation' (The Importance of Understanding Cultural Differences; The Power of Validation, Reassurance, and Support).ConclusionWomen of ethnic minority background identified barriers to accessing and engaging with perinatal mental health support on an individual, familial, community and societal level. Perinatal mental health services should be aware ethnic minority women might present with mental health difficulties in different ways and embrace principles of cultural humility and co-production to fully meet these women's perinatal mental health needs.

Dataset Information

A qualitative analysis of factors that influence Vietnamese ethnic minority women to seek maternal health care.

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A qualitative analysis of factors that influence Vietnamese ethnic minority women to seek maternal health care.

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