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A service evaluation of a specialist migrant maternity service from the user's perspective

02 September 2020
17 min read
Volume 28 · Issue 9

Abstract

Background

Meeting the complex needs of pregnant migrants requires an innovative approach. Migrant women's experiences and opinions should directly guide service development if these needs are to be met effectively.

Aims

To evaluate the specialist migrant maternity service provided by Kings College Hospital London based upon users' experience and satisfaction.

Methods

A qualitative service evaluation via semi-structured, multi-lingual, in-depth interviews with 10 service users. Data was analysed using a general inductive approach for thematic analysis.

Findings

Positive aspects: access to midwife and referrals, provision of essentials and transport, respect and kindness of caregivers. Negative aspects: poor maternal nutrition, lack of access to hygienic infant-feeding equipment, lack of social support building and lack of service signposting.

Conclusion

Women conveyed a high level of satisfaction with the service. The negative aspects that persist are, arguably, not within the immediate remit of the maternity team, yet they negatively affect the health of these women, and therefore merit awareness raising if holistic care is to be achieved. Seven service recommendations have been made.

Migrant women experience poorer maternal and perinatal outcomes compared to settled residents in their host country, including 10 times higher mortality (Heslehurst et al, 2018; Gieles et al, 2019; Moore et al, 2019; Rogers et al, 2020). This is driven by language barriers, lack of understanding of the care system, perceived discrimination and lack of cultural sensitivity (Higginbottom et al, 2019; McKnight et al, 2019). While NHS maternity services are freely available to pregnant asylum seekers in the UK, current maternity services are not adequately designed to meet their needs (Phillimore, 2016).

It is nine years since the National Institute for Health and Care Excellence ([NICE], 2011) recognised that in order to create a benchmark of good practice, there was an urgent need for a detailed map of existing service models for migrant women. There remains, however, a lack of detailed knowledge regarding available service models, their interventions, and effectiveness, particularly in a UK context (McKnight et al, 2019, Pangas et al, 2019).

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