Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in Denmark
Inequity in immigrants’ health during pregnancy and childbirth has been shown. We studied the Danish regional organization of public midwifery-based antenatal care (ANC) for immigrant women to assess the strengths and weaknesses of organizing ANC as either universal or immigrant-targeted....
Main Authors: | , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2019-09-01
|
Series: | International Journal of Environmental Research and Public Health |
Subjects: | |
Online Access: | https://www.mdpi.com/1660-4601/16/18/3396 |
id |
doaj-ab71567fbbe64b059b7948ec47381cf0 |
---|---|
record_format |
Article |
spelling |
doaj-ab71567fbbe64b059b7948ec47381cf02020-11-25T02:03:26ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012019-09-011618339610.3390/ijerph16183396ijerph16183396Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in DenmarkSarah Fredsted Villadsen0Hodan Jama Ims1Anne-Marie Nybo Andersen2Section of Social Medicine, Department of Public Health, University of Copenhagen, 1165 Copenhagen, DenmarkSection of Social Medicine, Department of Public Health, University of Copenhagen, 1165 Copenhagen, DenmarkSection of Epidemiology, Department of Public Health, University of Copenhagen, 1165 Copenhagen, DenmarkInequity in immigrants’ health during pregnancy and childbirth has been shown. We studied the Danish regional organization of public midwifery-based antenatal care (ANC) for immigrant women to assess the strengths and weaknesses of organizing ANC as either universal or immigrant-targeted. A telephone survey in 2012 to all the Danish maternity wards (<i>n</i> = 20) was conducted. Semi-structured interviews with midwives providing targeted care (<i>n</i> = 6) were undertaken and characteristics of care were qualitatively analyzed, having the immigrant density of the facilities, the Danish ANC policy, and theories of cultural competence as the frame of reference. Six maternity wards were providing immigrant-targeted ANC. Targeted care implied longer consultations and increased attention to the individual needs of immigrant women. At these facilities, navigation in the health care system, body awareness, and use of interpreter services were key topics. The selection of women for targeted care was based on criteria (including names) that risk stigmatizing immigrant women. The arguments for not providing targeted care included that immigrant-targeted care was considered stigmatizing. Current universal care may overlook the needs of immigrant women and contribute to inequities. A strategy could be to improve dynamic cultural competencies of midwives, interpreter services, and flexibility of the care provision of the universal ANC system.https://www.mdpi.com/1660-4601/16/18/3396health policyantenatal carematernal and child healthquality of caremigrationinstitutional practice |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sarah Fredsted Villadsen Hodan Jama Ims Anne-Marie Nybo Andersen |
spellingShingle |
Sarah Fredsted Villadsen Hodan Jama Ims Anne-Marie Nybo Andersen Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in Denmark International Journal of Environmental Research and Public Health health policy antenatal care maternal and child health quality of care migration institutional practice |
author_facet |
Sarah Fredsted Villadsen Hodan Jama Ims Anne-Marie Nybo Andersen |
author_sort |
Sarah Fredsted Villadsen |
title |
Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in Denmark |
title_short |
Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in Denmark |
title_full |
Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in Denmark |
title_fullStr |
Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in Denmark |
title_full_unstemmed |
Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in Denmark |
title_sort |
universal or targeted antenatal care for immigrant women? mapping and qualitative analysis of practices in denmark |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1660-4601 |
publishDate |
2019-09-01 |
description |
Inequity in immigrants’ health during pregnancy and childbirth has been shown. We studied the Danish regional organization of public midwifery-based antenatal care (ANC) for immigrant women to assess the strengths and weaknesses of organizing ANC as either universal or immigrant-targeted. A telephone survey in 2012 to all the Danish maternity wards (<i>n</i> = 20) was conducted. Semi-structured interviews with midwives providing targeted care (<i>n</i> = 6) were undertaken and characteristics of care were qualitatively analyzed, having the immigrant density of the facilities, the Danish ANC policy, and theories of cultural competence as the frame of reference. Six maternity wards were providing immigrant-targeted ANC. Targeted care implied longer consultations and increased attention to the individual needs of immigrant women. At these facilities, navigation in the health care system, body awareness, and use of interpreter services were key topics. The selection of women for targeted care was based on criteria (including names) that risk stigmatizing immigrant women. The arguments for not providing targeted care included that immigrant-targeted care was considered stigmatizing. Current universal care may overlook the needs of immigrant women and contribute to inequities. A strategy could be to improve dynamic cultural competencies of midwives, interpreter services, and flexibility of the care provision of the universal ANC system. |
topic |
health policy antenatal care maternal and child health quality of care migration institutional practice |
url |
https://www.mdpi.com/1660-4601/16/18/3396 |
work_keys_str_mv |
AT sarahfredstedvilladsen universalortargetedantenatalcareforimmigrantwomenmappingandqualitativeanalysisofpracticesindenmark AT hodanjamaims universalortargetedantenatalcareforimmigrantwomenmappingandqualitativeanalysisofpracticesindenmark AT annemarienyboandersen universalortargetedantenatalcareforimmigrantwomenmappingandqualitativeanalysisofpracticesindenmark |
_version_ |
1724948282507001856 |