Migrant Women’s Perceptions of Healthcare During Pregnancy and Early Motherhood: Addressing the Social Determinants of Health
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Recent guidelines from the World Health Organization emphasize the need to monitor the social determinants of health, with particular focus on the most vulnerable groups. With this in mind, we evaluated the access, use and perceived quality of care received by migrant women during pregnancy and early motherhood, in a large urban area in northern Portugal. We performed semi-structured interviews in 25 recent mothers, contacted through welfare institutions, who had immigrated from Eastern European countries, Brazil, or Portuguese-speaking African countries. Six native-Portuguese women of equal economic status were also interviewed for comparison. Misinformation about legal rights and inadequate clarification during medical appointments frequently interacted with social determinants, such as low social-economic status, unemployment, and poor living conditions, to result in lower perceived quality of healthcare. Special attention needs to be given to the most vulnerable populations in order to improve healthcare. Challenges reside not only in assuring access, but also in promoting equity in the quality of care.
KeywordsSocial determinants of health Maternal healthcare Migration
This study was funded by Fundação para a Ciência e Tecnologia (FCT)—Portugal, under the research project “Health and Citizenship: Gaps and needs in intercultural health care to immigrant mothers”. The authors would like to thank the study participants and the welfare institutions that collaborated with this research.
The study was approved by the Research Ethics Board of the School of Psychology and Educational Sciences, at the University of Porto. Approval for the conduction of the study was also obtained from the governing boards and Ethics Committees of all involved welfare institutions.
- 1.IOM. World migration report. Communicating effectively about migration, 2011. Geneva: International Organization for Migration; 2011.Google Scholar
- 2.Fernandes A, Miguel J. Health and migration in the European Union: better health for all in an inclusive society. Lisboa: Instituto Nacional de Saúde Doutor Ricardo Jorge; 2009.Google Scholar
- 4.Rumbold A, et al. Delivery of maternal health care in indigenous primary care services: baseline data for an ongoing quality improvement initiative. BMC Pregnancy Childbirth. 2011;11:16.Google Scholar
- 6.Dias S, Severo M, Barros H. Determinants of health care utilization by immigrants in Portugal. BMC Health Services Res. 2008;8:207.Google Scholar
- 11.CSDH. Closing the gap in a generation: health equity through action on the social determinants of health. In: Final report of the Commission on Social Determinants of Health 2008. Geneva: World Health Organization.Google Scholar
- 12.Machado MC, et al. Iguais ou diferentes? Cuidados de Saúde materno-infantil a uma população de imigrantes. Laboratórios BIAL; 2006.Google Scholar
- 13.Ganann R, Sword W, Black M, Carpio B. Influence of maternal birthplace on postpartum health and health services use. J Immigr Minor Health. 2011;14(2):223–9.Google Scholar
- 17.Zeitlin J, Mohangoo A. European perinatal health report. In: Cahn J, editor. EURO-PERISTAT Project. SCPE, EUROCAT, EURONEOSTAT; 2008.Google Scholar
- 18.Silva S, Fraga S. Qualitative research in epidemiology. In: Lunet S, editor. Epidemiology—current perspectives on research and practice. 2012, (InTech).Google Scholar
- 19.Bogdan R, Biklen S. Qualitative research for education. In: Pearson ES, editor. An introduction to theories and methods. 2003.Google Scholar
- 20.Ingleby D, et al. The role of health in integration, in Social integration and mobility: education, housing and health. In: Fonseca M, Malheiros J, editors. Lisbon: Centro de Estudos Geográficos; 2005. p. 88–119.Google Scholar