背景:生活在澳大利亚的非洲出生妇女的不良围产期健康结局明显较高。这个问题的部分原因是,与澳大利亚出生的妇女相比,她们对产妇保健服务的参与度较低。各种障碍可能会限制非洲出生的妇女获得和使用服务;然而,这些障碍没有得到很好的记录。因此,本综述旨在综合目前关于生活在澳大利亚的非洲裔女性获得产妇护理的障碍和促进因素的定性证据.
方法:搜索在MEDLINE中进行,CINAHL,Embase,PsychInfo,和2023年4月16日的产妇和婴儿护理数据库。检索到的所有文章都由两名独立审稿人精心筛选合格,任何分歧都通过讨论解决。使用混合方法评估工具对纳入文章的质量进行评估。研究在Covidence中进行了筛选,并在NVivo中进行了分析。研究结果是使用Levesque的医疗保健访问框架进行组织和呈现的。
结果:在558篇确定的论文中,共有472名参与者的11项研究符合资格标准。审查强调了提供商方面的障碍,例如信息短缺,未满足的文化需求,漫长的等待时间,妇女参与护理的比例低,歧视,缺乏护理的连续性。确定的用户方障碍包括沟通问题,在卫生系统中导航困难,与医疗保健提供者缺乏信任关系。相比之下,审查确定了提供者方面的促进者,包括积极的员工态度,服务可用性,设施靠近住宅,同时注意到用户侧促进者,例如文化同化和医疗保健提供者的重视感。
结论:这项审查确定了生活在澳大利亚的非洲出生妇女获得产妇护理的障碍和促进因素。强调了经验证据,这些证据将为解决非洲出生的妇女的独特健康需求的政策和实践提供潜在的变化。设计和实施文化安全的服务提供模式可以消除已确定的获取障碍,并改善非洲出生妇女在产妇护理中的参与度。此外,与积极的医疗保健经验相关的加强因素对于改善这一优先人群的产妇护理服务至关重要。
背景:PROSPEROCRD42023405458。
BACKGROUND: Adverse perinatal health outcomes are notably high among African-born women living in Australia. This problem is partly attributed to their lower engagement in
maternity care services as compared to Australian-born women. Various barriers might limit African-born women\'s access to and use of services; however, these barriers are not well documented. Therefore, this review aimed to synthesise current qualitative evidence on barriers and facilitators of access to
maternity care for African-born women living in Australia.
METHODS: The search was conducted in MEDLINE, CINAHL, Embase, PsychInfo, and
Maternity and Infant Care databases on 16 April 2023. All articles retrieved were meticulously screened for eligibility by two independent reviewers with any disagreements resolved through discussion. The quality of the included articles was evaluated using the Mixed Methods Appraisal Tool. Studies were screened in Covidence and analysed in NVivo. The findings were organised and presented using Levesque\'s framework of healthcare access.
RESULTS: Out of 558 identified papers, 11 studies comprising a total of 472 participants met the eligibility criteria. The review highlighted provider-side barriers such as shortage of information, unmet cultural needs, long waiting times, low engagement of women in care, discrimination, and lack of continuity of care. User-side barriers identified include communication issues, difficulty navigating the health system, and lack of trustful relationships with healthcare providers. In contrast, the review pinpointed provider-side facilitators including positive staff attitudes, service availability, and the proximity of facilities to residential homes, while user-side facilitators such as cultural assimilation and feeling valued by healthcare providers were noted.
CONCLUSIONS: This review identified barriers and facilitators of access to
maternity care for African-born women living in Australia. Empirical evidence that would inform potential changes to policy and practice to address African-born women\'s unique health needs was highlighted. Designing and implementing a culturally safe service delivery model could remove the identified access barriers and improve African-born women\'s engagement in maternity care. Moreover, reinforcing factors associated with positive healthcare experiences is essential for improving
maternity care access for this priority population.
BACKGROUND: PROSPERO CRD42023405458.