Child, Youth & Family Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia.
School of Women's and Children's Health, University of NSW (UNSW), Sydney, NSW, Australia.
Health Soc Care Community. 2020 Sep;28(5):1343-1365. doi: 10.1111/hsc.12950. Epub 2020 Jan 30.
Pregnant women from migrant and refugee backgrounds living in high-income countries (HIC) are at increased risk of adverse perinatal outcomes compared with women born in the host country. Women from migrant and refugee background have perinatal healthcare needs that are recognised internationally as a public health priority. The aim of this study was to identify, appraise and synthesise available evidence on the effectiveness of models of care in pregnancy or first 12 months postpartum for women from migrant and refugee backgrounds living in HIC. Care models were mapped in terms of (a) effectiveness at improving service access, (b) effectiveness at improving maternal and infant health outcomes, (c) acceptability and appropriateness from the perspective of women and (d) acceptability and appropriateness from the perspective of service providers. Using systematic scoping review methodology, qualitative, quantitative, and mixed methods research published in English 2008-2019 were included. The databases MEDLINE, Embase, Emcare, PubMed, Scopus, CINAHL, PsycINFO, Web of Science, Google Scholar, Cochrane Database of Systematic Reviews and Joanna Briggs Institute were searched between 27 February 2019 and updated 27 December 2019. Qualitative and quantitative data were analysed narratively. Seventeen studies, involving 1,499 women and 203 service providers, were included. A diverse range of interventions were identified, including bilingual/bicultural workers, group antenatal care and specialised clinics. All identified interventions were acceptable to women, and improved access, however, few provided evidence of improved perinatal outcomes. Gaps identified for future research include the use of qualitative and quantitative approaches to ascertain the experiences of women, their families, service providers and impact on perinatal outcomes. Synthesis of the included studies indicates the key elements of acceptable and accessible models, which were as follows: culturally responsive care, continuity of care, effective communication, psychosocial and practical support, support to navigate systems, flexible and accessible services.
与在高收入国家（HIC）出生的女性相比，来自移民和难民背景的孕妇在围产期有更高的不良结局风险。来自移民和难民背景的女性的围产期医疗保健需求被国际公认为公共卫生重点。本研究旨在确定、评估和综合现有证据，以了解针对居住在 HIC 的移民和难民背景女性的妊娠或产后头 12 个月的护理模式的效果。根据（a）改善服务获取的效果，（b）改善母婴健康结局的效果，（c）从女性角度的可接受性和适宜性，以及（d）从服务提供者角度的可接受性和适宜性来描述护理模式。采用系统范围审查方法，纳入了 2008 年至 2019 年以英文发表的定性、定量和混合方法研究。检索了 MEDLINE、Embase、Emcare、PubMed、Scopus、CINAHL、PsycINFO、Web of Science、Google Scholar、Cochrane 系统评价数据库和 Joanna Briggs 研究所数据库，检索日期为 2019 年 2 月 27 日，更新日期为 2019 年 12 月 27 日。对定性和定量数据进行了叙述性分析。纳入了 17 项研究，涉及 1499 名妇女和 203 名服务提供者。确定了多种干预措施，包括双语/跨文化工作者、小组产前护理和专门诊所。所有确定的干预措施都得到了妇女的认可，并改善了服务获取，但很少有研究提供改善围产期结局的证据。未来研究的差距包括使用定性和定量方法来确定妇女及其家庭、服务提供者的经验以及对围产期结局的影响。纳入研究的综合结果表明了可接受和可及的模式的关键要素，包括：文化响应式护理、连续护理、有效沟通、心理社会和实际支持、支持系统导航、灵活和可及的服务。
