Department of Health Informatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran.
BMC Pregnancy Childbirth. 2020 May 6;20(1):274. doi: 10.1186/s12884-020-02969-x.
An estimated 96% of registered refugees in Iran are Afghan. Almost half of them are young women at the reproductive age. The adequate maternity care is crucial for healthy pregnancy. There is limited knowledge regarding the access and adequacy of maternity care among Afghan women in Iran. The reports from ministry of health (MOH) implicate higher prevalence of perinatal complications in Afghan population. This mainly attributed to the inadequate prenatal care during pregnancy. Therefore, this paper explores the potential barriers to prenatal care among Afghan women in Iran.
Using convenience sampling, thirty pregnant Afghan women were recruited at three community health centers with the highest number of Afghan visitors in Tehran, the capital city of Iran. Data were collected through face-to-face interviews in Persian language using an interview guide. The interviewers were two bilingual Afghan graduate midwifery students. Each interview lasted for an hour. The questions regarding the concerns and experienced obstacles in seeking prenatal care were asked. The interviews were transcribed into original language (Persian) and analyzed using content analysis and further translated back into English. The main themes were extracted grouping the similar codes and categories after careful consideration and consensus between the researchers.
The financial constraints and lack of affordable health insurance with adequate coverage of prenatal care services, particularly the diagnostic and screening tests, were the most frequent reported obstacles by Afghan women. In addition, personnel behavior, transportation issues, stigma and discrimination, cultural concerns, legal and immigration issues were also mentioned as the source of disappointment and inadequate utilization of such services.
The findings of present study emphasize the necessity of available and most importantly, affordable prenatal care for Afghan women in Iran. Providing an affordable health insurance with adequate coverage of prenatal and delivery services, could reduce the financial burden, facilitate the access, and ensure the maternal and child health in this vulnerable population. The issues of fear and concern of deportation must be removed for at least illegal Afghan mothers to ensure their access to maternity care and improve the health of both mother and offspring.
伊朗约有 96%的登记难民为阿富汗人。其中近一半是处于生育年龄的年轻女性。适当的产妇保健对健康妊娠至关重要。关于在伊朗的阿富汗妇女获得和获得足够的产妇保健的知识有限。卫生部的报告表明，阿富汗人口的围产期并发症发生率较高。这主要归因于怀孕期间产前保健不足。因此，本文探讨了伊朗阿富汗妇女产前保健的潜在障碍。
采用便利抽样法，在德黑兰（伊朗首都）三家拥有最多阿富汗访客的社区卫生中心招募了 30 名怀孕的阿富汗妇女。使用访谈指南以波斯语进行面对面访谈收集数据。访谈员是两名双语阿富汗研究生助产士学生。每次访谈持续一个小时。询问了有关寻求产前保健的关注和遇到的障碍的问题。访谈以原始语言（波斯语）记录下来，并使用内容分析法进行分析，然后再翻译成英语。在仔细考虑并在研究人员之间达成共识后，通过提取相似的代码和类别来提取主要主题。
经济拮据和缺乏负担得起的医疗保险，以及产前保健服务（特别是诊断和筛查测试）覆盖不足，是阿富汗妇女最常报告的障碍。此外，人员行为、交通问题、耻辱和歧视、文化问题、法律和移民问题也被认为是失望和服务利用不足的根源。
本研究的结果强调了为伊朗的阿富汗妇女提供负担得起的产前保健的必要性。提供负担得起的医疗保险，涵盖产前和分娩服务，可以减轻经济负担，促进获得，并确保这一弱势群体的母婴健康。必须消除对被驱逐出境的恐惧和担忧问题，至少让非法阿富汗母亲能够获得产妇保健，以改善母婴健康。
