Schönborn Claudia, Castetbon Katia, Sow Mouctar, Racape Judith, De Spiegelaere Myriam
Research Centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles, Brussels, Belgium.
BMJ Open. 2020 Nov 30;10(11):e038400. doi: 10.1136/bmjopen-2020-038400.
In Europe, the social inequalities in perinatal health are usually found to be to the disadvantage of non-European immigrants and women with lower levels of education and income. Among the possible underlying mechanisms are inadequate access to healthcare services and suboptimal care. To explore this hypothesis in the Belgian context, our research will describe detailed maternal socioeconomic and migration characteristics, explore how these factors relate to each other, and how they relate to women's perinatal care trajectories and experiences of care.
Using a modified version of the Migrant-Friendly Maternity Care Questionnaire, we will survey 900 mothers of Belgian nationality or a nationality from a North or Sub-Saharan African country, and having given birth in four maternity wards in Brussels. The questionnaire has been adapted to the study objectives and the Belgian context. Interviewers will administer the 116-item questionnaire to all women agreeing to participate and meeting inclusion criteria, within 14 days of having given birth. Clinical information will be extracted from hospital records.
We will estimate the associations of women's socioeconomic and migration characteristics with:Women's antenatal care trajectories (timing of first antenatal consultation, minimum recommended number of consultations, and problems accessing care).Obstetric practices such as episiotomies, emergency caesarean sections, and inductions.Patient experience such as feelings of discrimination, respect, and understanding of information.We will use descriptive statistics, multiple correspondence analysis, and simple and multiple logistic regressions.
Ethical approval has been obtained from the hospital Ethics Committees and from the Université libre de Bruxelles (No: P2017/055/B406201730877). Written informed consent will be sought from all participants.In addition to disseminating findings and recommendations to the scientific community through open-source journal articles and conferences, we will also address local organisations and healthcare professionals via a written report and seminars.
在欧洲，围产期健康方面的社会不平等现象通常表现为非欧洲移民以及教育和收入水平较低的女性处于不利地位。可能的潜在机制包括获得医疗服务的机会不足以及护理质量欠佳。为了在比利时的背景下探究这一假设，我们的研究将描述详细的孕产妇社会经济和移民特征，探讨这些因素之间的相互关系，以及它们与女性围产期护理轨迹和护理体验之间的关系。
我们将使用经过修改的《关爱移民产妇调查问卷》，对900名比利时国籍或来自撒哈拉以北或以南非洲国家且在布鲁塞尔四个产科病房分娩的母亲进行调查。该问卷已根据研究目标和比利时的情况进行了调整。访谈人员将在所有同意参与并符合纳入标准的女性分娩后14天内，向她们发放这份包含116个项目的问卷。临床信息将从医院记录中提取。
我们将估计女性的社会经济和移民特征与以下方面的关联：
女性的产前护理轨迹（首次产前咨询时间、建议的最少咨询次数以及获得护理的问题）。
诸如会阴切开术、急诊剖宫产和引产等产科操作。
患者体验，如歧视感、尊重感以及对信息的理解。
我们将使用描述性统计、多重对应分析以及简单和多重逻辑回归。
已获得医院伦理委员会和布鲁塞尔自由大学的伦理批准（编号：P2017/055/B406201730877）。将征求所有参与者的书面知情同意。
除了通过开源期刊文章和会议向科学界传播研究结果和建议外，我们还将通过书面报告和研讨会与当地组织及医疗专业人员进行沟通。
