Hearn Fran, Brown Stephanie J, Szwarc Josef, Toke Shadow, Alqas Alias May, Essa Maryaan, Hydari Shogoufa, Baget Ashay, Riggs Elisha
Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia.
Department of General Practice, University of Melbourne, Parkville, VIC 3052, Australia.
Int J Environ Res Public Health. 2024 Apr 15;21(4):481. doi: 10.3390/ijerph21040481.
Listening to What Matters is an exploratory descriptive qualitative study that aimed to (1) understand how women of refugee background in Melbourne, Australia experienced access to health information and maternity and/or early parenting care during the COVID-19 pandemic and (2) whether pandemic health directives had an impact on structural inequities for women of refugee background who received maternity and/or early parenting care during the COVID-19 pandemic. Semi-structured interviews were conducted with 41 participants including 17 women of refugee background, who identified as belonging to the Karen, Assyrian Chaldean, Iraqi, Syrian, Afghan, Sudanese, or South Sudanese communities and 24 health and social care professionals who identified as providing pregnancy or early parenting care during the pandemic in the north western suburbs of Melbourne. Interviews with women were conducted in preferred languages by community researchers. Interviews with professionals were conducted in English by researchers. Reflexive thematic data analysis included constructivist positionality and a trauma and violence informed approach. The results reported in this paper include three themes, with four accompanying subthemes, as follows: theme (1), 'Structural inequities and the toll of the pandemic'; theme (2), 'Supportive infrastructure'; and theme (3), 'Cultural safety during the pandemic'. The results demonstrate that cumulative negative impacts such as unequal access to health information, family separation and isolation, inadequate household income, and mental and social health concerns had the potential to amplify pre-existing structural inequities for women of refugee background. Community engagement facilitated by bicultural workers, interpreters, and trusted care providers facilitated fast-paced, two-way communication that built capacity and health literacy for women who were unable to speak English and unfamiliar with the health care system and, improved experiences of care. More research is needed to understand how the intersectional cumulative impacts of structural inequities have affected maternal and neonatal health outcomes for women of refugee background during the pandemic, as well as any differences in maternal and neonatal health outcomes between Australian-born and refugee background women and babies.
《倾听重要之事》是一项探索性描述性定性研究，旨在：（1）了解澳大利亚墨尔本具有难民背景的女性在新冠疫情期间获取健康信息以及获得孕产妇和/或早期育儿护理的经历；（2）疫情期间的健康指令是否对在新冠疫情期间接受孕产妇和/或早期育儿护理的具有难民背景的女性的结构性不平等产生影响。对41名参与者进行了半结构化访谈，其中包括17名具有难民背景的女性，她们分别属于克伦族、亚述迦勒底族、伊拉克族、叙利亚族、阿富汗族、苏丹族或南苏丹族社区，以及24名健康和社会护理专业人员，他们在墨尔本西北郊区疫情期间提供怀孕或早期育儿护理服务。社区研究人员用参与者偏好的语言对女性进行访谈。研究人员用英语对专业人员进行访谈。反思性主题数据分析包括建构主义定位以及创伤和暴力知情方法。本文报告的结果包括三个主题及四个相关子主题，具体如下：主题（1）“结构性不平等与疫情的影响”；主题（2）“支持性基础设施”；主题（3）“疫情期间的文化安全”。结果表明，诸如获取健康信息不平等、家庭分离和隔离、家庭收入不足以及心理和社会健康问题等累积负面影响，有可能加剧具有难民背景女性原有的结构性不平等。由双语工作者、口译员和值得信赖的护理提供者推动的社区参与促进了快速的双向沟通，增强了无法说英语且不熟悉医疗保健系统的女性的能力和健康素养，并改善了护理体验。需要开展更多研究，以了解结构性不平等的交叉累积影响在疫情期间如何影响具有难民背景女性的孕产妇和新生儿健康结果，以及澳大利亚出生的女性与具有难民背景的女性及婴儿在孕产妇和新生儿健康结果方面的差异。
