School of Nursing and Midwifery, Deakin University, Burwood, VIC, Australia.
Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Melbourne, VIC, Australia.
Syst Rev. 2024 Aug 9;13(1):215. doi: 10.1186/s13643-024-02628-8.
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.
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.
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.
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.
PROSPERO CRD42023405458.
在澳大利亚生活的非洲出生的女性，其围产期健康结果显著较差。这一问题部分归因于与澳大利亚出生的女性相比，她们较少参与孕产保健服务。各种障碍可能限制了非洲出生的女性获得和使用服务的机会；然而，这些障碍并没有得到很好的记录。因此，本综述旨在综合目前关于澳大利亚生活的非洲出生的女性获得孕产保健服务的障碍和促进因素的定性证据。
于 2023 年 4 月 16 日在 MEDLINE、CINAHL、Embase、PsychInfo 和母婴保健数据库中进行了检索。由两名独立的审查员仔细筛选检索到的所有文章，以确定其是否符合纳入标准，任何分歧都通过讨论解决。使用混合方法评估工具评估纳入文章的质量。在 Covidence 中筛选研究，并在 NVivo 中进行分析。使用 Lévesque 的医疗保健获取框架组织和呈现研究结果。
在 558 篇已识别的论文中，有 11 项研究共纳入 472 名参与者符合纳入标准。综述突出了提供者方面的障碍，如信息不足、未满足的文化需求、长时间等待、妇女参与护理的程度低、歧视和缺乏护理连续性。确定的使用者方面的障碍包括沟通问题、难以在卫生系统中导航以及与医疗保健提供者之间缺乏信任关系。相比之下，综述还指出了提供者方面的促进因素，包括积极的员工态度、服务的可用性以及设施与住所的接近程度，而使用者方面的促进因素，如文化同化和被医疗保健提供者重视也被指出。
本综述确定了澳大利亚生活的非洲出生的女性获得孕产保健服务的障碍和促进因素。突出了为满足非洲出生的女性的独特健康需求而对政策和实践进行潜在改变的实证证据。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，并提高非洲出生的女性对孕产保健的参与度。此外，加强与积极的医疗保健体验相关的因素对于改善这一重点人群的孕产保健服务获取至关重要。
PROSPERO CRD42023405458。
