Aryasinghe Sarindi, Averill Phoebe, Waithe Carole, Ibuanokpe Susan, Newby-Mayers Rhianna, Lakhdar Nawal, Amine Sylla Moussa, Cox Elizabeth, Das Sabrina, Mayer Erik
NIHR Imperial Biomedical Research Centre, Imperial College London, London, UK
NIHR North West London Patient Safety Research Collaboration, Institute of Global Health Innovation, Imperial College London, London, UK.
BMJ Qual Saf. 2025 Apr 17;34(5):305-316. doi: 10.1136/bmjqs-2024-017848.
Ethnic inequities in maternity care persist in England for Black, African, Caribbean and mixed-Black heritage families, resulting in poorer care experiences and health outcomes than other minoritised ethnic groups. Co-production using an integrated care approach is crucial for reducing these disparities and improving care quality and safety. Therefore, this study aimed to understand the alignment of health and local authority professional perspectives with community needs on how to improve maternity experiences for this ethnic group within a London integrated care system (ICS).
Between March and June 2024, five workshops were conducted with health professionals, local authorities, voluntary, community and social enterprise (VCSE) sector and the public from Black, African, Caribbean and mixed-Black heritage backgrounds across the North West London ICS. Using the nominal group technique (NGT), attendees prioritised ideas to improve the experience of maternity care for families from Black, African, Caribbean and mixed-Black heritage backgrounds, which were thematically synthesised using framework analysis.
Fifty-four attendees, covering primary, secondary, regional and national health professionals, public health teams from three local authorities, VCSE sector and the public, generated 89 potential interventions across 11 themes. All attendees prioritised improving staff knowledge and capacity in culturally competent care and communication. Community-identified needs for advocacy mechanisms and mental health support throughout the maternity pathway were not reflected in professional priorities.
The study highlights the need for an integrated, community-centred approach beyond hospital settings when addressing ethnic inequities in maternity care, recognising key differences between community and professional priorities within an ICS. Leveraging lived experience expertise to lead the NGT community workshops was essential in building trust and buy-in of the overall prioritisation process.
在英格兰，针对黑人、非洲裔、加勒比裔以及具有混合黑人血统的家庭，产科护理中的种族不平等现象依然存在，相较于其他少数族裔群体，这些家庭的护理体验和健康结果更差。采用综合护理方法进行共同生产对于减少这些差距、提高护理质量和安全性至关重要。因此，本研究旨在了解在伦敦综合护理系统（ICS）中，健康和地方当局专业人士的观点与社区需求在如何改善该族裔群体产科体验方面的一致性。
2024年3月至6月期间，针对伦敦西北部综合护理系统中来自黑人、非洲裔、加勒比裔以及具有混合黑人血统背景的健康专业人员、地方当局、志愿、社区和社会企业（VCSE）部门及公众举办了五场研讨会。使用名义小组技术（NGT），与会者对改善黑人、非洲裔、加勒比裔以及具有混合黑人血统背景家庭产科护理体验的想法进行了优先排序，并使用框架分析对这些想法进行了主题综合。
54名与会者，包括初级、二级、区域和国家健康专业人员、来自三个地方当局的公共卫生团队、VCSE部门及公众，围绕11个主题提出了89项潜在干预措施。所有与会者都将提高工作人员在文化胜任护理和沟通方面的知识与能力列为优先事项。社区确定的在整个产科过程中对宣传机制和心理健康支持的需求并未体现在专业人员的优先事项中。
该研究强调，在解决产科护理中的种族不平等问题时，需要采取超越医院环境的综合、以社区为中心的方法，认识到综合护理系统中社区和专业人员优先事项之间的关键差异。利用实际生活经验专业知识来主导名义小组技术社区研讨会对于建立对整个优先排序过程的信任和认同至关重要。
