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The Struggle to Provide Culturally-Appropriate Maternity Care

first_imgPosted on September 28, 2017October 6, 2017By: Sarah Hodin, Project Coordinator II, Women and Health Initiative, Harvard T.H. Chan School of Public HealthClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)A core component of high quality health care is ensuring that services are people-centered—that providers incorporate the “preferences and aspirations of individual service users and the culture of their community.” The World Health Organization’s “Standards for improving quality of maternal and newborn care in health facilities” released in 2016 recommend that practitioners participate in regular in-service trainings to improve their interpersonal communication, counseling skills and cultural competence to encourage the provision of respectful maternity care. Organizations such as the Joint Commission, the National Institutes of Health, the International Confederation of Midwives and the International Federation of Gynecology and Obstetrics have also emphasized the importance of cultivating cultural competence in health care and offered practical guidance.How have program implementers, clinicians and researchers approached the issue of providing culturally-appropriate maternity care, and what challenges have they encountered?A recent paper in BMC Pregnancy and Childbirth aimed to answer these questions. This paper was a secondary analysis of a previous systematic review that the authors published in 2014 as part of the MHTF-PLOS Collection, “Integrating Health Care to Meet the Needs of the Mother-Infant Pair.” The authors reviewed 15 studies to examine how interventions to provide culturally-appropriate maternal health services—specifically related to patients’ ethnicity, language and religion—affected utilization of skilled antenatal, intrapartum and postnatal care.Ten of the 15 studies found that the intervention had positive effects on skilled maternity care utilization, especially antenatal care attendance.Keys to successThe following four themes illustrate barriers and facilitators to ensuring that women receive culturally-appropriate maternity care:AccessResearchers noted that financial and geographic barriers often inhibit women of certain cultural groups from seeking maternal health services, even if those services are culturally-appropriate. In some settings, gender-based restrictions on travel, low levels of education or literacy, limited knowledge of health services and a lack of social support or child care were also barriers to access. Facility-based interventions cannot be effective if the target population cannot access services.Community participationCreating mutual respect through coordination and communication among health workers and communities was essential for the success of interventions. Some program implementers highlighted the importance of establishing community ownership over interventions. Community-based participatory research is a promising approach that involves communities in program design from the beginning.Person-centered carePoor interactions between patients and providers was a common issue, with many women reporting caretakers’ unfriendliness, discrimination and negative attitudes. These experiences of disrespect and abuse decreased women’s self-worth and caused feelings of anxiety and shame. The most common strategy to combat these issues was employing staff with similar cultural or linguistic backgrounds to those of the women seeking care.Continuum of careSeveral interventions focused on a specific aspect of maternity care such as antenatal visits, but addressing issues of cultural appropriateness across the entire continuum of care was an important success factor. Collaboration among different care providers was essential to ensuring culturally-appropriate services to women at every encounter with health workers during pregnancy, delivery and postpartum.The stakes are highRespectful maternity care is a human right, and failing to guarantee culturally-appropriate care has serious implications. For example, women who do not receive respectful and culturally sensitive care at a health facility are less likely to seek facility-based maternity care in the future, which can have long-term consequences for both mother and baby.It is important to note that the 15 studies included in this review were conducted in Australia, Peru, the United States and the United Kingdom. Given how critical local contexts are in evaluating interventions to provide culturally-appropriate care, further research in other regions is needed to ensure that no woman is left behind.—Read the full, open access paper, “Interventions to provide culturally-appropriate maternity care services: Factors affecting implementation.”Learn more about respectful maternity care.Check out related posts from the MHTF blog:Respecting Choice in Childbirth: Preferred Delivery Positions Among Ethnic Minorities in VietnamIntegrating Culture Into Maternity Care Programs: A Systematic Mapping of InterventionsShare this: ShareEmailPrint To learn more, read:last_img read more

18 Robert Alfords overtime pick6 to beat Washin

first_img18) Robert Alford’s overtime pick-6 to beat Washington was the longest walk-off INTreturn since 1995 when Lorenzo Lynch had a 72-yard return for the ArizonaCardinals. (NFL press release)19) The Ravens defense gave up 505 yards of offense to the Cleveland Browns. (PeterKing’s MMQB)20) The Dolphins have a “head coach” younger than two NFL starting quarterbacks who earned victories in Week 5 (Peyton Manning and Matt Hasselbeck). (Peter King’s MMQB)21) Despite not having Josh Gordon for the year, the Browns throw on 72% of their plays. (Peter King’s MMQB)22) Only two players since the Super Bowl era have thrown for 100 yards, rushed for 70 yards and caught a pass in the same game: Randall Cunningham and Tyrod Taylor, who did it Sunday vs. Tennessee. (NFL press release)23) The Cardinals have scored 23 more points through their first five games than theirprevious record of 167 points in 1948. (Cardinals press release)24) Andy Dalton leads the NFL in passing yardage. (I was surprised when I was looking up something else and thought it was interesting)25) Chris Johnson is the NFL’s second leading rusher. (Cardinals press release)26) The Colts have won a record 16 straight divisional games. (Elias) Every week, as part of my show prep (and because I’m genuinely interested), I readthrough as many research notes I can find. Sometimes I research my own stats to seeif there’s a statistical trend that backs up what I think I’m seeing when I watch games.Unfortunately for my time efficiency, occasionally those stats show me nothing and Ithrow them out.Here are the stats (or interesting tidbits) from last week in the NFL in Research & Doug. Grace expects Greinke trade to have emotional impact Former Cardinals kicker Phil Dawson retires The 5: Takeaways from the Coyotes’ introduction of Alex Meruelo 1) Since the current playoff format at was adopted by the NFL, 4-1 teams have a 77%chance of making the playoffs. (ESPN Stats & Info)2) Rashad Johnson has more interceptions than the Seattle Seahawks…and 9 otherteams. (Me)3) The first quarterback in the 69-year history of the Cleveland Browns to throw for 300yards in three straight games is Josh McCown. (CBS broadcast)4) Every team since 1975 to score 100 more points than they allow through the firstfive games has played in the Super Bowl except this year’s Arizona Cardinals. (Cardinals press release)5) Russell Wilson has been sacked a league-high 22 times. (Peter King’s MMQB) 6) The last time the Cardinals scored 28 points in a quarter was 1987 when St. Louistrailed Tampa Bay 28-3 and came back with four TDs in the fourth quarter. RonWolfley contributed 2 yards towards the victory. (Cardinals press release and melooking up the game)7) Peyton Manning has six touchdown passes and seven interceptions while leading the 29th-best passing offense. (John Clayton)8) David Johnson is the first rookie since Pro Football Hall of Famer Gale Sayers(1965) to have multiple rushing touchdowns, multiple receiving TDs and a kickoff returntouchdown in his team’s first five games of a season. (NFL press release) Comments   Share   center_img Top Stories 27) Alex Smith completed 22% of his passes after Jamaal Charles tore his ACL. (ESPN Stats & Info)28) Before Sunday, Seattle’s last 17-point blown lead was 2004. (ESPN Stats & Info)29) The Atlanta Falcons have three defensive touchdowns this year after getting two last year. (ESPN Stats & Info)30) Tyrod Taylor has five rushes of 20 yards or more; all other NFL QBs have four. (ESPN Stats & Info)31) Tom Brady was sacked five times in the first half against Dallas but wasn’t pressured in the second half. (ESPN Stats & Info)32) Peyton Manning threw three interceptions on third down last year. He’s thrown four on third down this year. (ESPN Stats & Info)33) Charles Woodson picked off Peyton Manning for the first time, 17 years after being in the same draft class. (ESPN Stats & Info)34) The 49ers blitzed on only 9% of Eli Manning’s drops. Manning threw for 400 yards against four or less pass rushers and set a Giants record with 41 completions. (ESPN Stats & Info) Derrick Hall satisfied with D-backs’ buying and selling 9) Arizona Cardinals have seven rushing touchdowns. Last year they had six. (Cardinals press release)10) Peyton Manning is averaging 6.5 yards per attempt, the lowest mark of his career. (ESPN Stats & Info)11) Matthew Stafford had only 27 more yards passing than Carson Palmer and it tookStafford 18 more attempts. (My math skills)12) With :54 seconds remaining in the first half in Cincinnati, the vaunted “Legion ofBoom” grabbed their first interception of 2015. (FOX broadcast)13) Bruce Arians is 5-8 versus the NFC West and 19-4 against all other divisions.(Cardinals press release)14) Atlanta RB Devonta Freeman has more rushing TDs in his first three starts than any player in the Super Bowl era. (NFL press release)15) The last time the Cardinals had three games of forty points in the same season, Doug, Spade and the young crunk behind the glass weren’t born yet…and Wolf wasin Kindergarten. (Cardinals press release)16) Four days after turning 39, Oakland DB Charles Woodson became the oldest player in NFL history to pick off two passes in one game. (NFL press release)17) Russell Wilson threw only his third career red-zone interception Sunday. (FOXbroadcast) Did you know Cardinals safety Rashad Johnson has more interceptions this season than the Seattle Seahawks? (AP Photo/Ross D. Franklin)last_img read more