The perceptions and practices of Thai health professionals providing maternity care for migrant Burmese women: An ethnographic study |
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| Institution: | 1. School of Nursing and Midwifery, Faculty of Nursing, Suratthani Rajabhat University, 272 Moo 9 Surat-Nasan Road, Muang, Surat Thani 84100, Thailand;2. School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751, NSW, Australia;3. College of Health Sciences, VinUniversity, Hanoi, Vietnam;1. School of Nursing and Midwifery, Parramatta South Campus, Western Sydney University, NSW, Australia;2. Graduate Research School and the Centre for Research in Mathematics and Data Science, Western Sydney University, NSW, Australia;1. School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia;2. Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;3. Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institute, Sweden;4. Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia;5. Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia;1. Centre for Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Australia;2. Institute for Sustainable Futures, University of Technology Sydney, Australia;3. School of Public Health, Faculty of Health, University of Technology Sydney, Australia;1. NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia;2. School of Medicine, The University of Notre Dame Australia, Broadway, NSW, Australia;3. School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia;4. Obstetrics and Gynaecology Department, Canberra Hospital, Canberra, ACT, Australia;5. Royal Australian and New Zealand College of Obstetricians and Gynaecologists, East Melbourne, VIC, Australia;6. Next Practice Health, Erina, Sydney, NSW, Australia;7. Maternity Service, Wollongong Hospital, Wollongong, NSW, Australia;1. Auckland University of Technology, AUT Department of Management, Private Bag 92006, Victoria Street West, Auckland 1142, New Zealand;2. Ludwig-Maximilians-Universität München, Faculty of Psychology, Raum 3432, Leopoldstr. 13, 80802 München, Germany;3. Auckland University of Technology, AUT Midwifery Department, Private Bag 92006, 640 Great South Road, Manukau, Auckland 2104, New Zealand;4. New Zealand College of Midwives, PO Box 21-106, Edgeware, Christchurch 8143, New Zealand |
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| Abstract: | BackgroundAcross the globe, many women including economic and humanitarian migrants receive inadequate antenatal care. Understanding the difficulties that migrant women encounter when accessing maternity care, including the approach of health professionals, is necessary because inadequate care is associated with increasing rates of morbidity and mortality. There are very few studies of migrant women’s access to and experience of maternity services when they have migrated from a low- to a middle-income country.AimTo examine the perceptions and practices of Thai health professionals providing maternity care for migrant Burmese women, and to describe women’s experiences of their encounters with health professionals providing maternity care in Ranong Province in southern Thailand.MethodsEthnography informed the study design. Individual interviews were conducted with 13 healthcare professionals and 10 Burmese women before and after birth. Observations of interactions (130 h) between health care providers and Burmese women were also conducted. Data were analysed using thematic analysis.FindingsThe healthcare professionals’ practices differed between the antenatal clinics and the postnatal ward. Numerous barriers to accessing culturally appropriate antenatal care were evident. In contrast, the care provided in the postnatal ward was woman and family centered and culturally sensitive. One overarching theme, “The system is in control’ was identified, and comprised three sub-themes (1) ‘Being processed’ (2) ‘Insensitivity to cultural practices’ and, (3) ‘The space to care’.Discussion and conclusionsThe health system and healthcare professionals controlled the way antenatal care was provided to Burmese migrant women. This bureaucratic and culturally insensitive approach to antenatal care impacted on some women’s decision to engage in antenatal care. Conversely, the more positive examples of woman-centered care evident after birth in the postnatal ward, can inform service delivery. |
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| Keywords: | Burma Migrant women Maternity services Antenatal care Midwifery Ethnography |
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