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Hindrances and facilitators in humanitarian migrants' maternity care in Finland: qualitative study applying the three
Satu Leppälä1, Reeta Lamminpää1, Mika Gissler2,3
1Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
Rationale:
Humanitarian migration to Finland nearly ten-folded in 2015-2016 from 3 326 asylum seekers' yearly average to 32 476. Earlier research shows that humanitarian migrants sustain suboptimal maternal health in high-income countries, even though care facilities are available.
Aim And Objective:
This study aimed to investigate what factors do maternity care professionals identify as hindrances and facilitators in humanitarian migrants' maternity care process in Finland.
Methodological Design:
Study employed qualitative design. Eighteen midwives and maternity care public health nurses participated in semi-structured qualitative interviews that were audio-recorded and transcribed verbatim. Qualitative content analysis of the interview data produced meaning units, codes and categories.
Ethical Issues:
Research plan was reviewed and approved by the ethics committee of the local hospital district. Participants signed an informed consent prior the interviews.
Findings:
Hindrances and facilitators for care were organised in theoretical framework of Three Delays Model. Participants described multiple hindrances for caring process, of which language barrier constantly raised as a significant obstacle for seeking and receiving care, and for perceived quality of care. Correspondingly, interpreters facilitated the caring process at all of its phases. Rural location of asylum centres, long distances and lacking transportation to care hindered reaching the health facility. Complicated bureaucracy was described to affect negatively in receiving adequate care. Refugee and asylum centre workers facilitated decision to seek care, and reaching of health facilities.
Conclusion:
Interpreters can influence in the caring process in more versatile ways than we might have acknowledged this far. We recommend further research on interpreters' role in the caring process of pregnant humanitarian migrants.
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