Immigrant women’s experiences of maternity services in Canada: a meta-ethnography

Objective: to synthesise data on immigrant women's experiences of maternity services in Canada. Design: a qualitative systematic literature review using a meta-ethnographic approach. Methods: a comprehensive search strategy of multiple databases was employed in consultation with an information librarian, to identify qualitative research studies published in English or French between 1990 and December 2011 on maternity care experiences of immigrant women in Canada. A modified version of Noblit and Hare's meta-ethnographic theoretical approach was undertaken to develop an inductive and interpretive form of knowledge synthesis. The seven-phase process involved comparative textual analysis of published qualitative studies, including the translation of key concepts and meanings from one study to another to derive second and third-order concepts encompassing more than that offered by any individual study. ATLAS.ti qualitative data analysis software was used to store and manage the studies and synthesise their findings. Findings: the literature search identified 393 papers, of which 22 met the inclusion criteria and were synthesised. The literature contained seven key concepts related to maternity service experiences including social (professional and informal) support, communication, socio-economic barriers, organisational environment, knowledge about maternity services and health care, cultural beliefs and practices, and different expectations between health care staff and immigrant women. Three second-order interpretations served as the foundation for two third-order interpretations. Societal positioning of immigrant women resulted in difficulties receiving high quality maternity health care. Maternity services were an experience in which cultural knowledge and beliefs, and religious and traditional preferences were highly relevant as well but often overlooked in Canadian maternity settings. Key conclusions and implications for practice: in order to implement woman-centred care, to enhance access to maternity services, and to promote immigrant women's health, it is important to consider these women's social position, cultural knowledge and beliefs, and traditional customs in the health care

Sequential simulation model development

Sequential simulation (SqS) is a physical form of simulation that recreates care pathway trajectories rather than single episodes of care. Current physical simulation in health care focuses on specific tasks or particular teams and settings. However, the patient perspective is a journey through the care system and not an isolated component. To date, SqS has been used for a range of applications, including training multidisciplinary teams on end-of-life care, developing integrated care approaches, quality improvement projects, designing new models of care, evaluating new interventions, and improving care of the deteriorating patient in an acute setting, to name but a few. Many applications are possible, and therefore the design process can be lengthy and complex. This article outlines an approach the author took over a 3-year period to generate a usable SqS model through empirical and theoretical data. The model draws on process, observational, survey, and evaluative data to generate an understanding of the key components that constitute the design process of an SqS. This approach resulted in an empirically and theoretically driven model that can be used and refined by others in the field of health-care simulation

Sex trafficking in Nepal: A qualitative study of process and context. Abstract.

Thousands of Nepalese girls are trafficked to India and other neighbouring countries every year, primarily for sex work and the majority return to Nepal after spending a years in sex trade. The sub‐group of Nepalese girls who become involved in sex work via trafficking are the focus of this paper. The aim of this study was to increase understanding regarding the context of sex trafficking, the methods and means of trafficking, living conditions in brothels and survival strategies among trafficked girls. We conducted 33 in‐depth interviews in early 2013 with returned trafficking survivors (n=14) and policy‐makers, people working in trafficking related NGOs/INGOs (n=19) in Nepal. All 14 trafficking survivors were recruited in Nepal through the NGO working on trafficking field. The young girls trafficked from Nepal to India in this study were typically unmarried, illiterate and very young (8 to 14 years at the time of trafficking). The key methods of trafficking were false marriage, fake job offer, and abduction. Among the 14 respondents, some had spent one month and others nearly 5 years in Indian brothels. Respondents were either rescued, escaped or released by brothel owners. Four out of 14 were HIV positive. Most policy makers mentioned that poverty, unemployment and illiteracy are the causes behind the trafficking of young girls. The anti‐trafficking interventions need to be considered at a) community level before movement has begun; b) urban centres which are both source and transitory centres for trafficking; c) trafficking level when girls are highly mobile and when they are in brothels; and d) return from trafficking as girls to m ove back into the community

Policies and Strategies in Sexual and Reproductive Health

The topics covered in the book cover different aspects of sexual and reproductive health. This book provides novel research results that may be essential as a basis for the development of health policies and strategies in sexual and reproductive health. These policies are necessary to achieve greater health protection. Among others, issues as important as the increase in STIs, their risk factors, vulnerable situations and populations, as well as the issue of priority in reproductive health, such as the care that must be provided during pregnancy and childbirth in order to guarantee healthy women and children, are developed in the book. There is no doubt that women should be the preferential recipients of these health policies and strategies and, therefore, pathologies that have an impact on their quality of life as well as the situations of gender violence that these women experience also occupy a place within the content of this book. In this book, you can find interesting results allowing researchers to take into account in proposing new lines of research, students and academics to receive and transmit the most current and relevant knowledge, political leaders to develop adequate and efficient health policies and strategies, and clinical health professionals to work in clinical practice with the best available scientific evidence

Advancing Equality

In a world where basic human rights are under attack and discrimination widespread, Advancing Equality reminds us of the critical role of constitutions in creating and protecting equal rights. Combining a comparative analysis of equal rights in the constitutions of all 193 countries with inspiring stories of activism and powerful court cases from around the globe, the book traces the trends in constitution drafting over the past half century, and examines how stronger protections against discrimination have transformed lives. Looking at equal rights across gender, race and ethnicity, religion, sexual orientation and gender identity, disability, social class, and migration status, the authors uncover which groups are increasingly guaranteed equal rights in constitutions, whether these rights on paper have been translated into practice, and which nations and protections from discrimination lag behind. As the book reveals, beyond countering discrimination, advancing equality requires fulfilling everyone’s fundamental rights to health and education, essential social and economic rights. Serving as a comprehensive call to action for anyone who cares about their country’s future, Advancing Equality challenges us to remember how far we all still must go for equal rights for all

Advancing Equality

In a world where basic human rights are under attack and discrimination is widespread, Advancing Equality reminds us of the critical role of constitutions in creating and protecting equal rights. Combining a comparative analysis of equal rights in the constitutions of all 193 United Nations member countries with inspiring stories of activism and powerful court cases from around the globe, the book traces the trends in constitution drafting over the past half century and examines how stronger protections against discrimination have transformed lives. Looking at equal rights across gender, race and ethnicity, religion, sexual orientation and gender identity, disability, social class, and migration status, the authors uncover which groups are increasingly guaranteed equal rights in constitutions, whether or not these rights on paper have been translated into practice, and which nations lag behind. Serving as a comprehensive call to action for anyone who cares about their country’s future, Advancing Equality challenges us to remember how far we all still must go for equal rights for all

Continuity of Care and Shared Decision-Making in Interprofessional Collaborative Maternity Practices in Canada

Problem: The number of maternity care providers varies across Canada. Women from rural communities or those marginalized due to physical, psychological or social issues including newcomers, often experience challenges accessing health care (Fraser Health, 2014; Rogers, 2003). Interprofessional collaborative maternity care [IPCMC] has been credited as a means of increasing access and promoting sustainability of services (Miller et al., 2012; Society of Obstetricians and Gynecologists of Canada, 2008). Midwifery could play a greater role in delivery of services through IPCMC. However, little is known about collaboration in these practices. The purposes of this study are to explore factors influencing enactment of IPCMC and understand whether and how midwives can provide relational care in these practices in ways that are positively evaluated by women and staff. Method: A qualitative multiple case study design was used to explore variations in 4 IPCMC practices in British Columbia, Canada. Sources of data included: observation and semi-structured interviews with staff (n=40) and women receiving care (n=33). Thematic analysis was applied to interview transcripts, observational field notes and analytic notes. Findings and Conclusions: Collaborative care was well received by patients when expectations were clear and continuity of information and philosophy were exercised. Contextual factors influenced development and implementation requiring adaptation over time. Communication, organization, mutual respect and commitment enabled collaboration and relational care. Policy changes to promote and sustain IPCMC include broader definitions of continuity of care; increased support and adoption of integrated funding models. Interprofessional education is needed to develop skills for effective collaboration

International Profiles of Health Care Systems, 2011

This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views

Accessing cervical cancer screening in Nigeria: exploring the experiences of Nigerian-born immigrant women in Canada

This research study explored the experiences of women eligible for cervical cancer screening (CCS) in accessing CCS services in Nigeria. The goal was to develop an in-depth understanding of these experiences in order to provide facts that could inform policies and interventions that will improve the utilization of CCS services among Nigerian women. This descriptive study utilized naturalistic inquiry and an intersectionality theoretical lens for understanding women’s access to CCS and its possible intersection with socially constructed categories, which could have influenced these women’s experiences. Ten (10) Nigerian-Immigrant women who met the set eligibility criteria were recruited for interviews using purposive sampling and snowballing. Data was analyzed using an inductive thematic analysis approach. The study’s findings detail overarching themes that best capture the experiences of participants with accessing CCS programs in Nigeria. Future research is needed to engender best practices for the planning of CCS programs

Advancing Equality

In a world where basic human rights are under attack and discrimination is widespread, Advancing Equality reminds us of the critical role of constitutions in creating and protecting equal rights. Combining a comparative analysis of equal rights in the constitutions of all 193 United Nations member countries with inspiring stories of activism and powerful court cases from around the globe, the book traces the trends in constitution drafting over the past half century and examines how stronger protections against discrimination have transformed lives. Looking at equal rights across gender, race and ethnicity, religion, sexual orientation and gender identity, disability, social class, and migration status, the authors uncover which groups are increasingly guaranteed equal rights in constitutions, whether or not these rights on paper have been translated into practice, and which nations lag behind. Serving as a comprehensive call to action for anyone who cares about their country’s future, Advancing Equality challenges us to remember how far we all still must go for equal rights for all