Provider perspectives on maternal care challenges for Black and Latine Women in Indiana: a qualitative interview study.

IF 3.3 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Sexual and Reproductive Health Matters Pub Date : 2024-10-30 DOI:10.1080/26410397.2024.2423509
Lucia Guerra-Reyes, Rossmary D Márquez-Lameda, Ruhun Wasata, Oakley Byrne
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Abstract

Indiana consistently ranks among the states with the highest maternal and infant mortality in the United States, particularly affecting Black and Latine communities, endangering their right to safe and respectful maternal care. Providers working with these communities are crucial in identifying challenges faced by their clients, and to inform programmes and policies. We interviewed 32 clinical and community-based providers to understand their perspectives on the challenges faced by their Black and Latine clients from February to April 2021. Participants were identified through online sources and referrals. Interviews, conducted over online video, were recorded, transcribed, and analysed following a six-step thematic approach. Six areas of challenges emerged: non-medical infrastructure and policy problems, effects of systemic racism and bias, insecurity of the Latine community, dissatisfaction with maternal care delivery, issues in navigating maternal healthcare, and limitations to holistic models of care. The results demonstrate the interconnected structural, organisational, and interpersonal nature of the challenges. Though challenges were described at structural and organisational levels, the focus of state maternal care programs is largely at personal and interpersonal levels. Obstetric racism, citizenship restrictions, shortage of Black and Latine providers, and transportation issues are complex problems, requiring multilevel interventions and policies to ensure Black and Latine women can exercise their right to safe and respectful maternal care. A rights-based approach centring the needs of Black, Latine and other minoritised communities should be implemented to make effective changes with an equity focus.

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印第安纳州黑人和拉丁裔妇女在孕产妇护理方面面临的挑战:定性访谈研究。
印第安纳州一直是美国孕产妇和婴儿死亡率最高的州之一,尤其影响到黑人和拉丁裔社区,危及他们获得安全和受尊重的孕产妇护理的权利。与这些社区合作的医疗服务提供者在确定其客户所面临的挑战以及为计划和政策提供信息方面至关重要。2021 年 2 月至 4 月,我们采访了 32 位临床和社区医疗服务提供者,以了解他们对黑人和拉丁裔客户所面临挑战的看法。我们通过网络来源和转介找到了参与者。访谈是通过在线视频进行的,我们对访谈进行了记录、转录,并采用六步主题法进行了分析。结果显示了六个方面的挑战:非医疗基础设施和政策问题、系统性种族主义和偏见的影响、拉丁裔社区的不安全感、对孕产妇护理服务的不满、孕产妇医疗保健中的问题以及整体护理模式的局限性。研究结果表明,这些挑战在结构、组织和人际关系方面是相互关联的。尽管在结构和组织层面存在挑战,但国家孕产妇保健计划的重点主要在个人和人际层面。产科种族主义、公民身份限制、黑人和拉丁裔提供者短缺以及交通问题都是复杂的问题,需要多层次的干预措施和政策,以确保黑人和拉丁裔妇女能够行使其获得安全和尊重的孕产妇护理的权利。应以黑人、拉丁裔和其他少数民族社区的需求为中心,实施基于权利的方法,以公平为重点进行有效改革。
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来源期刊
Sexual and Reproductive Health Matters
Sexual and Reproductive Health Matters Medicine-Obstetrics and Gynecology
CiteScore
4.00
自引率
8.30%
发文量
63
审稿时长
16 weeks
期刊介绍: SRHM is a multidisciplinary journal, welcoming submissions from a wide range of disciplines, including the social sciences and humanities, behavioural science, public health, human rights and law. The journal welcomes a range of methodological approaches, including qualitative and quantitative analyses such as policy analysis; mixed methods approaches to public health and health systems research; economic, political and historical analysis; and epidemiological work with a focus on SRHR. Key topics addressed in SRHM include (but are not limited to) abortion, family planning, contraception, female genital mutilation, HIV and other STIs, human papillomavirus (HPV), maternal health, SRHR in humanitarian settings, gender-based and other forms of interpersonal violence, young people, gender, sexuality, sexual rights and sexual pleasure.
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