Project Details
Projekt
Analysis of contextual and health service factors in pregnancy and obstetric care for refugees (PROREF)
Subject Area
Empirical Social Research
Public Health, Healthcare Research, Social and Occupational Medicine
Public Health, Healthcare Research, Social and Occupational Medicine
Term
since 2019
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 409654512
Perinatal health of mothers and newborns is an important quality of care indicator. Study results on immigrant’s perinatal health are inconsistent: In industrialised countries they have similar or better obstetric outcomes compared to autochthones despite facing socioeconomic disadvantages. But specific vulnerability has been observed in newly immigrated women and refugees. In Germany little is known about antenatal obstetric care, and outcomes for refugees and how pregnancy and obstetric care services respond to diversity. PROREF will employ a mixed-methods design to understand how and to what extent contextual factors (geographical region, living conditions in shared accommodations) influence, pregnancy and obstetric care and perinatal health outcomes.Qualitative data will be collected in three regions and analysed via framework analysis. In WP1 problem-centered interviews with health care professionals will be conducted, to identify their perception and attitudes of providing pregnancy and maternity care to refugees, to analyse the role of contextual conditions in their care units. Also, case vignettes to be commented by health care professionals, will be developed with OTHER. In WP2 refugee mothers (up to 3 months after childbirth) will be questioned via problem-centered interviews and in focus group discussions (with EMPOW) analysing experiences, pathways, resources and obstacles in pregnancy and maternity care (related to e.g. the region of residence, the accommodation type, private social networks, institutions and other factors contributing to their agency). Quantitative data will be collected over a period of 24 months in two obstetric wards in Berlin. In WP3 the perinatal process and outcome data routinely collected in the framework of quality assurance in obstetric wards will be compared for women with refugee status, immigrants and patients born in Germany. In WP4 standardised interviews with women in the same maternity wards will be conducted regarding sociodemographic aspects and the adequacy of care using an adapted version of the Migrant Friendly Maternity Care Questionnaire. After informed consent of the study participants the perinatal and survey data will be linked and statistically analysed. WP3 and WP4 will cooperate with NEXUS, LARGE and DEPRIV. PROREF will generate knowledge on (a) the impact of migration status, language proficiencies, and other sociodemographic and contextual aspects and how they influence patient satisfaction, perinatal processes and outcomes, (b) the impact of health system and contextual factors on the self-perceived performance of professionals in providing care for refugees, othering practices and (c) on experiences of refugee women who recently gave birth to a child. With the lens-function of PH-LENS the results will define what is needed to increase health system resilience facing diversity in pregnancy and obstetric care in Germany.
DFG Programme
Research Units
