Universal or Targeted Antenatal Care for Immigrant Women? Mapping and Qualitative Analysis of Practices in Denmark

Sarah Fredsted Villadsen, Hodan Jama Ims and Anne-Marie Nybo Andersen
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Sarah Fredsted Villadsen: Section of Social Medicine, Department of Public Health, University of Copenhagen, 1165 Copenhagen, Denmark
Hodan Jama Ims: Section of Social Medicine, Department of Public Health, University of Copenhagen, 1165 Copenhagen, Denmark
Anne-Marie Nybo Andersen: Section of Epidemiology, Department of Public Health, University of Copenhagen, 1165 Copenhagen, Denmark

IJERPH, 2019, vol. 16, issue 18, 1-11

Abstract: Inequity in immigrants’ health during pregnancy and childbirth has been shown. We studied the Danish regional organization of public midwifery-based antenatal care (ANC) for immigrant women to assess the strengths and weaknesses of organizing ANC as either universal or immigrant-targeted. A telephone survey in 2012 to all the Danish maternity wards ( n = 20) was conducted. Semi-structured interviews with midwives providing targeted care ( n = 6) were undertaken and characteristics of care were qualitatively analyzed, having the immigrant density of the facilities, the Danish ANC policy, and theories of cultural competence as the frame of reference. Six maternity wards were providing immigrant-targeted ANC. Targeted care implied longer consultations and increased attention to the individual needs of immigrant women. At these facilities, navigation in the health care system, body awareness, and use of interpreter services were key topics. The selection of women for targeted care was based on criteria (including names) that risk stigmatizing immigrant women. The arguments for not providing targeted care included that immigrant-targeted care was considered stigmatizing. Current universal care may overlook the needs of immigrant women and contribute to inequities. A strategy could be to improve dynamic cultural competencies of midwives, interpreter services, and flexibility of the care provision of the universal ANC system.

Keywords: health policy; antenatal care; maternal and child health; quality of care; migration; institutional practice (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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