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Group antenatal care (gANC) for Somali-speaking women in Sweden - a process evaluation
Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden..
Dalarna Univ, Sch Hlth & Welf, Falun, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Reproductive Health and Migration.ORCID iD: 0000-0002-2900-2849
Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden..
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2022 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 22, no 1, article id 721Article in journal (Refereed) Published
Abstract [en]

Background Language supported group antenatal care (gANC) for Somali-born women was implemented in a Swedish public ANC clinic. The women were offered seven 60-min sessions, facilitated by midwives and starting with a presentation of a selected topic, with an additional 15-min individual appointment before or after. The aim of this study was to assess the feasibility for participants and midwives of implementing The Hooyo ("mother" in Somali) gANC intervention, including implementation, mechanisms of impact and contextual factors. Methods A process evaluation was performed, using The Medical Research Council (MRC) guidelines for evaluating complex interventions as a framework. A range of qualitative and quantitative data sources were used including observations (n = 9), complementary, in-depth and key-informant interviews (women n = 6, midwives n = 4, interpreters and research assistants n = 3) and questionnaire data (women n = 44; midwives n = 8). Results Language-supported gANC offered more comprehensive ANC that seemed to correspond to existing needs of the participants and could address knowledge gaps related to pregnancy, birth and the Swedish health care system. The majority of women thought listening to other pregnant women was valuable (91%), felt comfortable in the group (98%) and supported by the other women (79%), and they said that gANC suited them (79%). The intervention seemed to enhance knowledge and cultural understanding among midwives, thus contributing to more women-centred care. The intervention was not successful at involving partners in ANC. Conclusions The Hooyo gANC intervention was acceptable to the Somali women and to midwives, but did not lead to greater participation by fathers-to-be. The main mechanisms of impact were more comprehensive ANC and enhanced mutual cultural understanding. The position of women was strengthened in the groups, and the way in which the midwives expanded their understanding of the participants and their narratives was promising. To be feasible at a large scale, gANC might require further adaptations and the "othering" of women in risk groups should be avoided.

Place, publisher, year, edition, pages
Springer Nature, 2022. Vol. 22, no 1, article id 721
Keywords [en]
Group antenatal care, Maternal and child health, Antenatal care, Pregnancy, Migration, Somali-born women, Complex interventions, Process evaluation, Inequity
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-486351DOI: 10.1186/s12884-022-05044-9ISI: 000857982300001PubMedID: 36131237OAI: oai:DiVA.org:uu-486351DiVA, id: diva2:1702333
Funder
Swedish Research Council, 2015-02,470Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-00,957Available from: 2022-10-10 Created: 2022-10-10 Last updated: 2022-10-10Bibliographically approved

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Essén, BirgittaSchytt, Erica

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