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Midwives’ experiences of cultural competency training and providing perinatal care for migrant women a mixed methods study: Operational Refugee and Migrant Maternal Approach (ORAMMA) project

  • Fair, Frankie1
  • Soltani, Hora1
  • Raben, Liselotte2
  • van Streun, Yvonne2
  • Sioti, Eirini3
  • Papadakaki, Maria4
  • Burke, Catherine1
  • Watson, Helen1
  • Jokinen, Mervi5, 6, 7
  • Shaw, Eleanor8
  • Triantafyllou, Elena3
  • van den Muijsenbergh, Maria2, 9
  • Vivilaki, Victoria3
  • 1 Sheffield Hallam University, 34 Collegiate Cres, Sheffield, S10 2BP, UK , Sheffield (United Kingdom)
  • 2 Radboud University Medical Centre, Nijmegen, Netherlands , Nijmegen (Netherlands)
  • 3 University of West Attica, Athens, Greece , Athens (Greece)
  • 4 Hellenic Mediterranean University, Heraklion, Greece , Heraklion (Greece)
  • 5 The Royal College of Midwives, London, UK , London (United Kingdom)
  • 6 President of European Midwives Association (EMA), Antwerpen, Belgium , Antwerpen (Belgium)
  • 7 Vice Chair European Forum for National Nurses and Midwives Associations (EFNNMA), Lisbon, Portugal , Lisbon (Portugal)
  • 8 Technology and Medicine at the University of Manchester, Manchester, UK , Manchester (United Kingdom)
  • 9 Pharos, Centre of Expertise on Health Disparities, Utrecht, Netherlands , Utrecht (Netherlands)
Published Article
BMC Pregnancy and Childbirth
Springer (Biomed Central Ltd.)
Publication Date
Apr 29, 2021
DOI: 10.1186/s12884-021-03799-1
Springer Nature


BackgroundThe number of international migrants continues to increase worldwide. Depending on their country of origin and migration experience, migrants may be at greater risk of maternal and neonatal morbidity and mortality. Having compassionate and culturally competent healthcare providers is essential to optimise perinatal care. The “Operational Refugee and Migrant Maternal Approach” (ORAMMA) project developed cultural competence training for health professionals to aid with providing perinatal care for migrant women. This presents an evaluation of ORAMMA training and explores midwives’ experiences of the training and providing care within the ORAMMA project.MethodsCultural competence was assessed before and after midwives (n = 35) received ORAMMA compassionate and culturally sensitive maternity care training in three different European countries. Semi-structured interviews (n = 12) explored midwives’ experiences of the training and of caring for migrant women within the ORAMMA project.ResultsA significant improvement of the median score pre to post-test was observed for midwives’ knowledge (17 to 20, p < 0.001), skills (5 to 6, p = 0.002) and self-perceived cultural competence (27 to 29, p = 0.010).Exploration of midwives’ experiences of the training revealed themes of “appropriate and applicable”, “made a difference” and “training gaps” and data from ORAMMA project experiences identified three further themes; “supportive care”, “working alongside peer supporters” and “challenges faced”.ConclusionsThe training improved midwives’ knowledge and self-perceived cultural competence in three European countries with differing contexts and workforce provision. A positive experience of ORAMMA care model was expressed by midwives, however clearer expectations of peer supporters’ roles and more time within appointments to assess the psychosocial needs of migrant women were desired. Future large-scale research is required to assess the long-term impact of the ORAMMA model and training on practice and clinical perinatal outcomes.

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