What can we learn from the national implementation of The MAMAACT intervention?

Abstract

Abstract Initiatives to improve maternal and child health among non-Western immigrant populations in Western countries are still sparse. So far, interventions within antenatal care have primarily focused on doula support and group-based antenatal care. A qualitative evaluation of the implementation of the intervention was undertaken to explore midwives and non-Western immigrant women’s attitudes towards and experiences of using the MAMAACT intervention. The evaluation also investigated key contextual factors impacting the interventions utilization. Data consisted of focus group interviews with midwives (n = 9) and in-depth interviews with non-Western immigrant women (n = 15), as well as observations of midwifery visits (n = 42). Data were collected at five intervention sites across Denmark and it was analyzed using systematic text condensation. Findings show that midwives found the MAMAACT intervention to be a relevant tool, which was easy to implement in antenatal care. Several organizational factors such as task load, interpreter services and lack of cooperation with general practitioners impacted the implementation of the intervention. Non-Western immigrant women found the leaflet and app to be useful tools in distinguishing between normal and abnormal pregnancy symptoms. The degree to which the intervention was used by the women varied between the participants, and women also used other sources of information during their pregnancy. Contextual factors such as lack of social network and material resources as well as language proficiency impacted how women responded to their pregnancy symptoms. Findings show that in addition to targeting the intervention to midwives and non-Western immigrant women’s informational needs, structural factors such as the organization of antenatal care and women’s socioeconomic conditions need to be addressed in order to reduce ethnic disparity in reproductive health.