Nigerian mothers’ and midwives' perception of cultural competency
Research type
Research Study
Full title
A qualitative study of migrant Nigerian mothers' and midwives' perceptions of cultural competency in antenatal care
IRAS ID
261070
Contact name
Sarah Esegbona-Adeigbe
Contact email
Sponsor organisation
University of Hertfordshire
Clinicaltrials.gov Identifier
n/a, n/a
Duration of Study in the UK
1 years, 10 months, 2 days
Research summary
Research Summary
Title
A qualitative study of migrant Nigerian mothers' and midwives’ perceptions of cultural competency in antenatal care.Rationale
There has been an increased risk of migrant black African women since 2000, particularly Nigerian women, dying in childbirth compared to other ethnic minority groups. Poor or no antenatal care has been noted as a significant risk factor for Black African maternal deaths in the UK. Cultural factors have factored several times in maternal mortality reports as one of the reasons why Nigerian women do not engage with antenatal care resulting in maternal deaths but there is little evidence to support this. Cultural perceptions of Nigerian women in relation to the antenatal care they access will provide knowledge that can be used to increase their engagement and satisfaction with antenatal care, thus increasing maternal and fetal wellbeing. Midwives’ perceptions of culturally competent antenatal care can be compared to Nigerian mother’s views. Information will be utilised to improve strategies to increase access to antenatal care for these women.Research design/methods
A qualitative descriptive study will be conducted using open ended one to one interviews with Nigerian mothers and interviews/focus groups with midwives. The interviews and focus groups will be face to face or via telephone or online and will be audio taped and transcribed.Participants/setting
This study will be conducted in Newham University Hospital and Croydon University hospital in two London boroughs listed in the top six areas where women born in Africa give birth.Up to fifteen women and fifteen midwives will be recruited for this study. The inclusion criteria will be women aged 18 years or older, primigravida or multigravida who have delivered a live baby in the last year and migrated to the UK from Nigeria ideally within the last five years. Midwives who provide routine antenatal care will be approached to participate in interviews/focus groups.
Summary of Results
Maternal mortality is increased in Black women, particularly migrant African women. Although there are various causes for this disparity, maternal mortality reports have consistently stated that poor utilisation of antenatal care increases a woman’s risk of dying. Cultural factors have been acknowledged as influencing migrant women’s access and engagement with antenatal care. However, there are limited studies that document the cultural factors that are important to migrant Black African women during antenatal care provision. The aim of this study was to explore cultural competency in routine antenatal care and how this meets the needs of migrant Nigerian women. A qualitative descriptive approach was adopted for this study which was conducted in two London NHS Trusts. One-to-one interviews were undertaken with fifteen recently migrated Nigerian women who had delivered a baby in the last year at either Trust. In addition, two focus groups were conducted, each consisting of four midwives who worked at each Trust and had experience of providing routine antenatal care. The cultural competency models of Campinha-Bacote (2002) and Papadopoulos et al. (1998) were used as the conceptual framework. The findings show that midwives are aware of the importance of cultural competency during routine antenatal care provision. Four themes emerged from the focus group’s discussions: (1) antenatal care in the midst of cultural ambiguity, (2) lack of space for cultural understanding, (3) preserving culture and individuality and (4) cultural hesitancy and impediments. The one-to-one interviews with Nigerian mothers revealed a complex picture of their antenatal care experiences consisting of eight themes: (1) overlooking of culture during pregnancy care, (2) sharing but not exposing culture, (3) cultural expectations of antenatal care, (4) navigating pregnancy within two cultures, (5) cultural opinions on information needs, (6) essence of care versus cultural knowing and skill, (7) culturally embraced communication and interactions and (8) respectfulness across cultures. This study shows that women are not asked about their culture during routine antenatal care provision and that women hide or protect their culture. Mothers valued their culture however, traversing pregnancy in a new country was prioritised over their cultural needs. This study also highlights that midwives’ ability to demonstrate cultural competency during antenatal care provision is impacted by societal, personal, professional, and organisational factors. This research confirms the connectedness and gaps between midwives’ practice and migrant Nigerian women’s experiences of cultural competency in antenatal care and provides information that supports the need to strengthen cultural competency in midwifery education and practice.
REC name
London - Harrow Research Ethics Committee
REC reference
21/PR/1597
Date of REC Opinion
26 May 2022
REC opinion
Further Information Favourable Opinion