Group antenatal care (gANC) for Somali-speaking women in Sweden – a process evaluation

Ahrne, M; Byrskog, U; Essén, B; Andersson, E; Small, Rhonda; Schytt, E

doi:10.26181/23657448.v1

Group antenatal care (gANC) for Somali-speaking women in Sweden – a process evaluation

journal contribution

posted on 2023-07-11, 00:07 authored by M Ahrne, U Byrskog, B Essén, E Andersson, Rhonda SmallRhonda Small, E Schytt

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.

Funding

This work was supported by the Swedish Research Council (grant number 2015-02,470), Forte (grant number 2016-00,957) and the Doctoral School in Health Care Sciences, Karolinska Institutet.

History

Publication Date

2022-09-21

Journal

BMC Pregnancy and Childbirth

Volume

22

Article Number

721

Pagination

14p.

Publisher

Springer Nature

ISSN

1471-2393

Rights Statement

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